Changing contact tracing policies indicate a new phase of New Hampshire’s virus plan

  • Jamie Bourgeois, a contact tracer with the City of Nashua, working from her home office in Nashua on Friday. ALLIE ST PETER—Monitor Staff

  • Jamie Bourgeois, a contact tracer with the City of Nashua, works from her home office in Nashua on Friday. ALLIE ST PETER / Monitor staff

Monitor staff
Published: 11/14/2020 5:22:14 PM

The number of new COVID-19 cases has swamped the state’s ability to trace people who may have come in contact with those who are ill, state officials announced last week.

Instead of launching investigations into every Granite Stater who tests positive for COVID-19, the state’s contact tracers will now prioritize calling those who are especially vulnerable to the virus, including children, older adults, racial minorities, and healthcare workers.

This shift marks a new phase of New Hampshire’s response to the virus – from containing the spread of COVID-19 to lessening the impact of the virus on the community. Transmission within the community is so high, it’s no longer effective to track every single positive case, said Beth Daly, chief of the N.H Bureau of Infectious Disease Control. The state will instead shift its efforts towards encouraging the public to social distance, wear masks, and avoid gatherings.

Every day, the state’s coronavirus statistics seem to set new, disturbing records. As of Thursday, the state’s 14-day average of new cases was 197 – to put that in perspective, the 14-day average during the state’s peak last spring never surpassed 100.

Daly said if cases continue to increase at this rate, there could be further prioritization within the at-risk groups, though they haven’t planned exactly what that prioritization might look like.

“Contact tracing is part of the containment strategy to stop the spread of COVID-19, but it is one and only one layer or intervention for helping to prevent the spread,” Ben Chan, the state epidemiologist, said at a press conference Thursday. “As community transmission increases, it becomes a less effective strategy.”

Lori Shibinette, the Commissioner of the Department of Health, said they have asked healthcare providers to inform COVID-positive patients of the proper isolation and quarantine procedures.

James Potter, executive vice president of the New Hampshire Medical Society, said it will be challenging for physicians to add an additional responsibility onto their heavy workload.

“The absence of that is not doing the contact tracing at all,” he said. “I think every hospital and physician office will look at the new guidance and the protocols and try to figure out how they can make that work. In a crisis situation, you have to act as a team.”

The state will largely rely on individuals who tested positive for the virus to make their own calls to people they have recently come in contact with.

Jamie Bourgeois, a contact tracer with the City of Nashua, said she doesn’t anticipate this will work nearly as well as professional contact tracing. Bourgeois spends more than 40 hours a week taking detailed histories of COVID patients in the city, writing down names of people they could have come in contact with, contacting each high-risk contact on that list, and answering questions about safety protocols.

“It’s going to have an impact because there are going to be people who get missed,” she said. “Instead of being able to appropriately quarantine, they’re not going to know or maybe they misunderstand what that means and they’re going to get ill and spread it. If there aren’t the resources to do this work to full capacity, that’s the downfall.”

There is also a level of anonymity that will disappear without designated contact tracers. Typically, contact tracers call people who may have been infected with COVID-19 and, without disclosing any names, inform them that someone they have come in contact with tested positive. Bourgeois worries without the anonymity of contact tracing, some may be pressured to stay quiet about their diagnosis.

“Let’s say their contacts were work contacts and they work at a facility that just isn’t understanding,” she said. “There are all these reasons why they might just stay quiet.”

Despite her concerns, she understands why the state is making its decision. Employing enough staff to keep up with the growing caseloads is expensive. Nashua, which operates its own contact tracing program, announced Thursday they hired four new contact tracers to keep up with the rapidly increasing number of new cases using funding from the New Hampshire Charitable Foundation.

Bourgeois’ own position was funded from a donation from TikTok, a popular social media platform, to the CDC Foundation.

“We just don’t have enough people,” she said. “Where is the money to do the work, you know? I wouldn’t have this job if it wasn’t for TikTok – that kind of blows my mind.”

Daly said those who are concerned about not getting notified about exposure to COVID-19 should reassess their social distancing practices.

“If they’re worried about COVID, they shouldn’t be putting themselves in positions where they’re in close contact with people,” she said.

Teddy Rosenbluth bio photo

Teddy Rosenbluth is a Report for America corps member covering health care issues for the Concord Monitor since spring 2020. She has covered science and health care for Los Angeles Magazine, the Santa Monica Daily Press and UCLA's Daily Bruin, where she was a health editor and later magazine director. Her investigative reporting has brought her everywhere from the streets of Los Angeles to the hospitals of New Delhi. Her work garnered first place for Best Enterprise News Story from the California Journalism Awards, and she was a national finalist for the Society of Professional Journalists Best Magazine Article. She graduated from UCLA with a bachelor’s degree in psychobiology.

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