As states move through phases of reopening, “contact tracing” has remained a topic of national interest. For months now, talking heads in the government and media have hailed the strategy as the country’s saving grace. One NBC headline read, “Coronavirus contact tracing could stop COVID-19 and reopen America,” and a CNN article declared, “the US — or really any country — can’t safely reopen without significant amounts of contact tracing and testing.” With this starry-eyed perception, dozens of states have rushed to train and hire tens of thousands of contact tracers—what former CDC director Tom Frieden gleefully described as an “army” of tracers.
It’s true that contact tracing has been an indispensable asset many times in the past, helping to snuff out viruses by diligently tracking their spread. So it’s no mystery why some health experts are flocking to it in the current crisis.
In short, this is how it works: contact tracers conduct short, over-the-phone interviews of newly diagnosed patients about who they have recently been in close physical contact with. The fear is that these recent contacts may have contracted the virus from the patient before he was diagnosed. These contacts are then phoned by tracers, informing them of this risk and encouraging them to seek testing and self-quarantine immediately. Tracers continue this process on down the line with the aim of reducing the instances in which the virus is transmitted
A few states have also begun developing smartphone apps to conduct a digital form of contact tracing. Phones running the app exchange unique encrypted numbers via Bluetooth, which are then stored on the devices. If an app user is diagnosed with COVID, he’s supposed to notify the app, which then publishes the log of numbers his phone received in the last fourteen days. If one of these numbers matches one stored on another user’s device, the app will send that user an alert that he’s been in recent contact with a newly diagnosed COVID patient.
So far, the adoption of these apps has been left completely voluntary in the US, unlike in other countries like China and South Korea. Overall, though, most of the states have yet to show much excitement toward digital tracing. The main focus remains on building an “army” to track the virus’ spread, no matter what it might cost the country.
Contact tracing jobs are temporary, lasting for months or up to a year, with annual salaries ranging from $40,000 to $70,000. Those numbers are about on par with the entry-level salaries of registered nurses for a job that anyone completing a free six-hour course can be hired to do. Few, however, have questioned whether such pay is excessive or this use of taxpayer money prudent. It’s all been blindly okayed under the hallowed pretense of “public health.”
With experts recommending that the country hire a total of 150,000 contact tracers, these programs may end up costing the states somewhere between $1 billion and $10.5 billion altogether. On top of that sum lie whatever additional costs the handful of states developing digital tracing apps incur. Worse, bills currently floating around the House and Senate would, if made law, establish a federally led contact tracing program with a price tag as high as $100 billion. To government budget breakers, that may just look like zeros and decimal places, but there’s a serious economic toll to be reckoned with.
Increased government spending is often accompanied by a rise in taxes, and almost always by an expansion of the money supply. In either case, people’s wealth is subsequently decreased. Individuals and their families must, accordingly, cut back on how much they save, which in turn decreases the stock of loanable funds from the amount that would have otherwise been available. As a result, the amount of investment in the economy falls, dulling the momentum of economic growth. That could severely dampen the economy’s postrecession recovery.
In our present crisis—unlike any before—many businesses were shut down for months not by economic circumstance, but by state decree. That has contributed to the sharpest ever employment crisis in the US, with more than 20 million workers cut from payrolls in April alone. Some of these cuts were temporary furloughs, but a part of that number reflects permanent job loss—either from companies being forced to slash operating costs or going bankrupt outright.
Some of the proponents of the state’s contact tracing programs see themselves as killing two birds with one stone—helping to eliminate COVID while also putting people back to work. Senator Kamala Harris (D-CA) made this clear when stumping for the federal contact tracing bill she cosponsored: “Our policies must meet the needs of the current moment, and that means getting creative about how we get people back to work.”
But government jobs programs don’t actually create employment in any way besides superficially. The reality is that they siphon labor away from potentially productive ventures at wages propped up at artificially high rates. This too will defer the economy’s recovery and must—for the good of private enterprise—be halted immediately. But by the looks of it, the program will continue forward uninterrupted, as it plays perfectly into the narrative that the state can solve all of society’s ills—no matter what the economics and epidemiology really say about it.
Public Health Doublethink
Much of how the public should respond to the virus hinges on the question of how common asymptomatic transmission of it is. Unfortunately, the research available on this is limited and contradictory, allowing cunning politicians to play both sides of the fence in order to get their way.
Some early findings suggest that the virus undergoes considerable shedding in patients not showing symptoms, meaning that asymptomatic transmission is indeed common. Viewed through this narrow lens, it would seem that there’s cause to worry. However, the data suggesting the prevalence of asymptomatic transmission is ultimately rather paltry, and there’s evidence pointing to the contrary.
World Health Organization spokeswoman Maria van Kerkhove recently claimed that based on “a number of reports from countries who are doing very detailed contact tracing,” asymptomatic transmission is “very rare”—directly contradicting what public health officials had long assumed about the virus. If the risk of contagion remains low until symptoms appear, patients are far less likely to spread the virus to others. This notion too, though, is based on data that is, of yet, incomplete, leaving the question of asymptomatic transmission unsolved and open to further inquiry. But whatever the underlying reality is, a significant problem must inevitably emerge for defenders of the government’s pandemic response efforts.
