A robust network of “contact tracers” is needed to control the spread of the coronavirus and eventually reopen the country, experts say, a massive undertaking for a public health system that has been understaffed and underfunded for decades.
State and local health departments are lobbying Congress for billions of dollars to hire at least 100,000 contact tracers — workers responsible for tracking down people who have been exposed to confirmed coronavirus cases and asking them to self-quarantine.
The goal is to break the chains of transmission within communities and prevent outbreaks before they happen, especially when a second wave of the virus hits in the fall.
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Public health groups say at least $3.6 billion is needed from Congress hire contract tracers, of which there are only about 2,200 in the U.S.
“I think there is a real recognition that while this is a lot of people and a lot of money, the other side of the coin is a country where we continue to be in lockdown, where our commerce is forced to a fault, people are scared, and kids are not in school,” said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials (NACCHO).
“This is a big investment and is a big risk but it gets us out of the current situation we have,” Casalotti added.
Contact tracing is one of the oldest infectious disease interventions in the book.
Public health departments around the country employ more than 2,000 of these tracers to stop the spread of sexually transmitted diseases, HIV and tuberculosis. While most of these workers have been redeployed to the coronavirus response, hundreds of thousands more are needed to track a disease that is this infectious and fast-spreading, experts say.
“There’s been a lot of attention, rightfully so, paid to the need for more testing. But without contact tracing and being able to go to potential cases early and have them quarantined safely, we won’t be able to stop community spread of COVID,” said Anita Cicero, deputy director of Johns Hopkins Center for Health Security, and co-author of a national plan to use contact tracing for COVID-19.
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“I really do think that is the key, and a very important key, to helping us get back to some semblance of normalcy,” she added.
The method has been used in New Zealand and Iceland with success. Contact tracing is also a large part of the response in Asian countries but primarily relies on technology, which would likely run afoul of U.S. privacy laws.
The national contact tracing plan developed by Johns Hopkins Bloomberg School of Public Health and the Association of State and Territorial Health Officials (ASTHO) recommends starting with an additional 100,000 contract tracers for a 12-month deployment, with Congress needing to appropriate about $3.6 billion in emergency funding for state and local public health departments.
NACCHO, which represents local health departments, has made a similar recommendation.
But the number of contact tracers could grow as more cases are identified through testing. Former Centers for Disease Control and Prevention Director Tom Frieden has said at least 300,000 tracers are needed.
Contact tracing alone isn’t a cure for the nation’s testing woes.
“Testing is one of the critical components. If you can’t find the cases, there’s no way to successfully do the contact tracing that’s really going to stop the spread of the disease in its tracks,” Casalotti said.
Ideally, once a person tests positive for COVID-19, a contact tracer would connect with them and ask for information about whom they have been in contact with.
Most of the work could be done over the phone, so workers aren’t put at risk of catching the virus, though they might need to visit people’s houses occasionally.
Ideally, contacts of a COVID-19 case would be asked to quarantine for 14 days and would be connected with services, including paid time off, safe housing, access to food, medical care and other materials.
While it’s likely to be three to six months before there is widespread COVID-19 testing in the U.S., departments are looking to scale up their contract tracing forces now since it takes time to hire and train people, Casalotti said.
Departments are starting to look at who they have on staff who can be moved into contact tracing roles. Volunteers might also become a key part of the network, through the Peace Corps or the U.S Medical Reserve Corps, a national network of volunteers.
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Massachusetts is working with a global health nonprofit to recruit an extra 1,000 workers for contact tracing.
Vermont hopes to have 48 people by the end of the week solely focused on contact tracing, up from the two people they had on the project, according to VTDigger.
San Francisco is also building up a similar program.
But the public health workforce has shrunk by a quarter since the 2008 recession, and funding has been reduced by 30 percent in the last 15 years. About 100,000 people work at public health departments now.
While health departments got an infusion of coronavirus response money through emergency funding bills passed by Congress, it’s not enough to support a massive contact tracing program, experts say.
“We’re talking about doubling the public health workforce,” said Michael Fraser, CEO of ASTHO.
“But there’s no other way to do it and reopen [the country],” he added. “You have to have the capacity to contain individuals that have the virus. And then follow up with folks who might have been exposed and monitor them and in most cases, probably ask them isolate them as well.”
OTTAWA – Canada’s unemployment rate held steady at 6.5 per cent last month as hiring remained weak across the economy.
Statistics Canada’s labour force survey on Friday said employment rose by a modest 15,000 jobs in October.
Business, building and support services saw the largest gain in employment.
Meanwhile, finance, insurance, real estate, rental and leasing experienced the largest decline.
Many economists see weakness in the job market continuing in the short term, before the Bank of Canada’s interest rate cuts spark a rebound in economic growth next year.
