Life as a Covid-19 contact tracer: sleuthing, stress, and veering off-script - Bio-Defense Network
May 2020

Life as a Covid-19 contact tracer: sleuthing, stress, and veering off-script

About 50 Yale students have become members of a contact-tracing brigade charged with notifying people who may have been exposed to the coronavirus.

STAT’s Suzanne Sataline writes that all Maddie Bender knew when she called the New Haven, Conn., family was that a child had tested positive for Covid-19. Anyone who lived with the child was at risk of catching the new virus, and Bender needed to find out if they had symptoms, if new cases were taking root.

What she learned was that public health work during a pandemic is four parts shoe leather and intuition, one part empathy.

(NOTE: Bio-Defense Network is assembling a cadre of public health, nursing and allied health students and recent grads to conduct contact tracing nationwide.  Click here to find out more.

On the phone, the child’s mother complained she was breathing in short, sharp gasps. The woman had thought about seeking help at an emergency room but heard on TV that “it was so bad at the hospitals.” In a state where the governor has repeatedly urged residents to stay home, the woman had the impression she shouldn’t go to an ER.

Bender, a Yale University graduate and public health master’s student, tried to stick with the script she’d been given by the New Haven Health Department. “But I felt this woman should have called her doctor. She hadn’t had a physical in three years,” Bender recounted. She told the woman she needed to self-quarantine for 14 days but altered the line about contacting a physician first before getting urgent care. “It is OK to go to the emergency room if you need to go,” she said.

Before Covid-19 exploded and shuttered her campus, the 22-year-old was studying infectious disease outbreaks in class. Soon after, she and about 50 other students became public health sleuths for the city, members of a contact-tracing brigade charged with notifying people who may have been exposed to the coronavirus, and urging them to stay at home for two weeks to halt any chance of spread.

The task involves a good deal of detective work, profound humility, and tact. It also involves cold-calling people who may be irritated to hear from you. “When you get a random call with someone affiliated with the public health school and she knows personal information about you, but is missing crucial information, that can seem both intrusive and callous,” said Bender, who is the daughter of a physician.

Infectious disease experts say tracing is crucial for keeping the virus in check as states reopen their economies and ease restrictions. With local public health agencies long underfunded and understaffed, many are, like New Haven’s, recruiting students or other volunteers to perform the time-consuming work.

“The real advantage of contact tracing is to snuff out emerging or reemerging transmission cycles,” said Sten Vermund, dean of Yale’s School of Public Health, who helped set up the university effort to assist the city. “To blunt the severity of the epidemic on the upsurge … that is a great time to do contact tracing.”

Finding the best response to epidemics has always been difficult. Focus only on controlling known cases — through treatment and isolation — and a city can miss hidden spreaders. Lockdowns can slow an outbreak, but impose high costs. Contact tracing has proven to be an effective middle ground: quiz individuals who are sick or test positive and then track down the people they may have infected through coughing, sneezing, or exhaling viral particles. The tactic has contained smallpox and SARS, an earlier coronavirus, in 2003.

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