Pastor Matt Johnson speaks with a woman who came to collect a food donation, during the spread of the coronavirus disease (COVID-19), at One1Seven evangelical Anglican church in Sydney, Australia, April 17, 2020.
Contact tracing is detective work for infectious diseases: when a person is confirmed sick, it’s used to determine who else might be at risk.
Some US states are contact tracing all their confirmed COVID-19 cases, and some aren’t.
Here’s what it might sound like if a contact tracer called you up, to let you know you’d been exposed to someone who tested positive for COVID-19.
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What does it sound like when a disease detective comes calling, telling you that you might have caught someone else’s COVID-19 infection, the illness caused by the novel coronavirus?
“Hello, Hilary. My name is Daniel. I work at the Vermont Department of Health. Do you have about five to 10 minutes that we could talk? Is now a good time?”
This is how Daniel Daltry, a public health contact tracer and program chief at Vermont’s health department, starts a lot of his contact tracing phone calls these days.
“Is anyone around that you wouldn’t want to be speaking in front of?” he asks me. “Can I take just five minutes of your time, maybe?”
“Sure,” I reply.
Daltry’s working quickly, and as a contact tracer, his task is two-fold.
“I work here at the Vermont Department of Health and I get a chance to interview people, talk with people that have just been diagnosed with COVID,” he says. “After talking with those individuals about what they’ve experienced, I help them to think about who might be most at-risk for contracting this, because they’ve come in contact with them. During this conversation that I had, you were identified potentially as somebody that has been put at risk for having been exposed to COVID.”
There’s a long pause on the line, as Daltry waits for me to process what’s just been said. It can be scary, shocking, or confusing to be on the receiving end of his call.
I feel my heart racing.
“I want to come up for air at that moment, because I’ve just put a lot of information on their plate,” he says. “I have to be responsive, I have to try to feel or empathize with what it is they might be feeling. And I don’t have a ‘catch feeling’ to have. I’ve got to be open and present to each and every individual that I serve, because everyone’s gonna have their own reaction.”
Contact tracers work quickly to notify people that they might’ve been exposed to COVID-19
Daltry says the opening three minutes of the call are “make or break time” to connect with a contact. Usually, things go well.
A health emergency call center in Bogota, Colombia, April 1, 2020.
“I don’t want to say too much, I don’t want to say too little, but I also want to get to the top agenda item while I have their chance,” he says.
Time is of the essence, because the first 48 hours after an infected person develops symptoms are crucial for halting the spread of the virus, preventing more people from getting sick by putting any potentially exposed contacts (like me) in quarantine, preventing me from infecting even more people in the community.
Daltry says because of this time crunch, once a patient is identified as COVID-19 positive, anyone who they’ve had sustained contact with in the two days before they developed symptoms and got tested should be notified immediately by contact tracers, that same day. Sometimes, an infected person’s contacts number in the dozens, and notifying everyone becomes a massive undertaking, requiring multiple tracers on the phone.
If a contact is already feeling ill, especially if they’re older or medically high risk, Daltry would recommend they go get tested swiftly.
On our call, I say I’m feeling alright, and we wrap up the chat. If this were a real life scenario in Vermont, however, I’d now be one of the 30 people being “monitored” for COVID-19, and would be asked to stay home, isolate, and monitor myself for symptoms for 14 days, starting the countdown from when I last had contact with the now-sick person. (In places with widespread disease transmission, this kind of tracing work isn’t as useful, because everyone could reasonably assume they might’ve been exposed to the virus, and everyone is already being urged to stay home and isolate themselves.)
“Hilary, the information that I’ve given to you today, it’s in relation to your risk of potentially contracting [COVID],” Daltry says, readying to end the call.
“At this point, I wouldn’t tell you that you now have to go out and tell anyone that you might … we don’t know if you’ve had this. You and I had a little bit of a chance to talk about your symptoms. Right now, you are not feeling anything, and hopefully you’re going to continue not to feel anything, but until you either have symptoms that are suggestive of, or until you have a positive test, I would not encourage you to go around in telling people that you have it.”
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