# Workforce expansion

While contact tracing is routinely performed to control STDs, TB, and other communicable diseases, local health departments have limited front-line workforce (e.g., epidemiologists, disease intervention staff, public health nurses) to support contact tracing at the scale and pace of COVID-19. The [CDC provides resources](https://www.cdc.gov/coronavirus/2019-ncov/php/open-america/staffing.html) for training and supplementing existing staff for ongoing and surge support.

### Population-based estimates

For contact tracing to be effective, every diagnosed case must be investigated, which means the contact tracing workforce must be capable of responding quickly even during surges. [Find the number of staff you’ll need](https://preventepidemics.org/coronavirus/resources/contact-tracing-staffing-calculator/) using this calculator provided by public health organization [Resolve to Save Lives](https://resolvetosavelives.org/), and review additional estimates below.

| **Source of estimate**                                                                                         | **Estimated number of contact tracing staff per 100k population** |
| -------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------- |
| Massachusetts/Partners in Health (initial staffing, which PIH believes will need to be increased subsequently) | 14                                                                |
| Johns Hopkins/Association of State and Territorial Health Officers                                             | 30                                                                |
| Resolve to Save Lives                                                                                          | 100                                                               |

### Roles needed

| **Role** | **Who can fill** | **Description** |
| -------- | ---------------- | --------------- |

| **Contact tracers** | <ul><li>Local lay people trained and supervised by disease intervention specialists</li><li>Volunteers from academic public health community</li></ul> | <p>Communicate with contacts to gather data and inform about quarantine procedures.</p><p>May work remotely during shelter-in-place (e.g., one-on-one phone interviews or text-based messaging services) or in-person.</p> |
| ------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------ | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |

| **Case investigators** | <ul><li>Community health workers</li><li>Disease intervention specialists</li><li>Nurses</li></ul> | <p>Interview confirmed or suspected COVID-19 cases.</p><p>Interview newly diagnosed cases to determine period of infectiousness, elicit contacts, and identify clinical and other resource needs.</p><p>Delegate appropriate administrative work to contact tracers (e.g., finding contact information, reviewing isolation and quarantine recommendations and resources)</p> |
| ---------------------- | -------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |

| **Care resource manager** | <ul><li>Social workers</li><li>Case managers</li></ul> | <p>Arrange wrap-around services (e.g., food, medication delivery) for cases and contacts in isolation or quarantine.</p><p>Provide incentives, food, or referral to programs that provide financial assistance.</p> |
| ------------------------- | ------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |

| **Clinical consultant** | <ul><li>Nurses</li><li>Nurse practitioners</li><li>Physicians</li></ul> | Provides clinical support to case investigators or contact tracers if cases/contacts become symptomatic or require referral to the hospital. |
| ----------------------- | ----------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------- |

| **Data analyst** | <ul><li>Local lay people trained and supervised by disease intervention specialists</li><li>Volunteers from academic public health community</li></ul> | Data monitoring and analysis |
| ---------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------ | ---------------------------- |

| **Data entry technician** | <ul><li>Local lay people trained and supervised by disease intervention specialists</li><li>Volunteers from academic public health community</li></ul> | Careful data entry, review, and correction |
| ------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------ | ------------------------------------------ |

![](https://2141157483-files.gitbook.io/~/files/v0/b/gitbook-legacy-files/o/assets%2Fcontact-tracing-cookbook%2F-M6Y3SpY3FC-ogx3MMfC%2F-M6Y4FUgnmwc3ogzmNu0%2F0.png?generation=1588652741355281\&alt=media)

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