In normal times, Claire Macpherson was manager for San Juan Basin Public Health’s environmental health program, mostly inspecting restaurants to make sure local eateries followed safe food-handling procedures.
Now, with the coronavirus outbreak taking top priority for the health department, Macpherson’s work has turned into a part-time investigator, tracking down the spread of the disease as a contact tracer.
“It’s one of the most humanizing parts when responding to an emergency such as this,” she said. “We talk to people who are sick, and you see the personal effect COVID-19 has on people in the community.”
Contact tracing, where workers like Macpherson contact an infected person, then try to identify anyone else that person may have exposed, is regarded as one of the most important pieces to fighting the coronavirus pandemic.
By tracking individual cases, state health officials say, potentially affected people can be better directed toward quarantine, thereby limiting further spread of the virus to others.
“Testing only has this epidemiological benefit when you couple it with the tracing and the quarantines that go along with it,” Gov. Jared Polis said in April.
But it’s going to take a massive effort, Polis said, with hundreds of contact tracers working the phones to combat what’s considered a highly contagious disease.
How does it work?The entire process starts with testing, which is why having that capability in Southwest Colorado is so important, Macpherson said.
When a test comes back positive, the health department is notified. After the infected person is notified of the result by a medical provider, SJBPH contact tracers then step in and make the call to the person who tested positive.
Contact tracers start by asking questions to try to identify how a person was exposed or where a person may have contracted the virus.
“It’s inevitable that you’re going to expose someone while you’re sick in a lot of situations,” Macpherson said. “And our goal is to contact everyone we become aware of within 48 hours.”
After the list is made, contact tracers begin reaching out to those potentially exposed. Names of the original person infected are never disclosed, Macpherson said, to protect patient privacy. And it’s voluntary to participate.
“We tell them they could have been exposed, then ask how they’re feeling,” she said. “People are absolutely helpful and want to be part of the solution.”
Team of tracersAbout five to six staff members at SJBPH have been leading the contact-tracing effort, and because La Plata and Archuleta counties’ caseload has remained relatively low at about 80 confirmed positives, staff has been able to handle it in-house.
On average, each positive case results in about five people SJBPH must follow up with – family, friends or co-workers – who may have come in close contact with the infected person.
“I have more than 200 entries in my contact-tracing spreadsheet,” Macpherson said. “But obviously, we don’t have 200 positive cases. Just because you’ve been exposed, doesn’t necessarily mean you’ll become ill.”
Aside from following up with contacts, time is also dedicated to keeping track of who is in isolation or quarantine and helping them with services such as getting groceries or medicine. Everyone is checked up on 30 days later to see how they recovered.
“It is labor intensive,” said Claire Ninde, spokeswoman for SJBPH. “Many public health agencies nationally are overwhelmed and can’t do it. But I feel like we are pretty committed to ensure we keep the community safe.”
Volunteers at the readyWith businesses starting to reopen, and more tourists venturing into Southwest Colorado, health officials are bracing for a surge of potential positive cases, and with it, the need for ramped up efforts on contact tracing.
“We’ve been doing a good job social distancing and staying at home,” Ninde said. “But we may not be able to follow the contacts as much as we’ve been now as businesses start to open up.”
Should SJBPH’s current team not be able to handle the increased workload, the health department has been training 10 or so volunteers, mostly made up of retired doctors and nurses.
Kathleen McInnis, a former nurse who worked at SJBPH and went on to become executive director of Southwestern Colorado Area Health Education Center, said she saw contact tracing as a way to help out with the pandemic response.
McInnis and other volunteers have been engaged in virtual trainings for the past week. As restrictions aimed at slowing the spread of the virus ease, the contact tracer reserves will be ready to go.
“I did a lot of care coordination and helped people get resources they needed,” McInnis said. “So this is a good fit for me.”
Funding the fightMore federal and state money has been dedicated to contact tracing, but it is unclear how much Southwest Colorado will see of the funding.
Sen. Michael Bennet announced last week nearly $160 million from the Centers for Disease Control and Prevention would go to boost contact tracing in Colorado.
A spokeswoman with CDPHE said, “Contact tracing has been a component of our COVID-19 response since the first case was reported.”
“You may remember in the early days of the response we were able to determine if the cases were connected,” she said.
Macpherson said efforts so far have seen significant success in Southwest Colorado.
“People want to do the right thing and stay home when they’re sick or asymptomatic,” she said. “And by informing them of potential exposure, it can make a big difference in slowing down the spread.”