The Transition Away from Universal Case Investigation & Contact Tracing for Individual Cases of COVID-19 by Public Health Agencies

January 25, 2022

ATLANTA, GA & ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO), Council of State and Territorial Epidemiologists (CSTE), National Associations of County and City Health Officials (NACCHO), Big Cities Health Coalition (BCHC), and Association of Public Health Laboratories (APHL) support state, local, territorial, and tribal health departments in transitioning away from universal case investigation and contact tracing at this point in the COVID-19 pandemic to a more strategic approach of outbreak investigations and targeted case investigations. Although universal case investigation and contact tracing was implemented in spring 2020 to slow COVID-19 transmission, much has changed over the past year prompting the need for a revised public health approach. This includes the wide availability of safe and effective vaccines, better understanding of the epidemiology of the SARS-CoV-2 virus, and the emergence of the more infectious Omicron variant.

While universal case investigation and contact tracing during the initial phase of the pandemic was justified in the attempt to contain the pandemic, most experts agree this is no longer optimal. We urge a refocus of our public health efforts and resources, with an emphasis on targeting investigations in higher risk settings serving vulnerable populations and other critical measures to better protect the public.

Although it is no longer optimal for public health to universally investigate and monitor individual COVID-19 cases and their contacts, contact tracing remains a necessary public health tool for interrupting ongoing transmission of COVID-19 and preventing disease in the most vulnerable populations, especially in certain higher risk congregate residential settings (e.g., shelters, correctional facilities, and nursing homes) or in other specific situations, such as outbreak investigations or if warranted based on concerning changes in the clinical or epidemiological characteristics of the virus. Individual jurisdictions may also consider continuing contact tracing in other settings, including schools and child-care centers, depending on local context, priorities, and available resources.

The recommended transition away from universal case investigation and contact tracing for COVID-19 does not suggest that such tools have limited value in the setting of many priority infectious diseases. Indeed, case investigation and contact tracing by public health officials remains a vital, well-established method for the control of other communicable diseases, such as measles, tuberculosis, hepatitis A, HIV, and sexually transmitted diseases, like syphilis and gonorrhea.

Access the full statement on case investigation/contact tracing, including a list of six key public health strategies for COVID-19 prevention and care.

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About ASTHO

ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and Freely Associated States, and Washington, D.C., as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.

About CSTE

Founded in 1951, the Council of State and Territorial Epidemiologists (CSTE) represents the interests of State Epidemiologists from all 50 U.S. states and territories. CSTE is also the professional home to more than 2200 practicing applied epidemiologists at the state, local, tribal and territorial levels. For information, visit https://www.cste.org/.

Contact: Jeremy Arieh, Director of Communications, 770-458-3811, email: jarieh@cste.org