One nurse takes on the world of contact tracing during the time of COVID-19. Her story, her experience, and her opinions give an eye-opening behind-the-scenes look answering the question: how is contract tracing done?
The COVID-19 pandemic hit the U.S. in February of 2020 and life has been completely altered as we know it. I was supposed to go out to Arizona for a travel nurse assignment in March 2020, when slowly but surely things began to shut down across the country. My assignment, along with many other travel nurse assignments got cancelled. It’s been a wild and difficult time. I fell into a COVID-19 crisis assignment in New York for two weeks and then was fortunate enough to acquire a job as a COVID-19 contact tracer, working in my home state of South Carolina. But let me back-up. What exactly is COVID contact tracing you may ask? Let’s take a look!
Contact tracing is an age old tool used to help curb the spread of a certain disease. Contact tracing has been used to help curb the spread of various diseases from the bubonic plague, to syphilis, to HIV, and more recently with the likes of SARS and MERS. Though contact tracing has been around for some time, COVID has catapulted it into a household name.
Aggressive contact tracing has had very successful results with the likes of SARS and MERs but COVID has put it on scale of the likes we haven’t seen in modern history. There are two integral parts to COVID contact tracing; case investigation and contact tracing.
Case Investigation involves talking to the positive cases to gather data regarding their symptoms and onset, activities and close contacts during infectious period, and determining periods of isolation. Case investigation may also require you to connect them with local resources to help with food and supplies, providing CDC guidance, and providing work recommendations and excuses. Investigating their activities may include advising their workplace, gym, restaurant venue, or any other activity depending on the nature of the activity.
Case investigation plays an important part in gathering vital data to help public health officials study the nature of the disease, how it is spread, and how we can curb the spread. COVID is a federally mandated reported disease, just as are diseases like HIV, syphilis, and chickenpox. This means that they are reported to the CDC for tracking for public health purposes and thus along with the cases’ contact information (Undoubtedly you will get asked how in the world you got their contact information!).
COVID-19 Contact Tracing determines the close contacts of a positive case based on certain criteria. The contacts are also investigated for symptoms, given a quarantine time, and recommended testing based on symptoms and the current CDC guidelines. They are also connected with local resources and guidance and provided work recommendations. Contacting the close contacts proves to be one of the more difficult tasks as many cases may not readily give this information.
The Many Sides of Contract Tracing
COVID Contact Tracing is a very necessary tool for helping to curb the spread of this pandemic, but it’s not an easy one for many reasons. Let’s take a look at the good, the bad, and the ugly!
It can be very rewarding work, knowing you are helping shape history and working to the betterment of the situation. You are also working hand in hand with public health on a national level and shifting and changing weekly, if not daily, to new research, protocols, and recommendations.
Some of the people you talk with are so appreciative and kind and receptive to any advice and recommendations. It can also be very heavy. I have cried with some just at the sheer magnitude of the overwhelming nature of this pandemic. Mothers tearful and asking me when they can hold their children again, people isolated and alone with no family, parents losing money not being at work and wondering how they are going to put food on the table for their family.
Sometimes, you are there for your nursing judgement and skills. I contacted one person and in talking with her told her to immediately hang up and call 911. I called another person back a day later just to check on them because I knew they were alone and not doing well. It’s tough work, but knowing you can help these people get through this makes it worth it.
Another great bonus of this work was that it was all remote. Not many jobs you can do as a nurse from home! I loved working at home, being able to take lunch at home, and be with my dog more. Hours were flexible and for my job I could work as little or as much as I wanted. Flexibility and working from home were definitely some of my favorite attributes of this job!
COVID Case investigation and COVID contact tracing is a tricky job. You are calling people who are more than likely not feeling well with varying socioeconomic issues at a vulnerable and fearful time to ask them a bunch of detailed and personal questions. The virus unfortunately has been very politicized and with social media and other outlets spreading disinformation; there is a lot of mistrust. There is also a general lack of understanding of the purpose of the job of contact tracing.
You have to be quite skilled with people and developing a rapport to have them feel comfortable with you so you can discern the details you need. I have been hung up on and cursed at, and flat out disbelieved. There comes a point when you just have to work with the people who agree to share the information and move on from those who refuse.
In case investigation we get quite personal, asking about their symptoms and all their recent activities including where they work. It is ultimately of course to help stop the spread of this virus and help educate the workplaces, but I understand that it is quite uncomfortable to give this information. Then as if that isn’t enough, we ask for the names and phone numbers of everyone you have had close contact with during your infectious period.
Though many people may be willing to give you information about their own accounts, quite a few are unwilling to give out close contact information. This is understandably uncomfortable but I just try to emphasize that we are really trying to work for the greater good to help curb the spread of the virus. It is important that close contacts also quarantine so as not to potentially spread the virus even further. Many people can be asymptomatic or mild symptoms and unknowingly infect others. It is a balancing act to try to glean information from people but also respectful and gain their trust for the ultimate good of public health.
There comes a point, as it did for us in June and July, and will surely be again, where there is just no way to keep up with the contact tracing. When the peaks of positive cases explode, it is just physically impossible to keep up with the amount of case investigations and contact tracing no matter how well prepared you are and how many people you have working. So many people are left without being contacted and thus their contacts as well.
It can be a little disheartening! It is hard and frankly fairly draining work. But then again, nursing in general is a pretty darn tough job! We do it not because it’s easy, but because we are called to do it.
COVID-19 Contact Tracing was quite an interesting job and I am so thankful for the opportunity. It helped me to truly grasp the ins and outs of case investigation, contact tracing, isolation, and quarantine. Along with my COVID crisis assignment in NYC, this has given me tremendous experience within these historic times of COVID. In NYC, I was on the front lines and got first hand clinical experience with the virus. I learned how is contact tracing is done and through that recognize the importance of public health initiatives. Both experiences have made me a better and more experienced nurse, and I am grateful for both opportunities.
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I wish you all safety and wellness through this pandemic! Together, anything is possible. ~Katie
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