COVID-19: Contact Tracing
By Emily Sheng
As many states reopen from COVID-19 closures, scientists and public health officials are saying that there needs to be more contact tracers. A recent survey done by the National Public Radio determined that only seven states and Washington D.C. have enough contact tracers. Pennsylvania is estimated to need 4,000 more contact tracers with 2,000 based in the Philadelphia region.
But what do contact tracers actually do, and what makes them so important?
Who are Contact Tracers?
Contact tracers are members of a public health team working to investigate the spread of COVID-19 in a community. A contact tracer can be a paid employee or a volunteer. Most positions only require a high school degree and a passion to help the community. This summer, many contact tracers were college students, retired healthcare professionals, and those who recently lost their jobs.
The contact tracing process begins when a person goes to get tested for COVID-19. If a person tests positive for COVID-19, their name gets reported to the local health department and entered into a secure database as a laboratory confirmed case. The main function of contact tracers is to then reach out to those who may have been exposed to the person who tested positive. These people are called closed contacts and are defined to be those who have been within six feet of a confirmed case for more than 15 minutes.
A contact tracer will call the confirmed case and read off a script provided by the local health department. These calls typically take between 15 to 45 minutes. The script begins by confirming the identity of the close contact. If the contact is less than 18 years old, the contact tracer asks to speak with a parent or guardian. After this step, the contact tracer directly tells the person that he or she has been exposed to the coronavirus in the last few days. However, confidentiality is vital so the contact tracer cannot tell the person who exposed him or her to the virus.
The next step is to provide a brief summary of what COVID-19 is, how it can spread, and what the common symptoms are. Following this explanation, the contact tracer asks the contact if he or she has experienced any symptoms like a fever, chills, muscle aches, cough, shortness of breath, new loss of taste or smell, and others. If the respondent says yes to any of the symptoms, he or she is considered symptomatic. Otherwise, the respondent is asymptomatic. This determination is crucial for deciding whether the person should self-isolate or quarantine and for providing other instructions.
But isn’t self-isolation and quarantine the same thing?
Self-isolation is used for those who show symptoms while quarantine is for those who are asymptomatic. Both policies involve staying at home and practicing actions to protect others (including washing hands and wearing face masks) but isolation ends only when symptoms generally improve and not after a certain number of days. Only those who are symptomatic are told to get tested for COVID-19.
Helping the Community
Since both quarantine and self-isolation require many resources— like access to food without leaving your house, cleaning supplies, and separate living areas— the contact tracer asks the contact whether they need help in getting any of the required resources. For example, if a contact says that he can’t stay at home everyday since he has to go to work, the contact tracer helps by directing him to a state resources website like https://www.211colorado.org/covid-19/ that explains job protections.
The call ends with the contact tracer asking if the contact has any more questions regarding quarantine or self-isolation and thanking the contact for answering the call. Through this call, the contact plays an important role in stopping the spread of COVID-19 by learning what symptoms he or she can possibly develop and what actions to take to not spread the virus to loved ones.
The Challenges in Contact Tracing
As you can tell, the script that contact tracers read off of is long and repetitive! There are many obstacles to contact tracing that make it so difficult. One of the most important factors is time. Many people have busy schedules and simply can not pick up the phone when contact tracers first call them. If this happens, contact tracers will leave a voicemail message and hope to reschedule the call for a more convenient time. Another factor is the lack of trust between the contact and the contact tracer. The contact tracer can try to build trust by assuring the person that all information is only used by the public health department and will not be shared to any other governmental authority like Immigration and Customs Enforcement. Lastly, there can be a language barrier between the contact tracer and the contact that would require the help of an interpreter.
Contact tracers tell people that they can develop COVID-19 and explain to them how to protect their community by quarantining or self-isolating. All these reasons make contact tracing so important to our community in the fight against COVID-19!