If someone you know or had spent some time with recently tested positive for COVID-19, wouldn’t you want to know about that?
Connecting with individuals who may have been exposed to the virus that causes COVID-19 is a critical piece of Idaho’s plan to safely reopen and contain the spread of disease. As more people are tested, more disease will be discovered, and the spread of the disease will need to be managed and contained in safe, responsible ways. This process is called contact tracing.
Epidemiologists in Idaho’s seven local public heath districts have been organizing and leading the effort to notify people of their possible exposure to COVID-19 since the beginning of the outbreak. This is a process public health is familiar with and has used to contain communicable diseases for decades.
Here’s how it works.
When someone is diagnosed with certain infectious diseases that are reportable under state law, laboratories and healthcare providers report basic information, such as name and birthdate, of the diagnosed person (known as the “index case”) to the local and/or state public health agency.
Local public health epidemiologists use that information to contact and interview the diagnosed person. They ask the patient to try to remember everyone they may have been in close contact with while they were infectious. The epidemiologists then reach out to or contact those people, which is why they are called “contacts.”
To protect patient privacy, contacts are only informed that they may have been exposed to someone who had the infection. They are not told the identity of the patient who may have exposed them. All the interviews of contacts are voluntary. During the interviews, medical evaluation, treatment, and self-isolation are discussed and recommended, depending on the potential exposure to the disease.
Patients and contacts always get to decide how they will participate in this process, but public health staff are always grateful when they share as much information as possible because it helps lower the number of people who might get infected. Contact tracing helps people help others – it allows people to make informed decisions about their health, their potential exposures, and disease status, and allows them to take actions to protect themselves and others.
It is routinely done for infections such as HIV, pertussis, tuberculosis, salmonellosis, and gonorrhea.
And now, COVID-19.
The emergence of COVID-19 and its rapid spread has highlighted the importance of people helping public health quickly identify and address COVID-19 cases and contacts. For each case of the disease, the index case is interviewed by local public health as soon as possible to identify close contacts. For COVID-19, close contacts are people the original person (or index case) encountered in the two days before or during their illness, and who were within six feet of that person for more than 10 minutes.
Those who had close contact with the original person are interviewed and recommended to stay home, self-isolate, and monitor themselves for symptoms of illness until 14 days after the last time they were in close contact with the person, in case they also become ill. To the extent possible, public health staff check in regularly with them to make sure they are self-monitoring and have not developed symptoms. Those who develop symptoms are advised to seek medical care.
We are anticipating that more waves of COVID-19 may happen in the coming months, or in the fall. If those waves happen, the workload for local public health staffs will increase significantly.
To accomplish the anticipated increased volume of work, local public health agencies will increase their staff size and use tools to help manage the workload. A system called Sara Alert has been selected to help manage case investigations and contact tracing. Sara Alert is a secure digital tool, which people use to report symptoms (or lack thereof) via text, email, or phone call for the time they are watching for symptoms, up to 14 days. It is, in essence, a data management tool to help with a potentially large volume of people. All engagement with public health staff and the tool are at the patient’s discretion.
Sara Alert does not:
- Track patient movements. There are no plans to track patient movements now or in the future.
- Use involuntary processes (such as turning on locating information on the patient’s phone).
- Retain information about contacts after the monitoring period (up to 14 days) ends.
In addition to Sara Alert, the local public health districts employ epidemiologists who regularly do contact tracing. Many of the districts also are planning to or are currently adding staff through hiring, training students, and/or volunteers from the Medical Reserve Corps.
We encourage people to participate if they are contacted by local public health, so disease transmission can be identified and stopped. Participation helps protect you, your families, friends, and co-workers.
Dieuwke Dizney-Spencer is a deputy administrator in the Division of Public Health. She is working closely with Idaho’s seven local public health districts on the state’s strategy and plan for increasing the capacity for COVID-19 contact tracing.