Should contact tracing be a state responsibility?
Both Australia and the USA are federations of self-governing states, and like the rest of the world, both have been impacted heavily by COVID-19. While the pandemic has affected states differently in both countries, contact tracing has been a state responsibility. But I wonder, is that the way contact tracing should be done? When you look at unitary states such as South Korea and Singapore, where contact tracing is a national responsibility, those nations have fared better than most in bringing their case numbers under control?
When case numbers explode as the infection rate gets out of control contact tracing resources become overwhelmed, feeding further growth in case numbers. It seems when this happens, the only way to bring the situation under control is a hard lockdown. Which we all know (and have unfortunately experienced) brings the economy to a screeching halt, causing immediate and long-lasting economic damage. We have seen this recently in the Australian state of Victoria where infection rates took off almost overnight and contact tracing struggled to keep up. Neighbouring states have been able to hold case numbers and their economies are largely open. But the economical damage has already been done with Australia now officially in recession. A similar pattern exists across the USA.
When thinking about COVID-19 the following seems true:
- The coronavirus will be with the world for the foreseeable future. Outbreaks are to be expected and they can occur anywhere at any time, and when they do they may not be restricted to a major city that is well away from a state border.
- Infections can become clusters, which can become outbreaks, and all this can happen in days unless contact tracing is immediately done to a high degree of proficiency.
- Outbreaks that span state borders will require a coordinated, nationally consistent approach to contact tracing.
- Whether outbreaks span state borders or not, the economic impact is national, as we are now seeing with Australia’s ‘second wave’ in the state of Victoria.
Federal governments have responsibility for the defence of the nation, whether it be defence against a foreign actor or a plague that does not respect state boundaries and that threatens the lives and livelihoods of its citizens. States in Australia and the USA no longer run their own military and it seems silly to think they should do so for a risk that, like foreign invasions, only happens infrequently.
Now you could observe that the states are responsible for managing responses to natural disasters such as fire and flood, so why not also contact tracing for COVID-19? But fire and flood are perpetual seasonal risks, the response to which requires coordination of physical resources on the ground. It is logical that they be coordinated locally by the states, even though fires and floods can also span state borders. But contacting citizens who may be close contacts of an infected person (possibly located in another state) does not need to be a state-based activity to be effective, in principle — no different than collecting federal taxes providing federal social services.
What does a national approach to contact tracing require?
A communications system (aka a cloud contact centre system) that can be ramped up and down instantly, as and when required, and that can support campaign-based outbound communications via voice and digital channels.
A data management system for capturing and analysing contact details and that is integrated with the nation’s testing laboratories to accelerate and error-proof the process.
A knowledge management system that is kept up to date with instructions on how to use the communications and data management systems, and how to perform contact tracing processes and procedures effectively and compliantly so as to reduce the need and time to train people who may be urgently and unexpectedly co-opted into the job.
The three components above should be cloud-based so they can be instantly ramped up and down and deployed instantly to wherever in the federation they are needed to combat a fresh outbreak.
Contact tracing should be a national priority similar to the Army Reserve, and federal governments should assume responsibility for something that is patently theirs to provide to the nation, by implementing a best-of-breed approach to the three vital components listed above and make it part of the national pandemic readiness plan.
- Returning to a changed workplace
- Contact tracing is a very tough job – especially without good guidance