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Contact Tracers Swamped; Some COVID-19 Patients Never Got a Call

Single-day COVID-19 cases in Massachusetts hit an all-time high earlier this month of nearly 9,000. The growing numbers make contact tracing a gargantuan task, and at times, the effort has fallen behind.

Beverly Costa-Ciavola, who lives in Falmouth, tested positive for COVID-19 the day after Christmas, but never heard from anyone.

“No one called me, even though I was told that I would hear from the Department of Health if I tested positive, and that I should not try contacting people myself,” she said.

She took the test at Falmouth Hospital and only found out it was positive by checking her chart in response to an automated email.

She hoped a call from a contact tracer would help her figure out where she picked up the virus.

“I was disappointed that I didn't get contacted,” she said. “I have no clue where I got it from, so I thought maybe they could give me some little bit of an inkling.”

She said in the weeks leading up to her illness, she went to a couple of restaurants and stores, but didn’t spend time with family or friends.

Beyond peace of mind for the patient, contact tracing helps experts in public health understand how clusters of infection begin and stop new exposures before they happen.

As of early this week, the town of Yarmouth alone was following 102 active cases, said Health Director Bruce Murphy.

“There was an earlier cluster with a church out of Hyannis,” he said.

For the church cluster, the contact tracing required a language interpreter, but now it’s the sheer volume of cases that is giving towns a challenge.

Murphy said that like numerous communities on Cape Cod, Yarmouth was paying the Visiting Nurse Association to do contract tracing. But that started getting expensive.

Towns can refer cases to the state for free.

“With so many cases now, we need assistance,” he said. “The state provides it to us, so we're using them mainly to do all our contact tracing right now.”

The state’s effort is called the Community Tracing Collaborative, which has contracted with the nonprofit Partners in Health to make the calls.

Emily Wroe, a senior advisor on the project, said Partners in Health hired 2,000 people to do tracing, and they’re now handling about 70 percent of Massachusetts cases.

She said most of the larger towns on the Cape send the state several cases a day; for example, she sees cases regularly from Barnstable, Falmouth, Yarmouth, Sandwich, Bourne, and Dennis.

As the second surge ramped up, the Partners in Health tracers got busy fast. That’s when some cases fell through the cracks.

Over a period of two or three weeks in November, Wroe said, about a quarter of patients never got a call.

“Yeah, the surge happened really fast,” she said, “and we were just training contact tracers, to get our staffing back up to capacity to keep up.”

Tracers ask for information about how the patient was exposed and whom they may have exposed since then. They give instructions on how to self-isolate.

Wroe said they also check to see if the patient needs a delivery of food or medicine in order to isolate safely, and they work with local contacts to make that happen.

“We really make sure that people are able to safely isolate at home. And that means different things for different people,” she said.

As of this week, Partners in Health is running about three days behind, but Wroe said they’re reaching some 90 percent of patients referred to them.