Massachusetts is significantly scaling back its first-in-the-nation partnership with Partners in Health to track down people infected by the coronavirus, as the rate of positive cases in the state has held steady at or below 2 percent since mid-June.
Hundreds of contact tracers hired since the program was launched in April were recently laid off, and leaders in several cities and towns that collaborate with the Boston-based global health organization have expressed frustrations about problems with the initiative. Some have dropped out.
Governor Charlie Baker said Wednesday that there just wasn’t enough work for the Partners in Health employees who were tracking down close contacts of those infected.
“The number of people who need to be reached out to has dropped dramatically,” Baker said at a news conference. “We eventually had way more people than we needed.”
The Massachusetts program drew national attention when it was launched in the spring. Experts say contact tracing is crucial to help prevent clusters of infections from becoming widespread outbreaks.
Tracers call individuals identified as COVID-19 positive by the state Health Department, and ask about their activities and their close contacts — those who were within 6 feet for at least 15 minutes in the days before the infected person tested positive. The tracers then contact those people and urge testing and quarantining until they know whether they’re infected, too.
Exactly how many tracers and related staff have been laid off is unclear. The Baker administration said in a statement that the program hired and trained nearly 1,900 people, but by mid-June the force was down to about 1,200.
The administration said that after other departures, the program, a collaborative between local communities and Partners in Health, further reduced its team by another 350 people. It said it currently employs more than 700 people, including community health center staff.
With concerns that infections could increase as more businesses and then schools reopen, Baker said Partners in Health has assured him that many of the laid-off workers could be called back if necessary.
Local health departments also conduct contact tracing, and the state effort was meant to help with that effort. But the state collaboration with Partners in Health was plagued by problems from its start in early April, according to several local health department leaders. They said widespread computer glitches, gaps in training, and communication struggles led to significant delays in contacting infected residents.
Public health experts say ideally it should take no longer than three days to connect with and test those who may have been in close contact with an infected person. But some local health leaders said it often took longer than that for Partners just to connect with the initial infected person, delaying efforts to identify and isolate others.
While some of the problems have been fixed, delays and communication issues in the Partners in Health-led collaborative continue today, local health leaders said Wednesday.
“I gave up on [the collaborative] because it’s more of a pain than it’s worth,” said Wil van Dinter, Watertown’s public health nurse. “I handle all the calls myself. I don’t trust them [PIH] or the information they provide.”
Too often, van Dinter said, the Partners in Health team would return difficult cases to Watertown days after the information about a positive case first appeared in the state’s computer database and was assigned to the PIH team. After giving up on the collaborative, he said, he relied on them again about two weeks ago for cases over a weekend and found the problems persisted.
Van Dinter also said he has doubts about some of the data the collaborative has reported, saying on average the Partners in Health team was finding that each infected person only reported about two other close contacts. But Watertown has been routinely finding at least three close contacts for each infected person.
“If you report way less than what the average public health nurse is finding, then you seriously start having some doubts,” he said.
Framingham’s director of public health, Samuel Wong, said in an e-mail Wednesday that his community also opted out of the program.
“Framingham did not participate in the [Partners in Health] initiative partly because of communication issues with [the collaborative] but more importantly, it is because we have adequate local capacity to conduct case investigation and contact tracing ourselves,” Wong said. “Our local team of public health nurses know our community better in terms of available resources, and are able to connect with our own residents more effectively.”
Chelsea, which has been a hot spot for infections, has also had problems with the initiative, said Cate Fox-Lent, innovation and stategy adviser to the city manager. She said that while the contact-tracing portion has improved, communication with Partners in Health has not.
“I am frustrated,” Fox-Lent said.
She said Chelsea leaders have been asking the collaborative for weeks to share aggregate data on the infections in their city, such as the occupations of those infected, and whether there are common threads, such as having children in certain day care centers, or shopping in specific stores, that might help city leaders better target public education and inform decisions about reopening.
“I don’t know what the point of contact tracing is if you are not looking at the big picture,” Fox-Lent said. “Case numbers are really low and now is the time to figure this out.”
Statewide, it’s been a mixed bag for local public health officials, said Sigalle Reiss, president of the Massachusetts Health Officers Association and Norwood’s health director.
“A lot of it depends on the connections between the local health department and the [collaborative,]” Reiss said. “My experience in Norwood has been pretty positive, but I know it has not been that across the state.”
Reiss said that the Partners in Health initiative was a “Band-Aid” during the surge of COVID-19 cases, but that now is the time, during a lull in new cases, to build up local health departments to be prepared for what many expect will be a rise in new cases as more of Massachusetts opens up.
Partners in Health said Wednesday that it’s working to improve operations and ties with local health departments.
“This includes a new team of local health liaisons, starting next Monday and made up of former [collaborative] supervisors, that will be responsible solely for maintaining open lines of communication with local health departments,” the organization said in a statement. It said it is working on “quickly reaching out to new cases on the day a case is received, and contacts within 24 hours.”
Data provided Wednesday by the state indicate the collaborative has ”engaged with” a total of 47,000 people out of 55,000 people it has attempted to reach, an 85 percent engagement rate. It did not further identify what it means by engaging with a person, for instance whether any contact information was obtained.
The state’s nine-month contract with Partners in Health, which ends in December, shows that the Baker administration agreed to pay the organization as much as $55 million.
The administration also allocated $39 million for two other companies, Accenture and Salesforce, to establish and manage software for the collaborative
Dasia Moore of the Globe staff contributed to this report.