Despite ongoing softness in the labour market, however, strong wage growth has raged on in Canada. Average hourly wages in October grew 4.9 per cent from a year ago, reaching $35.76.
Friday’s report also shed some light on the financial health of households.
According to the agency, 28.8 per cent of Canadians aged 15 or older were living in a household that had difficulty meeting financial needs – like food and housing – in the previous four weeks.
That was down from 33.1 per cent in October 2023 and 35.5 per cent in October 2022, but still above the 20.4 per cent figure recorded in October 2020.
People living in a rented home were more likely to report difficulty meeting financial needs, with nearly four in 10 reporting that was the case.
That compares with just under a quarter of those living in an owned home by a household member.
Immigrants were also more likely to report facing financial strain last month, with about four out of 10 immigrants who landed in the last year doing so.
That compares with about three in 10 more established immigrants and one in four of people born in Canada.
This report by The Canadian Press was first published Nov. 8, 2024.
The Canadian Institute for Health Information says health-care spending in Canada is projected to reach a new high in 2024.
The annual report released Thursday says total health spending is expected to hit $372 billion, or $9,054 per Canadian.
CIHI’s national analysis predicts expenditures will rise by 5.7 per cent in 2024, compared to 4.5 per cent in 2023 and 1.7 per cent in 2022.
This year’s health spending is estimated to represent 12.4 per cent of Canada’s gross domestic product. Excluding two years of the pandemic, it would be the highest ratio in the country’s history.
While it’s not unusual for health expenditures to outpace economic growth, the report says this could be the case for the next several years due to Canada’s growing population and its aging demographic.
Canada’s per capita spending on health care in 2022 was among the highest in the world, but still less than countries such as the United States and Sweden.
The report notes that the Canadian dental and pharmacare plans could push health-care spending even further as more people who previously couldn’t afford these services start using them.
This report by The Canadian Press was first published Nov. 7, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
As Canadians wake up to news that Donald Trump will return to the White House, the president-elect’s protectionist stance is casting a spotlight on what effect his second term will have on Canada-U.S. economic ties.
Some Canadian business leaders have expressed worry over Trump’s promise to introduce a universal 10 per cent tariff on all American imports.
A Canadian Chamber of Commerce report released last month suggested those tariffs would shrink the Canadian economy, resulting in around $30 billion per year in economic costs.
More than 77 per cent of Canadian exports go to the U.S.
Canada’s manufacturing sector faces the biggest risk should Trump push forward on imposing broad tariffs, said Canadian Manufacturers and Exporters president and CEO Dennis Darby. He said the sector is the “most trade-exposed” within Canada.
“It’s in the U.S.’s best interest, it’s in our best interest, but most importantly for consumers across North America, that we’re able to trade goods, materials, ingredients, as we have under the trade agreements,” Darby said in an interview.
“It’s a more complex or complicated outcome than it would have been with the Democrats, but we’ve had to deal with this before and we’re going to do our best to deal with it again.”
American economists have also warned Trump’s plan could cause inflation and possibly a recession, which could have ripple effects in Canada.
It’s consumers who will ultimately feel the burden of any inflationary effect caused by broad tariffs, said Darby.
“A tariff tends to raise costs, and it ultimately raises prices, so that’s something that we have to be prepared for,” he said.
“It could tilt production mandates. A tariff makes goods more expensive, but on the same token, it also will make inputs for the U.S. more expensive.”
A report last month by TD economist Marc Ercolao said research shows a full-scale implementation of Trump’s tariff plan could lead to a near-five per cent reduction in Canadian export volumes to the U.S. by early-2027, relative to current baseline forecasts.
Retaliation by Canada would also increase costs for domestic producers, and push import volumes lower in the process.
“Slowing import activity mitigates some of the negative net trade impact on total GDP enough to avoid a technical recession, but still produces a period of extended stagnation through 2025 and 2026,” Ercolao said.
Since the Canada-United States-Mexico Agreement came into effect in 2020, trade between Canada and the U.S. has surged by 46 per cent, according to the Toronto Region Board of Trade.
With that deal is up for review in 2026, Canadian Chamber of Commerce president and CEO Candace Laing said the Canadian government “must collaborate effectively with the Trump administration to preserve and strengthen our bilateral economic partnership.”
“With an impressive $3.6 billion in daily trade, Canada and the United States are each other’s closest international partners. The secure and efficient flow of goods and people across our border … remains essential for the economies of both countries,” she said in a statement.
“By resisting tariffs and trade barriers that will only raise prices and hurt consumers in both countries, Canada and the United States can strengthen resilient cross-border supply chains that enhance our shared economic security.”
This report by The Canadian Press was first published Nov. 6, 2024.