At the outset, governors imposed the lockdowns for fear that asymptomatic carriers were spreading the virus. Since anybody could unknowingly be infected and contagious, lockdowns were put in place as a proactive quarantine on the entire population. But according to Dr. Don Printz, a former research leader at the Centers for Disease Control and Prevention, if there’s “shedding 2-5 days before any signs or symptoms, I would think [contact tracing] would be almost impossible.” Indeed, with an incubation period lasting between two and fourteen days, many patients would remain contagious for a long time without ever showing symptoms. New chains of transmission would easily emerge, generating exponential growth in the number of new cases. By the time contact tracers tried to map the probable path of transmission, the virus would have already spread to a number of other people—and on and on after that.
On the flip side, if asymptomatic transmission is “very rare,” as Van Kerkhove asserted, contact tracing may be a successful strategy. If only symptomatic patients are spreading the virus, though, the whole rationale for the lockdowns is then completely destroyed. For all the economic, political, social, and psychological damage that the lockdowns caused, they will have yielded absolutely no public health benefit. It boils down to this: it’s either (1) that the lockdowns were effective or (2) that the contact tracing is effective, but politicians can’t have it both ways.
Still, the government’s big spenders have pushed forward without delay. In fact, they’ve doubled down on their self-contradictions. The CDC, for instance, declared that “asymptomatic transmission enhances the need to scale up the capacity for…thorough contact tracing.” That is, of course, a repetition of the perennial call for more funding—oh, how our problems would disappear if only we spent more. Funneling more money toward programs that are inherently faulty won’t lead to better or more effective results, but to programs just as faulty, only with larger personnels.
Trying to Trace COVID Probably Won’t Work Anyway
Even casting aside politicians’ obvious public health duplicity, their contact tracing plans don’t stand up to scientific scrutiny. Whatever the case with asymptomatic transmission may be, COVID’s characteristics pose contact tracers unique and probably insurmountable challenges, leaving the US tracing “army” already besieged.
The first problem is that catching COVID is not activity specific, unlike other viruses like, say, HIV. Anyone in close proximity to a contagious COVID patient is at risk for inhaling virus-ridden droplets that had been coughed, sneezed, or breathed out—it doesn’t matter where people are or what they’re doing. That suggests that the virus may often be transmitted between complete strangers, in which case contact tracing is rendered impossible, as tracing relies upon patients recalling their recent contacts.
This has only been exacerbated over the past month with the Black Lives Matter riots springing up across the country—a perfect storm for the virus’ spread. Research has shown activities like yelling, singing, and chanting to extend the distance that infectious droplets are spewed into the air. Not only does this lead to more new cases, but it also makes it much more difficult—even impossible—for tracers to figure out who passed the virus to whom.
The second problem arises once symptoms begin to show. The way COVID manifests itself is multifarious, with some patients only exhibiting irregular symptoms not usually associated with the virus, like loss of smell, rash, and delirium. Many of its key symptoms—including dry cough, fever, and shortness of breath—are found in a variety of other illnesses, further muddying the waters. That leaves gaping holes in the health record and may lead to new, hard-to-trace outbreaks.
Though meant to increase efficiency and efficacy, digital tracing apps are also riddled with significant problems. If the apps aren’t downloaded by enough residents, many may easily fall through the cracks and infect others. The apps only confer public health boons if they’re in common and widespread use. But today, nearly 20 percent of Americans still don’t own smartphones and a recent poll indicated that only half of those who do would consider downloading a tracing app. And that’s not even to mention the fact that people don’t always have their phones on their persons, meaning that many interactions could take place untraced and under the radar.
In focusing entirely on proximity, digital tracing continues to get it wrong. Indoor airflow poses a risk of spreading infectious droplets across rooms and throughout entire buildings—far beyond the six-foot proximity the apps look for. This summer, that risk may be augmented by AC ventilation. Then there’s also the risk of touching infected surfaces, which may harbor traces of the virus for hours or up to a few days. The apps simply can’t account for this sort of spread, chipping further away at their overall effectiveness.
Moreover, there are some instances where people who are physically close together are extraordinarily unlikely to become infected, like in a supermarket checkout line, separated from the clerk by a plexiglass shield. Nonetheless, this would trigger an alert to be sent to people’s phones, warning them of possible COVID exposure with no further explanation, setting off a false alarm and probably a lot of worry and confusion. Divorcing the human factor from the process takes an undeniable toll on its reliability, when it was never that reliable in the first place.
Why should anyone still have faith in the government when it’s made fatal stumbles at every step of the pandemic? Public health officials were unable to stop the first instances of community spread of COVID in late January and even remained in denial that the virus was spreading uncontrollably until the end of February. The notion that contact tracing is right now serving as a useful strategy in the US—with active cases hovering around 1 million—is preposterous.
Officials may feign confidence in the decisions they make, but that’s fueled by pure optics, not science. Across all fifty states, these programs are on track to reroute billions of dollars and more than one hundred thousand workers away from otherwise valuable uses. And for what? All to spin our wheels and sink into a false sense of hope and security.
Author: James Ketler