In the early days of the coronavirus pandemic, city and county officials hired hundreds of contact tracers to help stop the spread of the coronavirus as the sheer number of cases overwhelmed local health departments.
The Illinois Department of Public Health provided approximately $250 million in funding to local health departments to hire additional people to perform contact tracing during the pandemic, according to a spokesperson.
Cook County received $41 million from the state to beef up its contact tracing efforts, allowing the health department to hire 400 people. The city of Chicago received more than $50 million to boost its community-led efforts.
“When we’re dealing with a highly contagious and potentially severe infection or (one) that can provoke a severe illness we try to do contact tracing,” said Dr. Rachel Rubin, co-lead and senior medical officer at the Cook County Department of Public Health. “With COVID, because it was an emerging infection and we didn’t know how it would work and manifest itself, (we) needed to be doing contact tracing.”
But as the coronavirus pandemic enters an endemic phase, contact tracing will become more targeted, according to officials.
“(When) we look ahead, we’re not going to be investigating every case,” Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, said in an interview with WTTW News.
Instead, resources will be focused on cases involving new variants, schools and high-risk settings, like long-term care facilities and other congregate settings, as well as other outbreaks, according to Arwady. “We’re going to be making sure we are putting extra resources into anything unusual.”
As part of its efforts to stamp out the coronavirus, the city of Chicago picked the Chicago Cook Workforce Partnership to spend $56 million in state and federal funds to hire 600 people to conduct community-level contact tracing. The city allocated an additional $28 million to fund case investigation and contact tracing efforts at partnering Chicago-based federally qualified health centers, hospitals and the Ambulatory and Community Health Network of Cook County through July 31.
After initially focusing on contact tracing, the community-level program expanded to focus on COVID-19 vaccinations once they became available, with workers helping schedule appointments, as well as manning vaccination clinics and the city’s COVID-19 hotline, according to Susan Massel, chief of communications and external affairs for the partnership.
Workers have also stepped up to help address vaccine hesitancy with outreach and door-to-door campaigns focused on Latino and Black Chicagoans, according to Patrick Stonehouse, a director of public health operations at the Chicago Department of Public Health who’s been working with the community-level contact tracers. So far, workers have knocked on approximately 19,000 doors through those outreach efforts.
“They’re incredibly inspiring, hard-working and thoughtful,” Stonehouse said, adding workers were eager to take on new tasks as the pandemic evolved. “That kind of willingness and determination is amazing to work with.”
More than 800 people have been employed via the program since its launch last year, with 612 working at its height, according to Stonehouse. Currently, around 500 people are employed through the program, which has been extended by the city’s health department through the end of the year.
Of the 349 no longer working with the corps, the vast majority – 71% – left for other job opportunities, according to Stonehouse, who said 101 people had been terminated for various reasons out of 807 hires. Some former corps employees have been hired by both the health department and the Chicago Cook Workforce Partnership, according to Stonehouse and Massel.
Next month, the Chicago Cook Workforce Partnership will hold a job fair those still working as part of the program with CDPH.
“We didn’t just want this to be a job,” said Massel. “We’ve got an unbelievably talented and emphatic and smart group of men and women from all walks of life that really reflect the city. … They have the skills any employer would want.”
Program participants are also briefed about open positions within the health department and other city departments during weekly meetings, according to Stonehouse.
The Cook County Department of Public Health is also in the process of winding down its contact tracing program, which was scaled down to about 100 workers after state funding ran out at the end of 2021, according to Rubin.
“Our contact tracers do a tremendous job. I can’t say enough about the folks we’ve trained and those who’ve stuck with us this last year and a half,” she said. “We are hoping to continue the program in a redesigned fashion through the end of the year.”
The loss of state funding came as the omicron variant began its rapid spread locally and as the Illinois Department of Public Health began working to centralize its COVID-19 contact tracing efforts, with IDPH taking the lead on most cases to decrease the load on local health departments.
“Contact tracing any and everybody has lost its usefulness,” Rubin said, adding the department has focused its resources on high-risk groups, like people living in long-term care facilities and congregate settings, as well as schools. “The (state’s) surge center basically took over the direct case investigation and contact tracing of almost all the cases.”
That state surge center will take a more targeted role in tracing efforts than the previous efforts.
The Illinois Department of Public Health has contracts with both Agility One Outsourcing and Deloitte Consulting services to staff its contact tracing surge center, paid for with approximately $43 million in federal funds, according to an IDPH spokesperson.
“As the pandemic moves toward endemicity, we will wind down to only one contract and continuously assess the need to continue the contract for the contact tracing surge center,” IDPH said in a statement. “The number of people staffing the surge center fluctuates with the levels of transmission.”
While the state handles the majority of cases, local health departments can still access details gathered by the state contact tracing surge center in order to identify any potential clusters or outbreaks.
The city of Chicago isn’t part of the state contact tracing surge center’s efforts, according to officials.
When the city’s community-level program wraps up, officials plan to use the same model for broader longer-term health initiatives by working with individuals who live in communities to act as public health ambassadors, according to Stonehouse. These individuals will “really connect with people on all sorts of issues, especially those specific to certain neighborhoods like hypertension or diabetes,” he said.
State, county and city officials say as the pandemic evolves into an endemic, fewer contact tracing resources will be necessary, but both Rubin and Arwady hope it’s more than pre-pandemic levels.
“We are a dramatically smaller department than we were years ago. What we’ve seen (with the pandemic) is you can’t turn something on quickly if you don’t have enough of a base that’s always working toward public health,” Arwady said, adding health departments need funding that’s not tied to specific diseases. “The problem is how can anybody build a fully-prepared, well-functioning operation.”