Contact tracing has been done on infectious diseases for years, but it arguably has never been more discussed or under as much scrutiny as it is now as the world grapples with the coronavirus pandemic and tries to reclaim some amount of normalcy.

Pennsylvania officials have identified the simple yet vital process as a key part of what’s needed for the state to start loosening pandemic-related restrictions and reopen the economy.

Contact tracing is incredibly important for tracking, monitoring and ultimately quelling the covid-19 pandemic, said Kristin D’Acunto, an assistant professor and infectious disease expert at Duquesne University.

“Contact tracing has been around for decades for all sorts of reportable diseases,” D’Acunto said, noting it is used to track infections from measles to syphilis.

The idea, she said, is to rein in the virus by identifying possibly infected individuals before they can spread it to more people.

What it’s not, however, is a new form of “Big Brother.”

“It has nothing to do with anybody keeping tabs on us or Big Brother watching,” D’Acunto said. “This is for the sole purpose of decreasing exposure and infection from covid-19 — to flatten the curve.”

The Pennsylvania Department of Health issued detailed guidance earlier this month on what contact tracing will look like in terms of identifying and isolating cases.

Public health staffers work with patients to review everyone they might have had close contact with while they were infectious and undiagnosed — usually starting about 48 hours before the onset of symptoms.

Pennsylvania Secretary of Health Dr. Rachel Levine has assured residents their contacts won’t be told who they were in contact with who has tested positive. Those contacts will be asked to quarantine for 14 days and monitor their temperature and watch for any other symptoms.

A public health employee will stay in contact with the person to make sure they’re monitoring themselves.

“This is a very, very well-established health activity,” Levine said of contact tracing.

Beyond minimizing the risk of spreading the virus, Levine said, contact tracing allows experts to collect demographic data that, taken as a whole, can show a clearer picture of who the virus affects and how.

From a technology side, much has been made of Mitre’s Sara Alert system. It’s not an app that tracks your movements but rather a web-based platform that contact tracers use to send daily emails, texts or phone calls to those who have tested positive as well as their close contacts.

Apple and Google also have worked together on a platform, and there is the possibility of a Bluetooth system that could alert people when they’ve been near someone with the virus. A Carnegie Mellon University professor has also developed an app called NOVID, which uses sound waves to sense when a user has been near another user who self-reported covid-19 symptoms.

For any app, D’Acunto said, users would have to agree, or opt in, to use it. App users also would be required to give the usual permissions, such as use of one’s location and other data.

“No one is going to download an app (to your phone) without your consent,” she said.

At the state level, Gov. Tom Wolf has said an army of civilians will be hired and begin tackling contact tracing in the coming months. The Commonwealth Civilian Coronavirus Corps will serve two purposes: It provides more resources for contact tracing, and it will create jobs for those who might be out of work because of the pandemic.

Beyond that, few details have been released.

In Allegheny County, the state will work with and rely on the county health department and its contact tracers to track the virus there. Allegheny County is one of just six counties in Pennsylvania with a health department.

The county has kept up with contact tracing efforts throughout the pandemic, but officials say they are working to build up those efforts in the first phases of loosened restrictions.

County health officials have developed a flexible formula to anticipate how many contact tracers they will need based on the number of cases per day. They are working under the assumption the average person will have six to 10 contacts and each contact tracer can reach about 15 contacts per day.

For example, if there are 25 cases per day, the health department will need about 13 contact tracers a day. If the county averages 75 cases per day, they will need about 40 contact tracers a day.

Dr. Debra Bogen, director of the Allegheny County Health Department, said with current staff and some new hires, the department already can call in 10 to 20 contact tracers. She said they also plan to bring in and train at least 50 volunteers from the Medical Reserve Corps.

The corps is composed of volunteers who can mobilize and assist in a variety of duties in times of crisis.

Health care giant UPMC already has begun contact tracing within its own walls. A patient with covid-19 is traced only as far back as their first contact within a hospital. Any tracking further back than that falls to the county.

In the surrounding counties, including Westmoreland, the state Department of Health will work with community health nurses and infectious disease specialists to track the spread of the virus. State health officials also have said they will partner with local universities and health systems.

D’Acunto said good contact tracers should be empathetic and understanding and be able to explain efficiently what that person needs to do next.

“It’s important to be empathetic and to not instill fear with these people,” she said. “There’s enough fear out there already with this.”

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