COVID-19 Contact Tracing in Two Counties — North Carolina, June–July 2020

Lash, R. Ryan; Donovan, Catherine V.; Fleischauer, Aaron T.; Moore, Zack S.; Harris, Gibbie; Hayes, Susan; Sullivan, Meg; Wilburn, April; Ong, Jonathan; Wright, Dana; Washington, Raynard; Pulliam, Amy; Byers, Brittany; McLaughlin, Heather P.; Dirlikov, Emilio; Rose, Dale A.; Walke, Henry T.; Honein, Margaret A.; Moonan, Patrick K.; Oeltmann, John E.; Griffing, Sean; Williams, Tanya; Luna-Pinto, Carolina; Romaguera, Raul; Thorpe, Phoebe; Villanueva, Julie; Bernstein, Kyle; Woodruff, Rachel; McFarlane, Mary; Pevzner, Eric; Cressman, Andrew; Carolina, North; Mobley, Victoria; Carolina, North; Samoff, Erika

Contact tracing is a strategy implemented to minimize the spread of communicable diseases (1,2). Prompt contact tracing, testing, and self-quarantine can reduce the transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (3,4). Community engagement is important to encourage participation in and cooperation with SARS-CoV-2 contact tracing (5). Substantial investments have been made to scale up contact tracing for COVID-19 in the United States. During June 1-July 12, 2020, the incidence of COVID-19 cases in North Carolina increased 183%, from seven to 19 per 100,000 persons per day* (6). To assess local COVID-19 contact tracing implementation, data from two counties in North Carolina were analyzed during a period of high incidence. Health department staff members investigated 5,514 (77%) persons with COVID-19 in Mecklenburg County and 584 (99%) in Randolph Counties. No contacts were reported for 48% of cases in Mecklenburg and for 35% in Randolph. Among contacts provided, 25% in Mecklenburg and 48% in Randolph could not be reached by telephone and were classified as nonresponsive after at least one attempt on 3 consecutive days of failed attempts. The median interval from specimen collection from the index patient to notification of identified contacts was 6 days in both counties. Despite aggressive efforts by health department staff members to perform case investigations and contact tracing, many persons with COVID-19 did not report contacts, and many contacts were not reached. These findings indicate that improved timeliness of contact tracing, community engagement, and increased use of community-wide mitigation are needed to interrupt SARS-CoV-2 transmission.