Contact Tracing Already Underway in OC
Saturday, May 16, 2020
Once somebody in Orange County tests positive for the coronavirus that causes COVID-19, two things happen.
First, depending on how the person feels, he or she is told to seek medical help or go into self-quarantine at home.
Second, behind the scenes, each positive test triggers the start of so-called “contact tracing,” a decades-old practice that health experts have used to reduce the spread of communicable diseases as varied as smallpox, the flu, and HIV.
Such tracing already is happening in Orange County to slow the spread of coronavirus. And its expansion is considered by health experts to be one key — along with expanded testing — to ending stay-at-home rules and rebooting the economy.
In the weeks since the coronavirus began to sicken and kill people locally, health officials have beefed up the county’s contact tracing team to include some 75 health detectives. Their job is to call every person who tests positive, ask who that person has been in contact within recent days, and then reach out to those people to tell them they’ve been exposed.
In a pandemic that figures to eventually hit many or even most residents, it’s a potentially heavy lift. But those calls could be informative beyond those who answer the phone.
Two months into the pandemic, health officials still don’t know the true spread of coronavirus locally. Testing isn’t as common in Orange County as it is in other counties, and the nature of COVID-19 — with many who have been infected not showing strong symptoms — makes it tough to know the true footprint of the disease.
Contact tracing can help improve that information. Every positive COVID-19 test is reported to the Orange County Health Care Agency and assigned to a contact tracer in the Public Health Services arm, said Jessica Good, the agency’s public information manager.
For COVID-19, the Centers for Disease Control and Prevention defines a “close contact” as anyone who was within six feet of an infected person for at least 15 minutes, from two days before the person started feeling sick till the patient is isolated.
The contact tracer calls the person who tested positive to ask them if they can isolate themselves from all others, including family members at home, for 14 days, and to help them arrange for food and medicine during that time. The agent then pieces together a timeline of when the patient began to show symptoms, and compile a list of who they might have exposed to the coronavirus.
Another contact tracer also reaches out, talking with people who might be infected but aren’t yet showing symptoms, are asymptomatic, or otherwise haven’t been tested. That agent also is supposed to regularly check in with that web of contacts and offer guidance based on their health history regarding testing, treatment and care.
This is done without naming names. Federal guidelines say contact trace connections are only told that they might have been exposed to COVID-19, not who might have exposed them.
“The goal is slowing the spread of novel coronavirus… by identifying those who are sick,” Good said.
It’s unclear how much pandemic-related contact tracing has been conducted so far in Orange County. The current tracing unit includes doctors, nurses, epidemiologists and investigators, and the agency has brought back some retired senior staff, including former Deputy Health Officer Dr. Helene Calvet, to consult.
Still, Good said the health agency has not yet hired anyone new for coronavirus-related contact tracing.
Statewide, some 20,000 people, mostly redeployed public workers from state and county offices, are being trained to become contact tracers, learning about data entry and interviewing. The push is part of Gov. Gavin Newsom’s initiative to keep track the spread of COVID-19 as the state begins to ease stay-at-home orders.
Locally, the County Health Care Agency hasn’t yet decided if it needs to tap the statewide program.
By May 14, the county had 3,968 positive cases — a number that health experts say is a fraction of the actual number of infected residents in a county of 3.2 million people and reflects the lack of testing since March. In recent days, as testing has expanded locally, the number of positive cases has grown. The number reported on Thursday, 229, was the biggest single-day total to date in Orange County.
“We have plans in place to surge if it becomes necessary, pulling from other areas within Public Health Services,” Good said. “If we exceed that capacity, we will request support from the California Department of Public Health.”
“If we cannot meet community needs there, we will work to train and onboard staff from other parts of the OC Health Care Agency and the County of Orange as a whole.