Virus detectives: Routt County contact-tracing team one of most effective strategies to containing COVID-19
STEAMBOAT SPRINGS — When a surge of positive COVID-19 cases came across the desks of Routt County public health officials in June, it was up to a local team of contact tracers to protect the community.
At the time, the county reported 10 new positive cases in a single week, a relatively high number for the population. David Wallace, a co-leader of the contact-tracing team, remembers making a flurry of phone calls to people who recently had come in contact with the infected victims. As more cases kept coming in, many of them were in some way associated with previous cases.
“It was like, is this ever going to end?” Wallace said.
A race against the clock
The task was an arduous one. Wallace and his team had to act quickly to respond to the spike in cases. The more time that passed, the further the virus could spread. The county established a pop-up testing station just to handle all of the close contacts the local tracing team had identified.
Some of the people who tested positive already had traveled out of state and attended large gatherings. A group of younger county residents admitted to having several get-togethers for backyard BBQs or volleyball games.
Wallace remembers having a lot of frank conversations with them about the health hazards their heedless behavior posed to their friends, family and others in the community.
It became a literal wakeup call for the people with whom Wallace spoke. They understood firsthand the importance of following the 6-foot social distancing guideline that has become a slogan for public health.
“It was good to see, even though it did create a lot of work for us,” Wallace said.
How contact tracing works
Contact tracing is not a new practice. Health officials regularly use it to track cases of other infectious diseases, like tuberculosis or HIV, explained Routt County Interim Public Health Director Roberta Smith.
The local contact-tracing team consists of nine county residents. Some of them have prior public health experience, but others just wanted to help the community. One of the team members speaks Spanish, and other translators are available to bridge any language gaps. Initially, the work was all volunteer-based, but by July the county made it a paid position due to the increasing workload.
In the fight against COVID-19, contact tracers act like virus detectives. They use whatever clues are available to trace the spread of the disease. This involves identifying people, known as who could have contracted COVID-19. The Centers for Disease Control and Prevention refer to these people as ‘close contacts,’ defined as anyone who spent 15 minutes or longer within 6 feet of a positive case.
The goal, Smith explained, is to notify close contacts and tell them to self-isolate before they potentially spread the virus.
Here’s how it works.
Say two people, a man named Jerry and a woman named Catherine, attend a dinner party. A couple days later, Jerry gets sick. He gets a COVID-19 test, and it comes back positive.
Jerry then gets a call from a Routt County Public Health contract tracer notifying him of the test results. He must self-quarantine for a minimum of 10 days, which is the average time it takes for the virus to leave the body after symptoms start, according to Smith. The contact tracer also asks about other people with whom Jerry has been in close contact recently.
Jerry tells the contact tracer about the party and lists the people who attended, including their contact information. Of note, all of the information that Jerry provides remains confidential. The contact tracer is not allowed to tell close contacts that Jerry might have exposed him or her to COVID-19 or that Jerry tested positive.
Catherine then gets a call from a contact tracer who notifies her she might have been exposed to the virus. She gets tested and self-isolates for 14 days, which is the time it takes for symptoms to develop. If the test comes back negative and Catherine does not get sick, she no longer has to isolate.
If the test comes back positive, Catherine must self-quarantine and provide a list of her close contacts in addition to seeking any necessary medical attention.
The nature of such calls requires a certain level of compassion, said the Routt County contact tracing team’s other co-leader, Tracey Melton. As she explained, some people are embarrassed to learn they have COVID-19 due largely to stigmas surrounding the virus. Others feel like they did something wrong.
Establishing trust and making the person comfortable are necessary to get the information Melton needs to protect the community.
Every investigation is different, Melton said, and there is a lot of work behind the scenes before she makes a phone call. Sometimes it’s as easy as calling the household of a positive person. If he or she already has been isolating, Melton might only have to speak with the people who live there. Other times, she has to reconstruct the person’s life over the previous days and weeks to compile a comprehensive list.
