Disease experts fearful rise in cases making contact tracing more difficult
A nurse administers a COVID-19 swab test to a patient in the parking lot of the Brentwood Recreation Center on Nov. 18. Contact tracing consists of locating people in close contact with someone who has tested positive for the coronavirus. Credit: Newsday/John Paraskevas
Long Island infectious disease experts fear that the continued rise in COVID-19 cases, long lines for testing and holiday gatherings over the next few weeks will combine to make tracing the source of coronavirus infections more difficult — and expand the virus’ spread even further.
"I’m worried that with the increasing rates we’re seeing right now — and the way it’s going to accelerate as we get to that three-week mark after Thanksgiving — we’re going to exceed the capacity to use contact tracing in any meaningful way," said Dr. Bruce Hirsch, an infectious diseases expert at New Hyde Park-based Northwell Health.
Experts expect an increase in COVID-19 cases in the next few weeks because of family gatherings over Thanksgiving weekend.
Contact tracing is when public health agencies attempt to locate anyone who was in close contact with someone who tests positive for the coronavirus. They are then told to quarantine.
As the number of COVID-19 cases increases, and with some people who have the virus attending family gatherings and parties with multiple other guests, health agencies will have ever-longer lists of people to try to locate, Hirsch said.
"That could quickly overwhelm the ability to do contact tracing," he said.
From Nov. 13 to Nov. 26, 7,300 coronavirus tests of Suffolk County residents came back positive, said Derek Poppe, a spokesman for Suffolk Executive Steve Bellone. The county sought contacts from each of these people, he said. If a person said they had no contacts to give, the county took them at their word, he said.
Medical experts, including Dr. Bruce Hirsch, an infectious diseases expert at Northwell Health, expect an increase in COVID-19 cases in the next few weeks because of holiday family gatherings. Credit: Northwell Health
Of the 7,300 who tested positive, only 144 refused to isolate, provide contacts or otherwise cooperate with the contact tracer, Poppe said.
Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Medicine, said that, even if there is adequate contact tracing, determining the root of infections becomes more difficult as people socialize more often with people outside their households during the holidays.
"What we’re seeing with the holiday season is that people are going to multiple events, and it’s going to be hard to tease out at which event the transmission occurred, and who also was at that event," she said.
In addition, unlike, for example, family gatherings, people often don’t know the names of most others at parties, so there may be no way to find them, she said.
And even when close contacts are located, they may not always abide by quarantine directives, Hirsch said.
"It’s a big ask of people right now," he said. "The kind of person who socialized with their family may not be the kind of person who will put up with a prolonged quarantine period and go out and get tested. It’s a complicated package of things we’re asking people to do."
With the number of COVID-19 cases in New York rising quickly, the chance of contracting the virus at a gathering is significantly higher than over the summer, when fewer people were infected, he said.
The state Wednesday reported 1,792 new infections on Long Island — similar to the number of new confirmed cases reported on some days during the peak of the pandemic in New York in mid-April, although testing was less widespread then.
"We’re starting out at such a high level that getting together right now is particularly dangerous," Hirsch said. "I’m very worried about the coming Christmas and winter holidays."
Nachman said the long lines for coronavirus testing are deterring some people from finding out if they carry the virus.
"They’re looking at these long lines that we’ve all seen and they’re saying, ‘I’m not waiting in line for two hours. I’m just going to go home. I’m fine. It’s only a cold,’ " she said.
People who get tested and find out they have the virus may self-isolate, helping limit COVID-19’s spread, Nachman said. But if people don’t get tested and don’t find out they have COVID-19, they may unknowingly infect others, she said. That includes those who do not have symptoms but are still contagious, she said.
Hirsch said the severity of COVID-19’s spread in the coming weeks depends on keeping anyone with the virus away from others.
"If a person who is infected gives it to more than one other person, this virus thrives," he said. "If this person gets the virus and passes it on to nobody, the virus is slowed down. And what we need to do is anything we can to slow this virus down."
With Matthew Chayes
David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.
