Why Contact Tracing is a Good Idea: Do you know what to do if you test positive?
I was a skeptic about contact tracing, mainly because I did not want my freedoms and privacy infringed upon. But now I think it is a good idea if we are going to be successful in stopping the spread of Covid-19; and it is a better option than keeping everything shut down.
Somewhat disagreeing with using phone apps for contact tracing, I understand the efficiency of technology. But to be transparent, I simply do not trust what the powers-that-be do with the information provided by that technology. Which is why I like the idea of real people doing the contact tracing (CT).
I completed the Johns Hopkins University Contact Tracing certification course, mainly because I was curious. And I wanted the most up-to-date information about severe acute respiratory syndrome coronavirus (SARS-CoV-2), the virus that causes Covid-19. It was very educational and I learned more than expected.
Here are some important definitions:
“Case”: a person with current symptoms and was possibly exposed to another case, and/or recent positive Covid-19 test results; cases stay in isolation
“Isolation”: separate cases from currently healthy people for at least 10 days starting after the first day of symptoms; to end the isolation safely, symptoms must be improving with NO fever within the past 24 hours (without medications to suppress the fever)
“Contact”: a person who has physically touched a case (with or without a mask); within six feet of a case for 10 minutes or longer (with or without a mask); more than six feet but sharing the same environment with a case for longer than 15 minutes (work, office, home); contacts stay in quarantine
“Quarantine”: lasts for 14 days since the most recent contact with the person who was infected (case); restricted movements and interactions when they have been exposed to cases; the contact in quarantine does not have symptoms and does not have a positive Covid-19 test
Ironically, three days after I completed the CT course, I asked my girlfriend if she would ask her hairdresser if she was providing services at home (since Los Angeles was shut down again on July 13, 2020). Her hairdresser informed her she was Covid-19 positive. I proceeded to use my contact tracing questioning for my girlfriend to relay to her hairdresser. The hairdresser started having symptoms July 12th and my girlfriend had her hair cut at the salon on July 11th.
What I learned in my CT course was that Covid-19-positive “cases” are infectious or contagious two days prior to symptoms starting (that risky asymptomatic phase we all hear about). My girlfriend had direct contact with a positive case and SHOULD HAVE started to quarantine counting 14 days from the day of that direct contact. Meanwhile, she was out and about in the community with no idea that she could start experiencing symptoms at any moment and be infectious to others.
What astounded me was that this hairdresser had zero knowledge that all of the people she came in direct contact with during those two days prior to her symptoms starting were potentially infected and should be notified; something I was not aware of myself until I completed the CT course. However, I would have thought someone would have advised the hairdresser to make those notifications since the doctors and nurses were not doing it; and contact tracing programs do not yet exist for CTs to make these calls.
This is precisely why we need professional contact tracers to call cases immediately after a positive Covid-19 test; which should be coordinated by the entity who tested and received those results. The CT would advise the positive case to stay isolated for at least 10 days and attempt to get the first names/phone numbers of everyone they were in direct contact with two days prior to their symptoms starting. The CT would then call the “contacts” and advise them to stay in quarantine for 14 days (since there is a 2–14 day incubation period when Covid-19 symptoms could begin).
The CT could also help with resources to assist cases and contacts to isolate and stay quarantined at home — such as food or medication delivery. The professional CT would most likely be experienced in social services, such as case managers or social workers. And they would be acting as Covid-19 case manager experts providing guidance and direction in an unknown situation. They would also have the knowledge about the importance of privacy and confidentiality.
After completing the CT course, and having my own experience with the need for this questioning and providing informed guidance (very similar to what I have done throughout my career), I realized it is not as scary as I thought. And I would hope to relay this message to those people who did test positive and to provide the reassurance they needed; encouraging them to take additional steps with protecting the community and controlling this virus.
The only way for this to work is if everyone is willing to work together; the same reasoning for wearing a mask to potentially protect others, which most support. Even people who are not in support of masks would most likely appreciate a friendly follow-up call if they tested positive for Covid-19. The CT would provide guidance and also take on the responsibility of contacting the people the contagious person may have infected. Hopefully, that positive case would want to do their part by staying in isolation and by preventing further spread in the community through the contact tracing.
When the CT makes those calls to those who were in direct contact with cases, those people are not told the name of the positive case — that should be kept confidential. But they are informed that they should be in quarantine from the date the direct contact with a case was made and what that means. And hopefully, those people considered “contacts of cases” would also be in support of preventing further spread in the community and remain in quarantine.
Staying inside, not working, not going to school, wearing masks when we do go out in the community, washing our hands, being careful with what we touch can only go so far. When people are inevitably infected after all we try to do to prevent it, we must have a plan to stop Covid-19 in its tracks and the historical public health concept of contact tracing seems to be the only answer.
Since there are not many contact tracing programs currently up and running (yet), it might be a good idea for the general public to be informed enough so they can do their own contact tracing among family, friends, and local businesses if they do end up testing positive for Covid-19. That is what I plan to do as an informed professional and concerned member in our community.