Contact Tracing Process

Since the start of the pandemic, the Public Health team at the 88^th MDG has been working to serve and protect you.  An essential part of the process is our contact tracing team who investigate COVID-19 positive patients, patients with COVID-19 like symptoms, or members that are considered close contacts by local Public Health Authorities or 88^th MDG Public Health Team members.

The key to initiating the process is updating the COVID-19 Unit Personnel Tracker (UCC)

• The sooner that the data on the UCC is submitted to the Public Health Team. The sooner recommendations will be given to the patient, close contacts, and leadership
• The UCC and instructions for contact tracing can be found here (pending).

Contact tracing slows the spread of COVID-19

• Contact tracing helps protect you, your family, and your community by:
  • Letting people know they may have been exposed to COVID-19 and should monitor their health for signs and symptoms of COVID-19.
  • Helping people who may have been exposed to COVID-19 get tested.
  • Asking people to self-isolate if they have COVID-19 or self-quarantine if they are a close contact.
• Avoid scams during contact tracing, the 88^th MDG team or county health contact tracers will not ask you for:
  • Money
  • Social Security number
  • Bank account information
  • Salary information
  • Credit Card numbers

Certain core principles of case investigation and contact tracing must always be adhered to:

• Case investigation is part of the process of supporting patients with suspected or confirmed infection.
• In case investigation, public health staff work with a patient to help them recall everyone with whom they have had close contact during the timeframe while they may have been infectious.
• Public health staff then begin contact tracing by warning these exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible.
• To protect patient privacy, contacts are only informed that they may have been exposed to a patient with the infection. They are not told the identity of the patient who may have exposed them.
• Contacts are provided with education, information, and support to understand their risk, what they should do to separate themselves from others who are not exposed, monitor themselves for illness, and the possibility that they could spread the infection to others even if they themselves do not feel ill.
• Contacts are encouraged to stay home and maintain physical distance from others (at least 6 feet) until 14 days after their last exposure, in case they also become ill. The CDC now has shorter options including 7 and 10 days with and without a test, respectively; however the 14 day quarantine remains the gold standard.  They should monitor themselves by checking their temperature twice daily and watching for cough or shortness of breath. To the extent possible, public health staff should check in with contacts to make sure they are self-monitoring and have not developed symptoms. Contacts who develop symptoms should promptly isolate themselves and notify public health staff. They should be promptly evaluated for infection and for the need for medical care.

Case investigation and contact tracing is a specialized skill. To be done effectively, it requires people with the training, supervision, and access to social and medical support for patients and contacts. Requisite knowledge and skills for case investigators and contact tracers include, but are not limited to:

• An understanding of patient confidentiality, including the ability to conduct interviews without violating confidentiality (e.g., to those who might overhear their conversations)
• Understanding of the medical terms and principles of exposure, infection, infectious period, potentially infectious interactions, symptoms of disease, pre-symptomatic and asymptomatic infection
• Excellent and sensitive interpersonal, cultural sensitivity, and interviewing skills such that they can build and maintain trust with patients and contacts
• Basic skills of crisis counseling, and the ability to confidently refer patients and contacts for further care if needed
• Resourcefulness in locating patients and contacts who may be difficult to reach or reluctant to engage in conversation
• Understanding of when to refer individuals or situations to medical, social, or supervisory resources
• Cultural competency appropriate to the local community

Time is of the essence.

• Identifying contacts and ensuring they do not interact with others is critical to protect communities from further spread. If communities are unable to effectively isolate patients and ensure contacts can separate themselves from others, rapid community spread of COVID-19 is likely to increase to the point that strict mitigation strategies will again be needed to contain the virus.