Infections were never Joachim Lazarek’s specialty. People are. But when the new coronavirus swept into Würzburg, Germany, in early March, the 39-year-old social worker found himself on the front lines fighting it as one of the city’s scores of contact tracers.

It’s like detective work: When someone in Würzburg tests positive for the virus, Lazarek conducts interviews to follow any trail of illness the person might have left in their wake, getting in touch with their contacts to advise them to quarantine and keep a diary of their health and anyone they meet.

“We try to understand the person at the other end of the line and get a picture of their whole lives,” Lazarek says. “Did you talk over the fence with someone? Were you at the doctor? Were you walking with your partner?”

Unlike the U.S., the U.K., and most other countries, Germany never gave up on contact tracing even as infections ballooned. Thanks to some of the world’s toughest privacy laws, the country’s 375 local health authorities couldn’t rely on digital surveillance for help. Instead, they recruited teams ranging from medical students to firefighters, who work via e-mail, telephone, and sometimes even fax. Their success is a key reason Germany has about a third the number of coronavirus deaths per capita as the U.S.

Germany’s tracing and testing put it in a good position to suppress any new infection clusters that pop up as it emerges from lockdown, according to Mike Ryan, executive director of the World Health Organization’s emergencies program. “Shutting your eyes and trying to drive through this blind is about as silly an equation as I’ve seen,” Ryan said in a May 11 briefing. “Certain countries are setting themselves up for some seriously blind driving over the next few months.”

As the U.S. boosts efforts to follow the infection’s path through communities, it will need more than 100,000 people like Lazarek to man the phones and hit the pavement—at a total cost in the billions. New York City says it plans to hire as many as 10,000. In Massachusetts, more than 45,000 people applied for some 1,400 jobs as contact tracers. New Jersey plans to hire at least 1,000 to supplement the work of 900 local health officials. All three states have cited Germany as a model.

Germany has been “very aggressive in their contact tracing,” New Jersey Commissioner of Health Judith Persichilli told reporters last month. “Their experience can inform our efforts as we look ahead, to ease some of our social distancing restrictions.”

Würzburg, a city of 130,000 about an hour east of Frankfurt by car, offers a case study in the effectiveness of low-tech contact tracing. The first two virus infections emerged on March 4, in people who had just returned from Italy. Before testing positive, they visited local relatives—and by March 5, three more family members were infected. The health authority staff started making calls.

While they had some experience with pandemic response from swine flu, it quickly became clear this would be on a different scale. New cases kept emerging: a young couple, a student and teacher who had been in the Alps, a handful of other schoolchildren, and a university employee who commuted into the city. Most worryingly, the virus emerged in the Ehehaltenhaus-St. Nikolaus nursing home. On March 12, an 83-year-old resident of the facility became the first person in Bavaria to die from the virus.

The health authority for Würzburg and the surrounding region soon realized there were too many cases for its staff to track, so the group started pulling in people from other departments. Lazarek, who worked with mentally ill adults, joined the team on March 9. “Covid-19 patients became everybody’s main job,” he recalls.

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