Experience of Public Health Departments in Implementation of COVID-19 Case Investigation and Contact Tracing Programs.

IF 3 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Public Health Reports Pub Date : 2024-11-01 Epub Date: 2024-05-23 DOI:10.1177/00333549241239556

Colleen Staatz, Penny S Loosier, Ruth Hsu, Michelle Fiscus, Reena Gupta, E Rain Sabin, Divya Vohra, Holly Matulewicz, Melanie M Taylor, Elise C Caruso, Nickolas DeLuca, Patrick K Moonan, John E Oeltmann, Phoebe Thorpe

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Abstract

Objective: Case investigation and contact tracing (CI/CT) are fundamental public health efforts widely used during the COVID-19 pandemic to mitigate transmission. This study investigated how state, local, and tribal public health departments used CI/CT during the COVID-19 pandemic, including CI/CT methodology, staffing models, training and support, and efforts to identify or prioritize populations disproportionately affected by COVID-19.

Methods: During March and April 2022, we conducted key informant interviews with up to 3 public health officials from 43 state, local, and tribal public health departments. From audio-recorded and transcribed interviews, we used the framework method to analyze key themes.

Results: Major adjustments to CI/CT protocols during the pandemic included (1) prioritizing populations for outreach; (2) implementing automated outreach for nonprioritized groups, particularly during COVID-19 surges; (3) discontinuing contact tracing and focusing exclusively on case investigation; and (4) adding innovations to provide additional support. Key informants also discussed the utility of having backup staffing to support overwhelmed public health departments and spoke to the difficulty in "right-sizing" the public health workforce, with COVID-19 surges leaving public health departments understaffed as case rates rose and overstaffed as case rates fell.

Conclusions: When addressing future epidemics or outbreaks, public health officials should consider strategies that improve the effectiveness of CI/CT efforts over time, such as prioritizing populations based on disproportionate risk, implementing automated outreach, developing models that provide flexible additional staffing resources as cases rise and fall among local public health departments, incorporating demographic data in laboratory reporting, providing community connections and support, and having a system of self-notification of contacts.

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公共卫生部门实施 COVID-19 病例调查和接触者追踪计划的经验。

目的：病例调查和接触者追踪（CI/CT）是在 COVID-19 大流行期间为减少传播而广泛使用的基本公共卫生工作。本研究调查了各州、地方和部落公共卫生部门在 COVID-19 大流行期间如何使用 CI/CT，包括 CI/CT 方法、人员配备模式、培训和支持，以及如何识别或优先考虑受 COVID-19 影响过大的人群：2022 年 3 月和 4 月期间，我们对来自 43 个州、地方和部落公共卫生部门的多达 3 名公共卫生官员进行了关键信息访谈。通过对访谈的录音和转录，我们使用框架法分析了关键主题：大流行期间对 CI/CT 协议的主要调整包括：(1) 确定外展人群的优先顺序；(2) 对非优先人群实施自动外展，尤其是在 COVID-19 激增期间；(3) 停止接触者追踪，将重点完全放在病例调查上；(4) 增加创新以提供额外支持。主要信息提供者还讨论了配备后备人员以支持不堪重负的公共卫生部门的效用，并谈到了 "合理调整 "公共卫生队伍规模的困难，COVID-19 的激增使公共卫生部门在病例率上升时人员不足，而在病例率下降时人员过剩：在应对未来的流行病或疫情爆发时，公共卫生官员应考虑能够提高 CI/CT 工作长期有效性的策略，如根据过高的风险确定优先人群、实施自动外联、开发可根据当地公共卫生部门的病例增减情况灵活提供额外人力资源的模式、将人口统计学数据纳入实验室报告、提供社区联系和支持以及建立接触者自我通知系统。

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来源期刊

Public Health Reports 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.00

自引率

6.10%

发文量

164

审稿时长

6-12 weeks

期刊介绍： Public Health Reports is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public Health. The journal is peer-reviewed and publishes original research and commentaries in the areas of public health practice and methodology, original research, public health law, and public health schools and teaching. Issues contain regular commentaries by the U.S. Surgeon General and executives of the U.S. Department of Health and Human Services and the Office of the Assistant Secretary of Health. The journal focuses upon such topics as tobacco control, teenage violence, occupational disease and injury, immunization, drug policy, lead screening, health disparities, and many other key and emerging public health issues. In addition to the six regular issues, PHR produces supplemental issues approximately 2-5 times per year which focus on specific topics that are of particular interest to our readership. The journal''s contributors are on the front line of public health and they present their work in a readable and accessible format.