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Could Mecklenburg County learn from a New Jersey city's contact tracing success?

Paterson, NJ credits persistence and policing in helping greatly reduce the spread of COVID-19 in the densely populated city.

MECKLENBURG COUNTY, N.C. — As Mecklenburg County struggles to get people to cooperate with COVID-19 investigations and contact tracing, the much more diverse, densely populated community of Paterson, New Jersey is finding a way to reach almost 90% of people who tested positive.

Just outside of New York City, Paterson has a large minority population, fewer high school graduates and more poverty than Charlotte, yet has become a national contact tracing leader. The city itself is much smaller than Charlotte and has far fewer COVID-19 cases.

"This is tedious work," City of Paterson Health Officer Dr. Paul Persaud said. "This is not easy to do. It takes a lot of work. It takes a lot of motivation and training also."

Dr. Persaud said his staff experienced the same hang-ups Mecklenburg County continues to face, but credits employees' persistence in helping them track down as many people as possible.

"People are always skeptical of giving information. We recognize that, but we have to be persistent and try to explain," he said. "We approach this in a very aggressive manner. When I say aggressive, we made sure if we call someone and we don't get them, we call until we find them. Persistence works. We continued to call. Our team's very dedicated and very motivated. We will not give up that easily."

The city's health department took it a step further. During Paterson's peak, Dr. Persaud sent community police officers out daily to drop off letters to people employees had trouble reaching. Those officers gently urged people to call the health department.

"Most of the time, we would get a return call," he said. "Some people would actually be angry that we sent the police. I sent police on a nurse, because a nurse was a contact and the nurse was actually working at a hospital. No one wants police to come to their house, but we were at a time when the disease was rampant in New Jersey, in Paterson, and we thought we had to get to these cases."

Dr. Persaud said the program has greatly reduced the spread of COVID-19 from a high of 262 new cases on a single day in April to just two new cases earlier this week.

Mecklenburg County Health Director Gibbie Harris recently shared her frustration about the difficultly investigators face reaching people and the lack of honesty from those who do cooperate. With a much younger population here and more cases in minority and immigrant communities, she's suggested either scaling back contact tracing or increasing enforcement. Her investigators are calling far more people every day than Paterson did and of those more than 800 daily calls, she said too many are not answering or failing to provide information.

"We're constantly trying to learn from others, but I haven't seen a particular place that's done it exactly the way we would want to do it in Mecklenburg and part of that is because every community is different," Harris said. "We try to learn from others, but then we have to tailor what we do to our community."

Mecklenburg County investigators aren't the only ones struggling to nail down where infections are originating and how they are spreading. North Carolina Health Secretary Dr. Mandy Cohen said it's a challenge statewide, 

"I definitely think improvement is needed," Dr. Cohen said.

She said it's important to continue focusing on prevention and continue working to better educate the public about contact tracing. She did not suggest enforcement as part of the solution.

"I think testing and contact tracing still have an important role in responding to this pandemic, but we are still having a lot of new cases every day, so it is certainly straining our local health departments' resources," Dr. Cohen said. "We continue to hire more staff to be able to respond to those efforts and to improve our ability to do contact tracing, but the other part of this for contact tracing is folks have to pick up the phone and have to work with our teams."

While Paterson has managed to track down most contacts, the city, which is much smaller, has significantly more deaths than Mecklenburg County. Dr. Persaud attributes those deaths to the pandemic hitting New Jersey harder early on and Paterson's vulnerable population. The majority of the city's 337 deaths occurred between April and June, according to data.

"I think it would be much worse if it wasn't for our contact tracing team," Dr. Persaud said.

For comparison, Mecklenburg County has 225 deaths as of August 5.

This story is part of WCNC Charlotte's partnership with the Charlotte Journalism Collaborative.

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