Impossible for Americans to replicate the model of taiwanese and south Korean digital traces cases of Covid-19: there, the authorities arrogated to themselves the access to mountains of personal data ranging from geolocation to the bank or credit card statements and travel and medical records.
In the United States, a country that is vigilant about the liberties of the individual and highly decentralized, a number of jurisdictions, cities and States are opting to hire thousands of investigators from public health will call on the phone, fastidious, all confirmed cases of Covid-19, in order to compile a list of all the people who have spent more than 15 minutes to less than two meters away from them… and call these contacts there then to encourage them to the quarantine.
It is a work of ants, low-skilled work in call centre, complementary to the multiple mobile applications and volunteers in development. No need to have a medical training. The agents are working from home, thanks to a software on their computer. Each call takes at least half an hour.
Massachusetts was the first to launch the program at the beginning of April: he’s going to recruit 1000 ” contact tracers “, researchers or enumerators of contacts (17 000 people have applied). San Francisco is also, at its own level. As for the other States, they are just beginning to plan.
“It is late,” said Joia Mukherjee, medical director of Partners in Health, the NGO chosen by Massachusetts to manage the program. “It would have been simpler to do after the first case. ”
But the delay can be made up for, she believes. “All the epidemics are highly localized. It is terrifying to look at the overall balance, but it is necessary to address the problem, city by city, neighborhood by neighborhood. ”
“If Liberia can do it, why not Massachusetts?” said Joia Mukherjee AFP.
In Africa, and in other countries, this kind of personalized follow-up is considered as the basis of public health. But for the past 40 years, adds the doctor, ” the United States was divested in public health for the benefit of the hospitals and activities that generate revenue.”
100 000 agents
In Wuhan, 1800 teams of five people have done this work, often volunteers. For the United States, it would be in proportion to 265 000 persons.
Researchers from Johns Hopkins have suggested 100 000 agents to begin with. A figure “staggering,” their confession.
The country currently has, at most, 5,000 experts, to follow up cases of communicable diseases such as HIV or tuberculosis, told AFP Michael Fraser, director-general of the association of public-health officials of the States and territorial communities (ASTHO).
It is not expected that the recruitment starts before two to four weeks in most States.
“The aim is to put in place before the reopening,” said Michael Fraser.
This is only on Monday that the federal government, by the voice of the vice-president, Mike Pence, has announced the sending of reinforcements of Centres for prevention and disease control (CDC) in each State: “10 to 12” to begin with, experienced investigators who will be able to coordinate the tracing at the local level.
But States such as Texas intend to begin to re-open stores and shops in the next few days. So that this great State would require at least 8000 officers of tracing, estimated to ASTHO.
“It will be risky” of déconfiner without having the means to monitor the resurgence of the epidemic, warns Michael Fraser, not to mention that it should go up in range at the same time that the capacity of screening. The lack of enough agents, it will be necessary to focus on retirement homes, hospitals and vulnerable populations.
To maximize the impact of this “human” approach, a technical trick helps to encourage people to get their phone when the agents call: in Massachusetts, instead of an unknown number, an agreement was reached with the operators to ensure that the user id ” Covid Care Team (care team Covid) appears on their phone.