A Framework for Sustainable Contact Tracing and Exposure Investigation for Large Health Systems

Contact tracing is a cornerstone of communicable disease containment and involves identifying, quarantining, and monitoring contacts of infected people. Although contact tracing is a known evidence-based strategy in the community setting, the COVID-19 pandemic highlighted the challenges to implementing labor-intensive contact tracing in the occupational setting of large health care systems and hospitals, the epicenter of the pandemic. We present a framework for feasible, scalable COVID-19 contact tracing in a large multistate health system in the United States employing approximately 69,000 health care personnel. The framework is shared with sufficient details to allow adoption or adaptation by other health systems. Continuous enhancement, optimization, and evaluation of the framework are ongoing.