MMWR Morb Mortal Wkly Rep. 2021 Jan 22;70(3):83-87. doi: 10.15585/mmwr.mm7003a3.
Case investigation and contact tracing are core public health tools used to interrupt transmission of pathogens, including SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19); timeliness is critical to effectiveness (1,2). In May 2020, CDC funded* 64 state, local, and territorial health departments to support COVID-19 response activities. As part of the monitoring process, case investigation and contact tracing metrics for June 25-July 24, 2020, were submitted to CDC by 62 health departments. Descriptive analyses of case investigation and contact tracing load, timeliness, and yield (i.e., the number of contacts elicited divided by the number of patients prioritized for interview) were performed. A median of 57% of patients were interviewed within 24 hours of report of the case to a health department (interquartile range [IQR] = 27%-82%); a median of 1.15 contacts were identified per patient prioritized for interview (IQR = 0.62-1.76), and a median of 55% of contacts were notified within 24 hours of identification by a patient (IQR = 32%-79%). With higher caseloads, the percentage of patients interviewed within 24 hours of case report was lower (Spearman coefficient = -0.68), and the number of contacts identified per patient prioritized for interview also decreased (Spearman coefficient = -0.60). The capacity to conduct timely contact tracing varied among health departments, largely driven by investigators' caseloads. Incomplete identification of contacts affects the ability to reduce transmission of SARS-CoV-2. Enhanced staffing capacity and ability and improved community engagement could lead to more timely interviews and identification of more contacts.
病例调查和接触者追踪是用于阻断病原体(包括导致 2019 冠状病毒病(COVID-19)的 SARS-CoV-2 病毒)传播的核心公共卫生措施;及时性对于有效性至关重要(1,2)。2020 年 5 月,CDC 资助了*64 个州、地方和地区卫生部门,以支持 COVID-19 应对活动。作为监测过程的一部分,62 个卫生部门向 CDC 提交了 2020 年 6 月 25 日至 7 月 24 日的病例调查和接触者追踪指标。对病例调查和接触者追踪负荷、及时性和效果(即,优先接受访谈的患者数与接触者数之比)进行了描述性分析。报告病例后 24 小时内,中位数为 57%的患者接受了访谈(四分位距 [IQR] = 27%-82%);中位数为 1.15 个接触者与每个接受访谈的优先患者有关(IQR = 0.62-1.76),中位数为 55%的接触者在患者被识别后 24 小时内得到通知(IQR = 32%-79%)。随着病例负荷的增加,报告病例后 24 小时内接受访谈的患者比例较低(Spearman 系数=-0.68),优先接受访谈的患者的接触者数量也有所减少(Spearman 系数=-0.60)。各卫生部门的及时接触者追踪能力存在差异,主要原因是调查人员的病例量不同。接触者识别不完整会影响降低 SARS-CoV-2 传播的能力。增强人员配备能力和能力,并改善社区参与度,可实现更及时的访谈和更多接触者的识别。