NEW YORK — New York City’s ambitious contact-tracing program, a crucial initiative in the effort to curb the coronavirus, has gotten off to a worrisome start just as the city’s reopening is about to enter a new phase Monday, with outdoor dining, in-store shopping, and office work resuming.
The city has hired 3,000 disease detectives and case monitors, who are supposed to identify anyone who has come into contact with the hundreds of people who are still testing positive for the virus in the city every day. But the first statistics from the program, which began June 1, indicate that tracers are often unable to locate infected people or gather information from them.
Only 35 percent of the 5,347 city residents who tested positive or were presumed positive for COVID-19 in the program’s first two weeks gave information about close contacts to tracers, the city said in releasing the first statistics.
Contact tracing is one of the few tools that public health officials have to fight COVID-19 in lieu of a vaccine, along with widespread testing and isolation of those exposed to the coronavirus. The early results of New York’s program raise fresh concerns about the difficulties in preventing a surge of new cases as states across the country reopen.
The city has successfully done contract tracing before with diseases like tuberculosis and measles. But as with much involving the coronavirus outbreak, officials have never faced the challenge at this scale, with so many cases across the five boroughs.
The city’s program has so far been limited by a low response rate, scant use of technology, privacy concerns, and a far less sweeping mandate than in some countries, where apartment buildings, stores, restaurants, and other private businesses are often required to collect visitors’ personal information, which makes tracking the spread easier.
China, South Korea, Germany, and other countries have set up extensive tracking programs that have helped officials make major strides in reducing the outbreak. In South Korea, for example, people at weddings, funerals, karaoke bars, nightclubs, and Internet-game parlors write down their names and telephone numbers so they can be traced later.
Dr. Ted Long, head of New York City’s new Test and Trace Corps, insisted that the program was going well but acknowledged that many people who tested positive had failed to provide information over the phone to the contact tracers or left interviews before being asked. Others told the tracers they had been only at home and had not put others at risk, and then did not name family members.
Long said one encouraging sign was that nearly all the people for whom the city had numbers at least answered the phone. He added that he believed that the tracers would be more successful when they start going to people’s homes in the next week or two, rather than just relying on communication over the phone.
“I do think that the program, especially because it is only two weeks old, is doing an outstanding job,” he said.
The city has made major strides in reducing the outbreak since the shutdown began in March, with only 327 new cases reported Thursday, down from several thousand cases a day during the peak. But phase two of the reopening Monday presents new risks, with 300,000 people likely returning to their jobs.
Perry Halkitis, dean of the School of Public Health at Rutgers University, which is guiding an effort to bring on thousands of tracers in New Jersey, called New York City’s 35 percent rate for eliciting contacts “very bad.”
“For each person, you should be in touch with 75 percent of their contacts within a day,” he said.
He suggested that the poor showing stemmed in part from the inexperience of the contact tracers and insufficient hands-on training.
“This is a skill,” he said. “You need to practice.”
The tracers are seeking the names and phone numbers of each person a confirmed-positive patient has been in close contact with from a few days before the onset of symptoms, defined as within 6 feet for at least 15 minutes. Each contact is then called, told that he or she may have been exposed to the virus, and asked to quarantine.
The relative silence from virus patients in New York City is one of several issues troubling the contact-tracing program.
Mayor Bill de Blasio, who has had tense relations with senior officials in his own Department of Health, stripped the department of oversight for the program in May, moving it under the umbrella of the city’s public hospitals agency. That has led to concerns among some former health officials that expertise would be lost in the process. (New York state is running a separate tracing program in counties outside New York City.)
Long said 50 experts from the Department of Health — the city’s contact tracers before COVID-19, who have handled epidemics such as measles and Ebola — are guiding the work of the tracing corps but are not tracing themselves.
“It’s tough to look at these numbers and say it’s a roaring success,” said Dr. Crystal Watson, an expert on contact tracing at the Johns Hopkins Bloomberg School of Public Health. “But I do think . . . it will build on itself.”
Halkitis at Rutgers said he thought the low cooperation rate was likely due to several factors, including the inexperience of the tracers; widespread reluctance among Americans to share personal information with the government; and de Blasio’s decision to shift the program away from the city’s Department of Health.
“You have taken it away from the people who actually know how to do it,” he said. “The DOH people, they are skilled. They know this stuff.”