Florida’s contact search challenges indicate how difficult it is for Covid-19 states to find proper contact tracking, which is a challenge even in the best of circumstances. The virus is so present in countries such as Florida that it is a seemingly Herculean task to search for every infected person and monitor all their close contacts.

CNN spoke to 27 Florida residents, or members of their families, who tested positive for Covid-19. Of these, only five responded that they had received a call from the health authorities to request their contacts.

There are concerns about the trace of contact nationally, not just in Florida. In a June interview, CNN asked Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, how he thinks seeking contact is going in the United States.

“I don’t think we’re doing very well,” he replied.

What is contact search?

Contact tracking is a centuries-old practice, and the basics haven’t changed much: basically, health professionals ask infected people for a list of everyone they’ve been in contact with who are potentially contagious. The worker then tells these contacts to quarantine and watch for symptoms.

A spokesman for the Florida Department of Health in Miami-Dade County sent a statement to CNN asking for contacts in his state.

“When the Ministry of Health receives notification that a person has been tested positive for COVID-19, the department conducts an extensive epidemiological study together with [Centers for Disease Control and Prevention] identify people who may have had close contact with the virus. These individuals are then reported by the county health department and instructed to self-isolate 14 days after exposure to the virus, and if symptoms occur, contact their county health department and health care provider immediately. This process is monitored in all individuals who test positivity in Florida, “Olga Connor wrote in an email.

The number of contact traces in Florida is unclear

It is not clear how many contact trackers are employed in the state of Florida, as the spokesmen of the Ministry of Health gave CNN two different numbers.

“More than 1,600 individuals, including students, epidemiologists and other staff from across the Department, are currently involved in contact that monitors every positive COVID-19 case in Florida,” wrote Candy Sims, a spokeswoman for the Florida Department of Health in Broward County on CNN.

The department has hired a private company to hire an additional 400 contact trackers, Sims added.

But Alberto Moscoso, a health department spokesman, quoted a number more, writing to CNN that Florida has 2,300 “people involved in seeking contact.”

Sims and Moscoso did not respond to CNN’s inquiries about the differences in their numbers.

“Immediately notify people you have been in close contact with while you are ill,” the graphic message states that those contacts should be quarantined for 14 days.

In Florida, the infographic doesn’t explain what to do if someone tests for positivity for Covid-19, but has never shown symptoms. According to the CDC, in that case, people should be notified if they had close contact with an infected person two days before that person passed the Covid test.

5 out of 27 Florida residents received a contact request

Of the 27 Florida residents who tested positive for Covid-19, five told CNN they had received a call from a health official asking for their contacts.

Among the 27 cases, the earliest diagnosis was in February, and the most recent last week.

Riveras contracted Covid in early March, when contact trackers were under much less pressure than they are now. Shaila Rivera said a Miami-Dade County Department of Health official called and asked questions about her illnesses, but did not ask about their contacts.

“We were surprised,” said Rivera, a pediatric nurse. “The whole conversation lasted less than a minute. There was no question as to who you had contact with? Did you go to work? None of that.”

Eleven others out of 27 said they, like Riveras, received calls from a Florida health official but were not asked for their contacts.

David Pugh, who lives in Broward County, said he received such a call.

“I don’t know we can count on the state to do a thorough job. I think there are obviously flaws in the system,” he said.

Doubts about the usefulness of looking for contacts

The contact search has been conducted since the first case in the U.S. more than five months ago, and there are several reasons why it has failed to contain the epidemic.

“How do you establish a contact search if someone has no symptoms?” Fauci said in an interview with CNN. “The standard, classic paradigm of identification, isolation, contact search doesn’t work no matter how good you are because you don’t know who you’re looking for.”

He also said some people are reluctant to talk to government officials.

“The dots aren’t connected because a lot of things are done over the phone,” Fauci said. “Fifty percent of the people because you come from power don’t even want to talk to you.”

In addition to these problems, some experts doubt the usefulness of seeking contacts in areas such as Florida where cases occur.

Epidemiologist Michael Osterholm has called on Florida leaders to focus on other strategies, such as finding where the virus is spreading.

With thousands of new cases a day in Florida, Osterholm doubted that seeking contacts would have much effect.

“If Florida could return less than 50 to 100 cases a day, seeking contact could be helpful. But for now, it probably won’t have a measurable impact,” he said. “It’s like trying to put out a forest fire with one fire truck. It just won’t make a dent.”