What to know about contact tracing — the process, recent changes and the questions that come with the call
photo by: AP Illustration / Peter Hamlin
At the beginning of the COVID-19 pandemic, disease investigators in Douglas County had the time to contact people with positive cases of the virus and track their contacts. But as cases rose in the county in June and July, the job of contact tracing became more arduous. Since early July, the Kansas Department of Health and Environment has taken over the contact tracing process for Douglas County.
The Journal-World interviewed leaders from the local health department on Wednesday to find out what people should expect if they receive a call from a disease investigator or contact tracer, as well as what other changes have occurred in the contact-tracing process.
What to expect if a disease investigator calls
People who have tested positive for COVID-19 should expect a call from a disease investigator within 24 to 48 hours of notice of their confirmed case.
A disease investigator is not the same thing as a contact tracer; a disease investigator can do contact tracing, but a contact tracer cannot necessarily be a disease investigator. A disease investigator is trained to do the primary interview with a person who has tested positive for COVID-19.
First, the disease investigator will ask for basic information such as date of birth, address, email address and race or ethnicity. The investigator will confirm that the person has received a positive lab test. Then, the investigator will ask about how that person is feeling. The investigator will answer any questions, give instructions on what isolating means, discuss the need to trace symptoms such as a fever and make sure the person knows that he or she should be showing improvement before coming out of isolation.
The disease investigator will then gather information about the disease itself by asking questions such as: How did this sickness start and when did it start? What were you doing two weeks prior to the positive result and where were you? This is to try to figure out how the person may have contracted the disease.
“What I’m looking for is where may you have picked it up? What led to this — that you’re sick?” said Kathy Colson, a retired public health nurse who began working for the health department during the pandemic.
photo by: Lawrence-Douglas County Public Health
Then, the disease investigator will ask for the names and phone numbers of people with whom the person was in close contact for the 48 hours prior to the onset of symptoms, as that is believed to be the contagious period. Close contact is defined as individuals who were closer than 6 feet apart for longer than 10 minutes.
Lawrence-Douglas County Informatics Director Sonia Jordan said that the focus was on “people rather than places” because the disease is believed to be transmitted primarily through respiratory droplets as opposed to airborne-based transmission.
“We’re looking at how could a droplet from me get to … you. This is why something like a mask is so important and why that 6 feet for longer than 10 minutes is important,” Jordan said.
photo by: Lawrence-Douglas County Public Health
Lawrence-Douglas County Public Health has two full-time disease investigators and one part-time disease investigator. Jordan and Colson are also trained in disease investigation, as well as some nurses within the health department. Lawrence-Douglas County Public Health will be bringing at least four additional disease investigators on board this fall.
What to expect if a contact tracer calls
If named as a close contact of someone who has tested positive for COVID-19, expect a call from a contact tracer.
After asking for basic information, the contact tracer will ask how a person is feeling. If the person feels symptomatic, the contact tracer will help him or her get tested. Right now, the health department is able to test only people who are symptomatic, but if asymptomatic close contacts want to be tested, the health department suggests they reach out to their health care providers to see if they might be able to help.
The contact tracer will also ask the person if he or she has the resources to stay in quarantine and if anything is needed, such as food or a note to stay home from work. Contact tracers will typically check in two to three times a week throughout a close contact’s 14-day quarantine.
Kristi Zears, director of communications for KDHE, said the department currently has 52 contact tracers but that it would be onboarding new contact tracers each week until it has 100 full-time workers.
When asked how many of these 52 contact tracers work on cases within Douglas County, Zears said that tracers “are assigned to follow groups of contacts and will work where the need is.”
Jordan said Lawrence-Douglas County Public Health could go back to doing its own contact tracing if need be, but that it currently thinks KDHE has more capacity to handle the job.
“We’ve been in a lot of conversations with KDHE to assure that they have the capacity to be able to continue managing contact tracing in an appropriate way for us and in a successful way and they are confident that they will be able to,” Jordan said. She added that having KDHE handle the contact tracing also allows Lawrence-Douglas County Public Health the opportunity to focus on the disease investigation process.
A look at what’s changed within the contact tracing process
In early June, a bill passed by the Kansas Legislature limited the health department’s ability to do contact tracing, Jordan said, because it stated participation in the process must be voluntary.
People who test positive for COVID-19 and their close contacts have the option not to give any information to disease investigators or contact tracers. That means that if a positive case decides not to state whom he or she has recently been in contact with, there’s nothing the health department can do.
Jordan said that prior to this change, while Lawrence-Douglas County Public Health would not have forced an unwilling patient to disclose information, it did have more legal backing and “more power to persuade.”
Now, a supplemental note to House Bill 2016 reads that “participation in contact tracing shall be voluntary, and no contact or infected person shall be compelled to participate in, nor be prohibited from participating in, contact tracing.”
Jordan wanted to share the following information with people who might consider not disclosing information.
“What I would say is we are very skilled in patient privacy. It is one of our highest priorities, and we work continuously to make sure that patient information is protected,” she said.
The health department does not release patients’ names or any information about them. If close contacts ask who exposed them to the virus, a contact tracer will not state the person’s name, but will simply share on what date the investigator believes the person had been exposed.
Jordan said that in addition to quarantining and quick testing, one of the most effective ways to prevent the spread of any infectious disease is to report contacts so that the health department may get in touch.
“They are doing their part to break active transmission at that point,” Jordan said.
The vast majority of people in Douglas County comply in the disease investigation and contact-tracing process, Jordan said. Colson said many people she spoke with during the disease investigation process have already reached out to friends to inform them.
George Diepenbrock, spokesman for Lawrence-Douglas County Public Health, said close contacts were likely people that the patient cared about — people the patient would want to ensure are protected.