Life of a contact tracer: Unique job for a unique time
Sep 29, 2020 10:30AM
By Shaun Delliskave
Keesha Lafoe, contact tracer for the Salt Lake County Health Department, examines her next case in EpiTrax. (Photo courtesy RaLynn Delliskave)
By Shaun Delliskave | [email protected]
It’s a job that no one had really heard of until this year, yet being a contact tracer has meant life rather than death for many people susceptible to contracting the COVID-19 virus. For Murray resident Holly Birch, a clinic manager and registered nurse for the Salt Lake County Health Department’s International Travel Clinic, coronavirus meant being pressed into service as a contact tracing team leader when international travel came to a screeching halt across the globe in March.
As the pandemic impacted every facet of society, many county workers found their offices shut down, and employees who qualified switched over to contact tracing. “I have been working in the clinic for 18 years and with Salt Lake County for 21 years. Currently, due to the coronavirus pandemic, I am leading a couple of teams of contact tracers for the county,” Birch said.
When a person is tested for COVID-19, all the positive results from the State Health Department are entered into a system called EpiTrax. At the start of each day, county and regional health departments across Utah have a list of new positive cases in their areas and assign those cases out to investigators. An investigator contacts each infected patient within 24 hours (on rare occasions, within 48 hours) of being given a case.
Investigators ask a specific series of questions regarding the person’s symptoms and who lives in the same home. They also ask about where they work—so the health department can notify the workplace of a potential exposure, which is anonymous—where else they’ve been, and who else they may have exposed during a time frame of two days before becoming symptomatic and up until the health department’s call. The investigator then instructs the patient on how to isolate themselves from the rest of the household and how to quarantine all other household members. They also advise on cleaning the house, wearing masks, and monitoring for symptoms.
“Hearing the stories of families and people who are really struggling with their illness, with money issues; patients who have died and the heartbreak that the people are going through,” Birch said. “The other difficult part is that one case for an investigator can easily [become] six cases if there are five other people who live in the house, and then they become positive cases.”
Most contact tracers are assigned four cases per day because, on average, it takes about two hours to complete an investigation. In addition to interviewing the patient, the tracer completes all the charting, sends letters to employers if needed, notifies the workplace exposure teams, and helps put the family in contact with community resources. When positive cases go up in the community, tracers may be assigned more than four cases a day.
Infected patients aren’t always forthcoming, kind, or cooperative. The pandemic has been at the center of a lot of political strife over government responses to the virus and false information. Some who have it may react fearfully or with denial.
“We definitely get people who won’t answer their phone, return texts, respond to letters, or aren’t particularly nice on the phone. However, some people have shown a lot of gratitude to us for helping them find resources to help them, and many have said they just really appreciate knowing someone cares about them,” Birch said.
As the medical community has learned more about the virus and how to treat it, contact tracers have seen firsthand how county residents have had to make changes in their daily lives.
“I’ve been most surprised that so many people think that it isn’t a real thing or that it wasn’t going to happen to them,” Birch said. “I think we need to come together as a community and think about our neighbors, friends, those around us, and wear masks, whether you believe they work or not.”
In Salt Lake County, the total number of cases between March and mid-September stood at around 26,000, with nearly 250 deaths. Even with a vaccine promised soon, it is unknown how long county employees will continue working as contact tracers.
For now, Birch implores everyone, “please, if you are sick, stay home. Always wear a mask if you go out in public areas, wash your hands well, and stay socially distant whenever possible.”