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Tracing a virus: SLO County ups its contact tracing game as it tries to slow the spread of COVID-19

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If you receive a call from a number that begins with 805-781 or 805-788, according to readyslo.org, it could be a contact tracer checking in on you or notifying you of possible exposure to the coronavirus.

Any individual who tests positive for the coronavirus in San Luis Obispo County, or elsewhere in the state of California, will get a call from a contact tracer.

Locally, the county's Public Health Department employs contact tracers—trained investigators who follow up on each individual who has a confirmed COVID-19 case. The goal of gathering the information is to understand or identify patterns of the virus' spread.

Contact investigation isn't a new tool for tracing the spread of infectious disease, according to registered public health nurse Kristen Edler. She said counties throughout the state conduct these types of investigations for diseases such as pertussis (whooping cough), measles, tuberculosis, salmonella, and E. coli.

"So we do investigate those diseases in a very similar manner. Clearly, we typically don't have this extended disease burden," Edler said. "I don't think it makes the news, and yet we are always working behind the scenes trying to protect the community and keep people safe."

Before COVID-19 became a concern in San Luis Obispo County, Edler said she was already working with the communicable disease (transmissible disease) sector of the county Public Health Department. In March she moved to a full-time position to conduct contact investigation and follow-up.

Edler and the other 24 SLO County contact tracers conduct daily follow-up calls with COVID-19-positive individuals until they are released from isolation. Each tracer is tasked with asking when the individual became symptomatic, where they've been, and who they might have been around since two days before they felt those symptoms, county spokesperson Michelle Shoresman said.

"They have asked specific questions about participation at protests or visits to bars or other places where they might have had close contact with others," she said.

The contact tracer asks for the individuals' contact information, and if available, the contact information for people they have had close contact with during that time, Shoresman said. Without giving away personal information, unless given consent, the contact tracer will notify the possibly infected individuals of the situation and give guidance on what to do next.

Tracers also issue self-isolation orders and help connect COVID-19-positive individuals with care and services, if needed. If an infected person needs medical assistance or help with getting groceries, for instance, a contact tracer can provide them with resources.

Edler said she hasn't had a typical workday since March. The number of phone calls she makes depends on what cases she's working on, and each case is unique.

"I would say anywhere from 50 to 100. When you have a case, then you've got to call them to speak to them, speak to their employer, and then find out all their contacts, and with things being reopened there tends to be more contacts to identify and reach out to," Edler said.

Each of those additional contacts also means she has to reach out to their respective employers. On average, one case could result in 10 to 20 phone calls, she said.

The cases have increased, she said, as they're finding that many people are beginning to socialize with their extended families.

"We tend to see more contact in those situations where people are having parties and graduation parties and things of that nature and maybe not social distancing," Edler said.

Edler has a background in working in the health care field but it's not a requirement for the position, rather it's simply a preferred skill set, Shoresman said. Currently, the county Public Health Department is prioritizing bilingual skills in its selection criteria for the position.

CONTACT WEB Contact tracers in SLO County reach out to coronavirus-positive individuals to understand the spread of the virus. - IMAGE COURTESY OF THE CENTERS FOR DISEASE CONTROL
  • Image Courtesy Of The Centers For Disease Control
  • CONTACT WEB Contact tracers in SLO County reach out to coronavirus-positive individuals to understand the spread of the virus.

According to the Centers for Disease Control (CDC), a large number of case investigators, or contact tracers, are needed to quickly identify contacts and ensure they do not interact with others in order to protect communities from further spread of the virus.

If communities can't effectively isolate patients and ensure contacts separate themselves from others, the CDC states that rapid community spread of COVID-19 is likely to increase to the point that strict mitigation strategies will be needed to contain the virus.

State guidance says a county must have at least 15 contact tracers for every 100,000 people.

Locally, Shoresman said the county is bringing on several individuals to fill contact tracing positions and have a few more about to start the process.

"We continue to monitor our staffing level and will add more to our team if needed," she said.

In an effort to mitigate the spread of the coronavirus, Gov. Gavin Newsom launched California Connected, the state's contact tracing program, and public awareness campaign in May. The state's program is led by the Newsom administration in collaboration with the California Department of Public Health, local public health departments, UCSF, and UCLA—all of which have launched an online training academy to develop a culturally competent and skilled contact tracing workforce. The state initially launched 10,000 contact tracers statewide as part of its plan to reopen California.

Also on the Central Coast, the Santa Barabara County Public Health Department's contact tracers participate in a variety of training, including the UC academy and California Connected program.

It currently has a pool of 79 contact tracers and has about 30 to 40 contact tracers scheduled during the week, according to Suzanne Grimmesey, the county's chief quality care and strategy officer.

"Based on recent data, public health contact tracers have been able to connect with approximately 94 percent of index cases/contacts called," Grimmesey said.

Edler said that contact tracers successfully make contact with almost all the calls they make to coronavirus-infected individuals. However, if someone doesn't pick up the phone, the contact tracer will leave a message. Some of those messages don't get returned, but Edler urges the community to call contact tracers back to learn more about the situation and how they can help. Δ

Staff Writer Karen Garcia can be reached at kgarcia@newtimesslo.com.

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