Results of a positive case could arrive at any moment. That means either Melton or Wallace, the two co-leaders, must be ready to take a call 24/7. The more cases that arrive, the longer it takes to conduct contact tracing.
“We may be working for 15 minutes, or we may be working all day or night,”Melton said.
The good, the sad and the funny
After making so many calls in recent months, the team of contact tracers has amassed a collection of memorable conversations that range from humorous to heartbreaking.
Wallace remembers calling a local restaurant where all of the employees were potential close contacts. The restaurant only had one landline phone, so about 20 employees formed a line that stretched outside and across the porch of the establishment. One by one each employee got on the phone and answered Wallace’s questions.
“About half of them turned out to be close contacts and needed to quarantine,” he said.
On a more somber note, Theresa Harrison recounted how the first person she called as a contact tracer, back when she started the job in July, was a woman in her late 80s. As Harrison notified the woman about she might have contracted the virus, Harrison thought of her own mother who is around the same age. While she could not see the woman on the other end of the line, Harrison could only imagine the woman’s concern.
“You feel so bad for that person because they are the most vulnerable,” Harrison said.
While some people are hesitant to give the personal information necessary to do contact tracing or might prefer to call close contacts on their own, Harrison said the vast majority are cooperative.
“We do our best to make it as easy as possible and as friendly as possible,” she added.
A major part of Harrison’s training for the job focused on how to talk with people about the situation. She and other contact tracers also completed a confidentiality course that discussed how to properly protect people’s personal information.
Again, most people the contact tracing team contacts understand the importance of the call and answer the questions without issue.
- All contact tracers are trained in how to manage health and other sensitive information in order to protect your privacy.
- The public health worker who contacts you will state their name and their organization. They should provide you a number to call back to verify their identity and contact information for their supervisor when the caller requests it.
- Public health will never ask for your social security number or financial information. If a caller asks for this information, do not give it.
- Currently, public health will not be going door to door to conduct contact tracing. For the foreseeable future, all contact tracing for COVID-19 will be over the phone or through secure online forms.
- Only certain people at your local public health agency and the state health department can see your information. It is only used to reach out to your contacts with important information about testing and next steps. Public health will not share your information with other entities or outside organizations.
- Public health does not share your health or personal identifying information without your permission.
- Public health stores records securely.
Elsewhere in the state, fraudulent calls have complicated legitimate COVID-19 response work. Earlier in the week, Boulder County Public Health warned the public about reports of contact tracing scams. Multiple people said they received calls from someone claiming to be a public health employee and asking for a credit card number to buy a COVID-19 test.
According to the state health department’s website, contact tracers never will ask for the following information:
- A social security number or financial information
- A payment of any kind
- Proof of residency
To confirm the call is legitimate, people can contact the Routt County Public Health Department at 970-870-5577.
A long road ahead
Contact tracing has proved to be one of the most most effective strategies to contain the COVID-19 pandemic. Tracing efforts in Boulder County were instrumental in achieving declines in cases following a spike earlier in the summer, according to public health officials.
“It’s truly one of the most critical tools that we have in the toolbox for preventing disease transmission in our community,” Carol Helwig, a communicable disease program manager for Boulder County Public Health, told 9NEWS in July.
Until a vaccine or effective treatment arrives, contact tracing will continue to be a major component to Routt County’s public health protocols. The local tracing team might see some heavier workloads in the months ahead as officials warn of a spike in cases come cold and flu season.
At a Routt County Board of Health meeting Wednesday, Dr. Brian Harrington said the county’s disease prevalence was at a “relatively stable and at a high moderate level.” He and other health officials emphasized the importance of following health protocols to keep case counts low and continue a road to recovery. If cases rise to a high enough level, local or state leaders could impose tighter restrictions.
With that in mind, Roberta Smith, the county’s interim public health director, advises people to continue practicing social distancing, wash their hands, limit contact with others and to get a flu shot as soon as possible.
“These are all tools we have to hopefully decrease the spread of virus in our community,” Smith said. “That way a contact tracer doesn’t have to call you.”
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