In summary

Given California’s rich cultural diversity, the state needs contact tracers that are able to speak with patients in their native language and with cultural sensitivity.

By Anthony Iton, Special to CalMatters

Dr. Anthony Iton is senior vice president of the California Endowment, tony@tonyiton.com. He has a medical degree from Johns Hopkins University School of Medicine and a law degree from the University of California, Berkeley. Follow him on Twitter @dr_tonyiton.

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As California’s daily COVID-19 case count surpassed 11,000 for the first time, it is clear that the state is by no means out of the woods with this pandemic.

Despite new and needed statewide mask orders, the hard reality is that until we have fortified our public health infrastructure to effectively manage this disease until there’s a vaccine, more Californians will get infected, be hospitalized and die from COVID-19.

And because this pandemic is disproportionately wreaking havoc on communities of color, we will continue to lose more Black and Brown lives.

When the virus first struck the nation at the beginning of the year, state and local leadership, following public health experts, not only allowed us to get ahead of the rest of the country and flatten the curve at the start of the pandemic, but to avoid a surge in deaths. And it is public health expertise that will help us manage the next equally dangerous phase of this pandemic.  

One of the most powerful tools in our arsenal is contact tracing. But if we want to get it right, we have to create a contact tracing army that matches the demographics of the folks most affected.  In California, that means we must invest in contact tracing that is led by people of color.

Based on my experience running Alameda County’s public health department, one of the nation’s largest, I know that contact tracing works. Contact tracing has successfully managed the spread of tuberculosis and sexually transmitted diseases, and played a critical role in stopping the spread of diseases like Ebola and SARS. And it works best when it utilizes contact tracers that are from the very communities that are most impacted by disease. 

In contact tracing, tracers work with a patient to help them recall everyone with whom they’ve had close contact during the timeframe they may have been infectious, and help safely manage their interactions thereafter. It requires building trust between the contact tracer and the patient. And given California’s rich linguistic and cultural diversity, it requires contact tracers that are able to speak with patients in their native language and with cultural sensitivity.

The coronavirus is tearing through Black and Brown communities in California like a heat-seeking missile. These communities are more likely to be uninsured, low income and often harbor a great deal of suspicion, if not outright mistrust, of government authorities, even ones focused only on health. Culturally incompetent contact tracers will risk worsening this epidemic by driving these communities underground and away from quarantine, isolation and care.

Investing in a new contact tracing workforce is about investing in our future and in national security. It isn’t just about addressing COVID-19, but planning for the next national emergency or global pandemic. 

For decades, public health leaders have witnessed investments in public health infrastructure and workforce dwindle. In fact, core funding for disease prevention and health promotion programs has declined by $580 million federally and has remained flat in states since 2010. COVID-19 made it clear that we do not have the proper infrastructure to address a global pandemic, which forced our economy to grind to a sudden and devastating halt.

Investing in a new contact tracing workforce is also about California’s economic recovery and ensuring those most impacted by COVID-19’s economic impact are not shut out.  We now have thousands of newly unemployed workers who can quickly fill contact tracing jobs with the adequate training and consideration.

Our recent polling shows that a majority of Californians are aware and supportive of contact tracing, but we now need federal and state resources to fund contact tracing at scale.  And it can’t just be one-year funding, it has to be stable funding for the next two to three years so local public health departments can invest in building a strong workforce. We also need state leaders to provide policies that facilitate the hiring of contact tracers of color, because we know if this is not an explicit ask, people of color will be left out.

If this pandemic has revealed anything, it is that Black, Brown, Asian American-Pacific Islanders and immigrant Californians are the backbone of our state. They helped keep our state running during the pandemic and it’s crucial they help lead us out of it.

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