Contact tracing is a crucial to controlling COVID-19 spread

Marion County Health Department Administrator Lloyd White.

FAIRMONT — As the world continues to wait to for a proven COVID-19 vaccine, certain measures have been deemed effective to help slow the spread of the coronavirus.

Early research is showing that face coverings slow the virus’ spread, along with social distancing — staying six feet away from the nearest person has probably become second nature.

Health officials say contact tracing is proving to be an effective tool used to isolate and monitor individuals who have been in contact with a COVID-19 positive person putting them at a higher risk of contracting the disease themselves.

Contact tracing is employed to control the spread of infectious diseases. Prior to the COVID pandemic, it was routinely used to address matters such as sexually transmitted diseases or tuberculosis.

With contact tracing, trained health experts interview infected individuals and then attempt to locate others with whom the infected person has been in recent contact. Those individuals — the contacts — are then questioned about their symptoms, if any, and offered medical advice and treatment, if needed.

If a contact does not show symptoms, they’ll be checked throughout the disease incubation period, which with COVID-19 is 14 days. If a contact tests positive, the process repeats and continues into another “generation” of contacts.

With the coronavirus, South Korea famously and effectively employed contact tracing to drastically cut its new infection rate early in the pandemic.

The Marion County Health Department is busy these days conducting contact tracing. But as Lloyd White, the health department’s administrator, will attest, tracking down a person’s contacts can be a monumental task.

“It’s a very difficult thing to do, to be honest with you,” said White. “If we have a confirmed COVID-19 case, we’ll contact that person and then ask them to give us the names, phone numbers or addresses of their close contacts. We define close contacts as anybody they’ve spent 15 minutes with or longer and were within six feet unprotected.”

That’s when the real work begins.

“When they provide us their contacts, we must then contact the contacts. We need to inform them of the need to quarantine for 14 days and perform all the follow-ups we recommend,” White said.

But making contact itself with a potentially infected individual isn’t always easy.

“It becomes challenging when people won’t answer their phones and won’t return phone calls. If we can’t contact those individuals and have them quarantined, they’re potentially exposing a transmittable disease to a lot of folks. Such a thing could be prevented if we can get in contact with them, but we can’t always,” White said.

The Marion County Health Department has been conducting contact tracing throughout the coronavirus pandemic.

Two department registered nurses make many of the contact tracing calls, but all of the environmental health staff contributes. The health department is in the process now of hiring another RN to assist with contact tracing.

White spelled out a scenario that’s not uncommon.

“Imagine if you go to a party where there’s 25 people and someone tests positive. Imagine how long it takes to reach all those individuals,” he said. “It’s very complex and extremely time-consuming, to say the least. But it’s also the most effective way to stop the spread of any communicable disease.”

White said the health department must also act quickly, too.

“If I get information about a positive case, I can’t wait until tomorrow to get their contacts because such a delay could potentially expose many other people. We’re very aggressive in doing contact tracing,” he said.

As COVID-19 has migrated from primarily affecting older citizens during the early days of the pandemic to infecting many younger people today, the challenges of contact tracing have only increased.

Elderly individuals, for the most part, are less mobile, have fewer daily contacts with others, and, importantly, respond well to communication requests from the health department.

“Early on, almost all our cases were in the older population. Older people answer their phones. They return phone calls. But with the younger generation, it’s much more challenging because they don’t answer phone calls and won’t give you all their contact information,” White said.

Sandy Hassenpflug, Marion County public health nursing director, is a point person for the county’s contact tracing efforts. She confirmed White’s contention that younger people prove to be more of a contact tracing challenge than did older citizens.

“The elderly people were honest and upfront with us. They communicated effectively. They were willing to respond and answer our questions,” Hassenpflug said. “But as the governor opened up the community and loosened stay-at-home restrictions, we’re finding it harder to do with younger people.”

Hassenpflug said younger people seem to be less willing to cooperate with health department officials.

“With the younger population, many of whom are testing positive, they’re harder to reach. It sometimes takes us several phone calls to get ahold of them. Many times, they won’t call us back,” she said.

Young people are also more guarded about their personal information and less likely to provide their friends’ information.

“They’re not as cooperative, to be honest, as were the more elderly population we saw in the beginning. They’re not willing to give us their contacts’ names and numbers. The young people are not as receptive. It’s making our job more difficult to keep the community safe,” she said.

In response to younger individuals’ preference for text messaging over phone conversations, the local health department has purchased a system to reach them more effectively.

“We’re now installing an automated system where we’re able to reach the contacts by text message and, if they give us permission, ask them things like ‘How are you feeling today?’ or ‘Do you have any symptoms’? If so, we’ll advise them to be tested and assist them in doing so,” White said.

Even though contact tracing is a challenge, Hassenpflug said health department staff is tenacious when it comes to tracking down those who might have been exposed to COVID-19.

“We have a good staff here and we’re like bulldogs. We don’t give up easily. We’ve been hung up on more than once, but we come back. We’re effective,” she said. “We try to educate them and work with them. We try to understand their fears and mindset. With the right communication skills, though, we try to reach and get through to them.”

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