The county, country and the world has seemingly had to learn a whole new vocabulary to use when addressing the COVID-19 pandemic. One of those terms which has come into frequent use, but can be easily misunderstood, is contact tracing.
“Contact tracing is the single-most effective way to slow the spread of disease, especially when vaccines are not available to protect against the virus,” Steph Stookey, San Juan County’s lead public health nurse in communicable diseases, told the Journal. “Contact tracing entails identifying all people who may have been exposed to a disease or virus, contacting them quickly, and giving them practical guidance and resources they need to prevent exposing others to the virus.”
When a positive case is identified in San Juan County, public health nurses and surveillance staff jump into action. The team begins by contacting and interviewing the patient to find out whether they have symptoms, when their symptoms started and who they have been in contact with while they’ve been infectious, Stookey explained.
“Contact tracing, when done quickly and effectively, stops the virus in its tracks,” Stookey said.
Based on the interview with the patient, the team then identifies the people who have come into contact with the patient and therefore were exposed to the disease.
“This is where the contact tracing action really picks up,” Stookey said.
Contact tracers then notify every person identified as having close contact with the patient and alert them of the potential exposure — ideally within 24 hours, Stookey explained. The people contacted are provided with education, information and support to understand their risk. Additionally, they’re informed as to how to quarantine or self-isolate, how to monitor themselves for illness and told when they should contact a health care provider. They’re also reminded that they can still spread infection if they do not feel ill, Stookey said.
“When our public health staff are working with cases and contacts, they do much more than collect information,” Stookey said. “They use these moments to talk with the case and contacts about how to prevent spreading the virus — by isolating or quarantining — what symptoms to look for in the days or weeks ahead, when to call a health care provider, and assist in arranging for testing.”
According to Stookey, the public health staff also checks in with patients and their contacts throughout their isolation or quarantine to answer questions or help them find additional support.
“When needed, we connect them with others in the emergency response effort to make sure groceries, medications and supplies can be delivered safely so people can stay in their homes,” Stookey said. “We can also arrange for individuals to move to a separate isolation or quarantine facility if they are unable to do so safely in their own home.”
Typically, initial contact and follow up is made by the phone, Stookey explained.
“This also protects staff from going to the infected person’s home and risking being exposed to the virus,” Stookey said. “Occasionally we will go to a person’s house, but that is less common.”
In instances of school or workplace spread, the tracing team will work with the school or the employer. Public health will notify them that a student or employee has been infected and, with the help of the school or employer, identify who has been in close contact with the patient to contain the spread.
The team works with general timelines, such as finding out who all worked a particular day or what shift. According to Stookey, the patient’s personal information is not shared with the people who are contacted about potential exposure.
“Oftentimes, a case chooses to tell their contacts — such as family, friends or an employer — they’ve been infected,” Stookey said. “However, that is not information public health staff will share out unless the case or contact has specifically asked us to do so.”
To protect patient confidentiality, Stookey explained, the people contacted are only told may have been exposed to someone with the disease but are not told who the person is. She continued, adding that the teams are highly trained to work with patients and contacts in a way that does not individually identify others so that all cases’ and contacts’ information remains confidential.
“The process can feel invasive, but most people are usually very understanding of why they are being contacted, and that we are asking for their information and cooperation to protect their loved ones and community,” Stookey said. “In all COVID cases we have investigated, people have been extremely cooperative and understanding and the relationships with our public health teams and community members have been extremely positive.”
According to Stookey, the community has been volunteering to help with contact tracing. She said hundreds of offers have come in to assist and the team has tried to respond to every citizen who has volunteered. Stookey said the volunteers are a reflection of how motivated and caring the community is.
For now, however, Stookey explained that there are enough trained staff and volunteers to perform contact tracing. She added that the Washington State Department of Health also trained more than 700 staff to assist counties when needed.
“Our community can help by supporting and trusting our public health professionals to use their skills and strategies for identifying cases and contacts,” Stookey said.
A case could be discovered through routine screening for a surgical procedure who hadn’t been identified earlier because they lacked symptoms, Stookey explained. She noted that it is not a failure of the public health system or contact tracing teams for cases to be discovered late.
“It’s a reflection of the nuances and complexities that come with this virus,” Stookey said. “And even with the complexities and nuances, our public health contact tracers are armed with the most current training and resources to reach out and stop the spread in its tracks — one case and contact at a time.”
For the latest information about San Juan County’s response to the COVID-19 pandemic, visit sjccovid.com.