What do contact tracers do? A reporter attends a training course to find out

BY TREVOR BROWN
Oklahoma Watch
05/29/2020 01:30 PM
Main Cherokee Phoenix
Oklahoma Watch is a nonprofit, nonpartisan media organization that produces in-depth and investigative stories on important issues facing the state. For more Oklahoma Watch content, go to oklahomawatch.org. COURTESY
What does it take to be a contact tracer? And what should you expect when a contact tracer calls you?

I set out to answer these questions by enrolling in a six-hour online Coursera training class developed by Johns Hopkins Bloomberg School of Public Health.

The class is a pre-requisite for those applying to be a contact tracer in New York and is similar to an online class Oklahoma requires for new contact tracers before they undergo additional training.

Here’s what I learned after taking the online class and narrowly passing the final exam to earn my course certificate.

Crash Course in COVID-19

If you don’t know the COVID-19 basics, you will now.

Emily Gurley, an infectious disease epidemiologist at the Bloomberg School of Public Health, begins the class by going over the virus’ origins, symptoms and how it is spread.

For a reporter who’s been covering the pandemic for the past few months, most of this was just a refresher. But Gurley went over lessons that are critical for contact tracers to know. Among them:

1. How long is the incubation period for the disease?

2. When does someone become contagious?


3. How long does it take, and what are the conditions, for someone with COVID-19 to no longer be infectious?

The answers:

1. Two to 14 days, but typically five days.

2. Two days before showing symptoms.

3. At least 10 days since initially showing symptoms, symptoms are improving and there is no fever for the previous three days.

The course then outlines the six steps of contact tracing:

1. Introduce yourself.

2. Inquire about the person’s infectious period.

3. Identify contacts.

4. Instruct “the case,” as the person is called, to isolate until they are no longer contagious. Help them safely connect to needed social or community services.

5. Initiate contact tracing by calling their contacts and advising them to quarantine.

6. Check in with the infected person and their contacts regularly until their quarantine period for each ends. 

Applying the Lessons

Get ready to test your new knowledge.

The course goes over various scenarios in which contact tracers need to find out what day the infected person could have been contagious to see who needs to be reached and how long they might be asked to self-quarantine.

The answer is trickier than you would think – and the quizzes bear that out. But fortunately, you can fail the quizzes as often as you like. You can attempt the final exam twice in a three-day period, and need an 85% to pass.

When to Share Information

The next section covers ethical issues.

Students are told they are allowed to ask about private information, such as where the person was and whom they saw, because it’s in the interest of public health.

During the interview, the contact tracer might learn other sensitive information that isn’t pertinent, such as that a person is undocumented. That should not be shared with anyone, including law enforcement, Gurley said, because it has no impact on the spread of the virus.

In another example, Gurley said a contact tracer could find out in an interview that a person with COVID-19 was in close contact with his wife, two children and a girlfriend he was having an affair with. Although the girlfriend should be contacted and asked to quarantine, the contact tracers should not tell the wife or anyone else about the affair, Gurley said.

Not Everyone Is a Contact

Contact tracers are told to collect all necessary information during an investigation. This includes finding the location and types of interactions, contact information of any businesses or venues the person attended, the names of close contacts and details such as what movie the person attended or the number of an airplane flight they took.

But just because a COVID-19 patient went out during their infectious period doesn’t necessarily mean a contact tracer needs to reach every person the patient was around.

Instead, contact tracers are told to focus on three types of contacts: any physical contact; any close contact, generally defined as being within 15 feet of someone for 10 to 30 minutes, and any proximate contact, defined as keeping a six-foot distance but being in the same room with another person for an extended time.

Customer Service

Much of the final third of the course could apply to almost any other customer service job, such as at a call center.

Students are trained in how to develop rapport, use active listening and how to assess a person’s feelings, needs and requests.

“A good attitude will always improve the quality of a call,” Gurley said.

But Gurley said a common issue is that some may not want to cooperate because of distrust of the government or a variety of reasons. In addition to reassuring the contact that the information won’t be disclosed to others, she advises that these are issues “you just need to be prepared for.” When someone is having problems, she also suggests using phrases such as, “This is a difficult time” or “Everything is moving so fast.”

Troubleshooting

In case students have any preconceptions that this will be a cake walk, Gurley highlights various challenges they will likely face.

Those include dealing with uncooperative callers or knowing how to interrupt when someone is too talkative. “If they stop to take a breath, that might be a good time to interject,” Gurley advises.

She says contact tracers also need to “be equal parts detectives, investigators, social workers and therapists,” as they seek to quell people’s anxieties or work out a plan for how someone, especially a person in a vulnerable group, can quarantine safely.

Watch and Learn

Intermixed with Gurley’s lessons are sample calls performed by actors.

In one, we watch as a contact tracer struggles with an older patient and then we have to identify the tracer’s mistakes. Those could be failing to introduce themselves properly, using too many technical terms and offering opinions on potential medical treatment.

In another example, the contact tracer is able to elicit answers by focusing on three tips: hear what they’re saying, listen to what they’re feeling and give them enough silence to open up.

The Final Exam

After about five hours, students take the final exam. The 40-question graded test must be completed in 40 minutes, and only one failure is allowed in a three-day period.

I got all but two correct. I mistakenly selected that a person who talked to a “case” in their home for eight minutes should be considered a contact. And I whiffed on a question dealing with how long someone can leave isolation after their symptoms improve. That netted me a passing grade of 91.8%.

If I were to follow through on becoming a contact tracer, this would just be the first step. In Oklahoma, health departments require additional training and often have contact tracers watch others before they begin on their own. Even with my certificate of completion in hand, I recall what Gurley said as she ended the final lesson: “Remember, the pandemic is ongoing.”

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