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Design, Implementation, and Outcomes of a Volunteer-Staffed Case Investigation and Contact Tracing Initiative at an Urban Academic Medical Center.
Feuerstein-Simon, Rachel; Strelau, Katherine M; Naseer, Nawar; Claycomb, Kierstyn; Kilaru, Austin; Lawman, Hannah; Watson-Lewis, Lydia; Klusaritz, Heather; Van Pelt, Amelia E; Penrod, Nadia; Srivastava, Tuhina; Nelson, Hillary C M; James, Richard; Hall, Moriah; Weigelt, Elaine; Summers, Courtney; Paterson, Emily; Aysola, Jaya; Thomas, Rosemary; Lowenstein, Deborah; Advani, Preeti; Meehan, Patricia; Merchant, Raina M; Volpp, Kevin G; Cannuscio, Carolyn C.
  • Feuerstein-Simon R; Department of Family and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Strelau KM; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia.
  • Naseer N; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia.
  • Claycomb K; Biomedical Graduate Studies, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Kilaru A; Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Lawman H; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia.
  • Watson-Lewis L; Biomedical Graduate Studies, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Klusaritz H; Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Van Pelt AE; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia.
  • Penrod N; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.
  • Srivastava T; Center for Emergency Care Policy and Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Nelson HCM; Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • James R; Philadelphia Department of Public Health, Philadelphia, Pennsylvania.
  • Hall M; Now with Novo Nordisk, Plainsboro, New Jersey.
  • Weigelt E; Philadelphia Department of Public Health, Philadelphia, Pennsylvania.
  • Summers C; Department of Family and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Paterson E; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia.
  • Aysola J; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia.
  • Thomas R; Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.
  • Lowenstein D; Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Advani P; Penn Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Meehan P; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia.
  • Merchant RM; Biomedical Graduate Studies, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
  • Volpp KG; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia.
  • Cannuscio CC; School of Nursing, University of Pennsylvania, Philadelphia.
JAMA Netw Open ; 5(9): e2232110, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2047368
ABSTRACT
Importance The COVID-19 pandemic has claimed nearly 6 million lives globally as of February 2022. While pandemic control efforts, including contact tracing, have traditionally been the purview of state and local health departments, the COVID-19 pandemic outpaced health department capacity, necessitating actions by private health systems to investigate and control outbreaks, mitigate transmission, and support patients and communities.

Objective:

To investigate the process of designing and implementing a volunteer-staffed contact tracing program at a large academic health system from April 2020 to May 2021, including program structure, lessons learned through implementation, results of case investigation and contact tracing efforts, and reflections on how constrained resources may be best allocated in the current pandemic or future public health emergencies. Design, Setting, and

Participants:

This case series study was conducted among patients at the University of Pennsylvania Health System and in partnership with the Philadelphia Department of Public Health. Patients who tested positive for COVID-19 were contacted to counsel them regarding safe isolation practices, identify and support quarantine of their close contacts, and provide resources, such as food and medicine, needed during isolation or quarantine.

Results:

Of 5470 individuals who tested positive for COVID-19 and received calls from a volunteer, 2982 individuals (54.5%; median [range] age, 42 [18-97] years; 1628 [59.4%] women among 2741 cases with sex data) were interviewed; among 2683 cases with race data, there were 110 Asian individuals (3.9%), 1476 Black individuals (52.7%), and 817 White individuals (29.2%), and among 2667 cases with ethnicity data, there were 366 Hispanic individuals (13.1%) and 2301 individuals who were not Hispanic (82.6%). Most individuals lived in a household with 2 to 5 people (2125 of 2904 individuals with household data [71.6%]). Of 3222 unique contacts, 1780 close contacts (55.2%; median [range] age, 40 [18-97] years; 866 [55.3%] women among 1565 contacts with sex data) were interviewed; among 1523 contacts with race data, there were 69 Asian individuals (4.2%), 705 Black individuals (43.2%), and 573 White individuals (35.1%), and among 1514 contacts with ethnicity data, there were 202 Hispanic individuals (12.8%) and 1312 individuals (83.4%) who were not Hispanic. Most contacts lived in a household with 2 to 5 people (1123 of 1418 individuals with household data [79.2%]). Of 3324 cases and contacts who completed a questionnaire on unmet social needs, 907 (27.3%) experienced material hardships that would make it difficult for them to isolate or quarantine safely. Such hardship was significantly less common among White compared with Black participants (odds ratio, 0.20; 95% CI, 0.16-0.25). Conclusions and Relevance These findings demonstrate the feasibility and challenges of implementing a case investigation and contact tracing program at an academic health system. In addition to successfully engaging most assigned COVID-19 cases and close contacts, contact tracers shared health information and material resources to support isolation and quarantine, thus filling local public health system gaps and supporting local pandemic control.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Contact Tracing / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Female / Humans / Male Language: English Journal: JAMA Netw Open Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Contact Tracing / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Female / Humans / Male Language: English Journal: JAMA Netw Open Year: 2022 Document Type: Article