THE ROLE OF PUBLIC HEALTH POLICY IN SUPPORTING STATE AND LOCAL CONTACT TRACING PROGRAMS IN THE UNITED STATES
Johns Hopkins University
Case investigation and contact tracing (CI/CT) are fundamental public health strategies that have been used to break chains of infectious disease transmission in a variety of historic outbreaks. It is critical that public health agencies have CI/CT program components in place prior to the detection of an outbreak to ensure that these programs are ready to be leveraged when an outbreak is first detected. The goal of this research is to identify the capacities and capabilities required to implement and sustain effective CI/CT programs in United States (U.S.) state, tribal, local, and territorial public health agencies (herein, public health agencies) and to identify key federal policies and resources needed to support these programs so they can be readily leveraged in future outbreaks. This research was conducted in three parts. First, a narrative literature review was conducted to identify the capacities, capabilities, outcomes, and impacts of CI/CT programs. Second, semi-structured qualitative interviews were held with ten state and local public health agencies as well as four experts in CI/CT to discuss the capacities and capabilities identified during the literature review and lessons learned around scaling-up and sustaining CI/CT programs during the COVID-19 pandemic and the 2022 mpox outbreak. Finally, a narrative literature review and interviews with six public health policy experts explored federal policies that impacted the scale-up and maintenance of several CI/CT capacities during the COVID-19 pandemic and the 2022 mpox outbreak. Findings from the narrative literature review and interviews resulted in the first comprehensive documentation of CI/CT capacities, capabilities, outcomes, and impacts of CI/CT programs and a conceptual framework that illustrates the relationships between these components. The interviews explored the CI/CT capacities that should be maintained as baseline functions in public health agencies on a continuous basis to ensure preparedness to conduct CI/CT in future outbreaks, and identified lessons learned around scaling-up CI/CT during the COVID-19 pandemic and the 2022 mpox outbreak. The second narrative literature review and interviews with public health policy experts resulted in federal policy recommendations to ensure public health agency preparedness to conduct CI/CT during future outbreaks and pandemics.
Case investigation, contact tracing, infectious diseases, preparedness, public health policy