Contact tracing: Disease detective work that helps keep the community safe
By Mary Wade Burnside
Provided you don’t hang up, the contact tracer, such as the ones at Monongalia County Health Department who sprang into action in March, will have some questions for you about what you might have done during a specific period of time.
“What I do is go through each day and ask them questions about their day, ‘Did you work?’ ‘Did you go out?’ ‘Did you run errands?’ This tends to help them jog their memory,” said Jennifer Goldcamp.
Goldcamp is the director of nursing at MCHD Clinical Services, which was closed to most patients during the first 2 ½ months of the pandemic. Goldcamp and her fellow nurses became MCHD’s lead investigators and contact tracers, with help from additional employees, including a temporarily hired emergency department nurse and MCHD’s regional epidemiologist, Dr. Diane Gross.
Usually the calls go smoothly, but sometimes they can be tricky. “Some people can be reluctant to talk about personal matters.” Goldcamp said. “People forget things. I understand that. I can’t always remember what I did yesterday.”
And, she added, “When they are called, they can feel put on the spot and get rattled. Some people are embarrassed and feel like they are in trouble.”
But nothing could be further from the truth. Everyone is in this pandemic together.
“We’re not out to punish anybody,” she said. “We are just trying to stress the importance of isolating and quarantining to protect you and the people in the community.”
Finding people can also take some time. “In certain cases, we only have pieces of information such as parts of names or just an employer.”
Once communication is established, contact tracers continue to make daily calls or initiate a text system to monitor symptoms. This monitoring is not only to individuals who tested positive, but also to their contacts.
“We follow positives daily for 10 days and their contacts for 14 days,” Goldcamp said.
Of course, if a contact develops symptoms, the clock resets to prevent further spread of the virus.
In the experience of Monongalia County Health Department, one positive individual can have anywhere from 1 to 20 contacts with whom an MCHD employee needs to follow up.
Contacts of contacts generally aren’t traced because the risk is low. But figuring out who is a contact takes some questioning.
“Someone will say, ‘I said hello to my neighbor at the grocery store,’” Goldcamp said. “I wouldn’t necessarily be worried about that since it would be a short amount of time,” especially if they were wearing masks.
Sometimes it is difficult to track individuals down, and that’s when a group of employees will suit up in N-95 masks, eye protection and maybe gloves to go out and locate those who couldn’t be reached by phone.
“We had to do that about seven times,” said Joe Klass, MCHD Threat Preparedness specialist. “Five of those cases were new phone numbers or people not understanding what was required of them.”
Once MCHD located them, they realized the importance of the quarantine and kept in touch with MCHD while they were being monitored.
The first few months of the pandemic “was a flurry of activity,” Goldcamp said, quoting MCHD executive director and county health officer Dr. Lee B. Smith when he said, “We’re building the ship as we sail it.”
Now that it’s June, Goldcamp can view the experience so far with more perspective. “For the most part, people took it seriously and stayed home,” she said. “They were smart about it and it didn’t overburden hospitals.”
Cases in Monongalia County were rising slowly until the last week or so, and other areas of the state and the country are experiencing a surge in cases. Goldcamp knows that no matter what happens, activity will be ramping up in the next few months. That’s because MCHD Clinical Services be providing back-to-school vaccines and, in the fall, flu vaccines.
And as West Virginia University tests about 35,000 students, faculty and staff members in July and August, MCHD will jump into the fray again, performing contact tracing for any positive cases that may result.
“It’s just the beginning of what we’ve gone through,” Goldcamp noted.