Public health experts say contact tracing is one of the key tools for slowing the spread of COVID-19 through the identification and monitoring of people who may have been exposed to someone who has tested positive for the virus. An effective tool used for decades to manage communicable diseases such as tuberculosis and measles, these experts say the process is only as effective as the cooperation they receive from the contacts they attempt to reach.
According to the N.C. Department of Health and Human Resources website, there are 1,500 contact tracers now working in the state to slow the spread of COVID-19. During a press briefing on July 7, N.C. Department of Health and Human Services Secretary Mandy Cohen acknowledged that contact tracers in the state are only able to reach one-third to one-half of the people they seek to contact. “Contact tracing is hard…We know this is a challenge. We are not close to where I would like to be in terms of folks we want to contact,” she stated.
Last week, the Voice posed questions via email to the Dare County Department of Health and Human Services (DCHHS) regarding contact tracing in Dare County, how it works, and how effective it is. Below are the responses from DCHHS Director Sheila Davies and DCHHS Communications Specialist Kelly Nettnin.
Q: How many contact tracers are working in Dare County currently and are there plans to increase the number of contact tracers now that cases are increasing?
A: Currently we have 20 contact tracers working in Dare County. We have another 20 – 25 on reserve if needs increase.
Q: How do contact tracers determine who the close contacts are? Can you typically get in touch with people who have been in close contact?
A: Close contacts are individuals who were less than 6 feet away from individuals for 10 minutes or more. In the majority of cases, we do not have any issues with getting in touch with people, once they have been identified and we have their contact information.
Q: How do contact tracers contact people who have been exposed? If they can’t reach them via phone, what’s the next step?
A: People who have been exposed are contacted via phone. If we cannot reach them by phone, we may do a home visit. If an individual is uncooperative, the health director can issue an isolation or quarantine order. A quarantine order is issued to someone who has been identified as a direct contact of a laboratory confirmed positive case and requires the individual to stay at home for a minimum of 14 days.
An isolation order is issued to an individual who has tested positive for the COVID-19 virus and that individual must stay in isolation until otherwise directed by the health department based on the presence of symptoms or time in isolation.
Q: How can you be sure someone is isolating or quarantining, and what can you do if you find out they are not?
A: We call individuals daily to confirm they are quarantining or isolating. If we find out they are not following the orders, the health director issues a written isolation or quarantine order. If the order is violated, the individual will receive a citation and be required to appear in court. Violating a quarantine order or an isolation order is a misdemeanor offense pursuant to NC law G.S. 130A-25 and punishable by up to 2 years imprisonment.
Most individuals are cooperative and willing to isolate or quarantine without written orders. Recently, we have encountered individuals who do not wish to cooperate and as a result, they are issued written isolation or quarantine orders.
Q: To what extent are you getting cooperation from those infected and those exposed?
A: Until this week, the majority of individuals have been cooperative. This week we have experienced some disturbing and irresponsible behavior from individuals who are being called by our team members regarding isolation and quarantine. This week our callers have been hung up on and spoken to inappropriately when they have called. Additionally, people have refused to cooperate, refused to provide critical information for contact tracing and indicated they will not comply with quarantine and isolation orders.
Q: What if the infected person is a summer worker who lives in a house with multiple people? How are they asked to isolate themselves?
A: If a contact tracer contacts someone, they are asking individuals to isolate or quarantine depending on their specific situation. If an individual is living in a house with multiple people, they are asked to remain in their room and have a bathroom dedicated to just their use, if possible.
Q: Based on what your contact tracers are seeing, is what we are seeing primarily community spread or direct contact such as family members or friends gathering together?
A: Currently we are seeing more direct contact cases than community spread.
