‘Heard The Call To Help’: Director Of NYC Test & Trace On Identifying 1 Million Close Contacts

After COVID-19 first swept through New York City, officials launched the Test & Trace Corps—arguably the largest contact tracing effort of its kind in the country.

The corps tracks down so-called “close contacts” of known COVID cases to keep individual outbreaks from spiraling out of control. The program recently recorded its 1 millionth close contact—a major milestone that conveys the extent of its outreach.

But winter is coming, which means more time spent indoors and at home. The reopening of businesses and schools means several more sources of infections to track, and the delta variant continues to linger stubbornly over the city.

Dr. Ted Long, a primary care physician and Test & Trace Executive Director, joined WNYC host Michael Hill to discuss these threats and what the Test & Trace Corps has learned since its launch in June 2020.

Michael Hill: To track down those 1 million closed contacts, the corps placed nearly 2.5 million phone calls and sent more than 2 million text messages. But contact tracers do way more than notifying people when they're exposed. Would you briefly lay out the corps’ three principles?

Dr. Ted Long: I would say the most important thing about our Test & Trace corps in New York City is we've put together a group of contact tracers that are all New Yorkers—that saw the devastation that happened in their communities. They heard the call to help, they responded and they joined the corps. So when you get a call from somebody in New York City, it's not somebody that doesn't know what you've been through or what you're going through.

It's somebody from your community—that's lived through the same horrors that you had to live through in March and April of 2020 and has joined the team in New York City to help. What they're going to do with you is they're going to ask you, if you've been diagnosed or have a positive test for COVID, who could you have exposed when you were infectious?

It's a sensitive area, but a million times now we've been able to identify close contacts or New Yorkers that have been exposed. And that gives us a unique ability in New York City to really offer to help in terms of how we can help you to isolate or quarantine to keep our cities safe.

Hill: Winter is coming, which means more time is spent indoors and at home, and according to recent Test & Trace data, New Yorkers are most often exposed to COVID by someone who lives with them.

How common is that? [In an earlier interview on Monday, Dr. Long said this applied to 64% of cases in a recent week]. Does Test & Trace offer any services to prevent this kind of transmission?

We have detailed information on where people are getting infected across New York City that we review, and that's how we've shaped our program over time.

We're very adaptable. For example, I'm a primary care doctor myself. I practice in the Bronx—I have throughout [the] COVID [pandemic]. I've diagnosed my patients with COVID. I've helped them through it.

The number one question I get from all of my patients I've diagnosed with COVID is, "Hey, Dr. Long, that's the virus I've been hearing about in the news. So, what do I do now?"

In New York City, because we know that it's hard if you live in a multi-generation home with close quarters, we have a free hotel program. We'll pick you up for free. Drive you there for free. Give you free food or even free medical care while you're there.

We also have free resources that we connect you through contact tracing, like free at-home testing for anybody exposed to COVID in New York City [and] free at-home vaccinations for all New Yorkers. We connect you to monoclonal antibody treatments, which can be life saving.

And we have a very unique part of our program too.

Based on what I've heard from my patients is that sometimes you feel like you have to go to work to support your family, even if you have been exposed or even, sometimes, if you've been diagnosed with COVID. In New York City, we have an answer for that. We have a direct cash assistance program that others don't have so that we can actually pay you to make the right decision to keep your family and your community safe.

Hill: Still a fair amount of exposure outside of the home. And what's most common there?

So what we're seeing in our data is outside of the home, we're seeing an increase in exposure at gatherings. This, of course, is not shocking as the city continues to reopen. But this is why we need to continue to do contact tracing as a way to connect people to resources.

So if you've been exposed at a gathering in other cities, you might be informed of this if there is a contact tracing program, and that's where it would end.

But here in New York City, if you've been exposed, we're going to offer you all of the resources that I just talked to you about, in terms of helping you to really be able to quarantine and meet you wherever you are to make the right decision to keep your community and family safe.

Hill: Let's pivot to schools here for a minute: How does equity come into play when it comes to testing and contact tracing? I ask because we're seeing some public data that show COVID testing is more common for schools in high-income areas.

Well, I can speak to this from the perspective of our New York City public schools and what we do there is actually very simple.

We do a 10% random sample every week at every public school. So, it's the same 10% at every school. If you look at last year, we did more than 1.5 million tests using the same percentage at every school that we were going to, and this year we've already done over 100,000 tests just in the beginning of the school year.

Hill: We're hearing from parents who are finding out about COVID cases in schools by word of mouth. A parent told us that a principal informed them of a case in their school, but they didn't hear from Test & Trace until 10 days later.

How long does it typically take for a Test & Trace to communicate with close contacts? And does it depend on the size of the exposure event?

Long: The same day that we're made aware of a case, we have pre-written letters that we work with the principals to send out, so they don't have to put anything into their own words. It's all written with appropriate public health guidance, and families always get that the same day.

Sometimes it's at night though, because sometimes we learned about cases at night, but we always, our priority is to make families comfortable knowing that when their kids go to school in the morning, they would have already heard if their kids were exposed and need to quarantine or what's going on with their school.

That's always the same day that we hear about it. [Separately, a Test & Trace spokesperson said in general including outside of schools, “for those that complete intake, the majority of cases (92%) are reached within 24 hours.”]

From Test & Trace, we usually call that same day or the following day. And if there are specific situations where we might have had a wrong number for a family or something like that, um, you can actually always encourage that feedback, all 212-COVID19, we 'd love to hear it.

[Editor’s note: On the flip side, phone calls from NYC contact tracers will always come from a phone number beginning with 212-540-XXXX or 212-242-XXXX. The tracer can also provide a special code that you can use to verify their existence via the city's“Validate My Tracer” tool.]

Hill: I know so many people that are working toward that day when we no longer have pandemic in our daily vocabulary, and COVID-19 may be a thing of the past.

What happens to Test & Trace when the pandemic finally cools off. And do you feel optimistic about the city's future?

We've had an incredible team of people that develop these skills, these experiences with how to connect to you and your community because they're from your community. We can't let all of that go by the wayside. So actually I'm really excited about what we're going to do.

We're going to form a new public health corps [which was launched by Mayor Bill de Blasio on September 29th].

Or we're going to take all of our contact tracers and the skills that they've developed and turn them into community health workers, so that anybody that wants to stay on our team can join me in my primary care practice to help me to take care of my patients when they leave the four walls of my office, which has always been my dream in primary care.

This will actually truly, in my mind, set New York City up as the public health capital of the country, which we can only do because of everything we've been doing with contact tracing in the fight against COVID.