I’m an epidemiologist currently focused on contact tracing for COVID-19. I’m in charge of the vaccine preventable disease program at our county public health department. My responsibilities include monitoring the health of patients and the contacts of patients who have been recently diagnosed with a disease.
Contact tracing is a method of identifying and gathering information about symptoms, exposure and travel history, and close contacts of people diagnosed with communicable diseases. Close contact includes household members, co-workers, healthcare workers, or anyone in community settings where they may have exposed others. We use contact tracing to help stop the spread of many different kinds of diseases, not just COVID-19.
First, we receive cases from the physicians of patients who have been recently diagnosed with a disease. Then, we prioritize the cases on how communicable, or contagious, the diseases are. During contact tracing, we work with confirmed-case patients to help them recall those with whom they have had close interaction.
We also ask contacts to monitor their symptoms, self-isolate for 14 days from the last day of their exposure to the case, wear a mask, and maintain a social distance of 6 feet or more. If a contact develops symptoms, he or she is asked to notify public health staff and seek medical attention.
When we contact people, we identify ourselves as public health professionals and assure them that none of their personal health information will be shared with anyone. To maintain patient confidentiality, no identifiable information about the case [patient] is provided.
We try to build a rapport, asking different questions to understand their risk. We educate them on the disease they have, or may have come in contact with, and encourage them to ask us any questions they might have.
A typical day begins with me checking my email, making a plan to address the high-priority cases first, and then discussing the plan with my supervisor. In a day, I may investigate at least four or five new cases. Each investigation usually takes 30 to 45 minutes. It really depends on whether I’m able to reach the patient and have a discussion with them about their symptoms and exposure history.
In addition to those new cases, I follow up with existing cases if we need more information or have not been able to reach people who may have been exposed to the patient. I also field calls from the public, school staff, or healthcare professionals if they have questions or need guidance on COVID-19.
COVID-19 has changed my work completely. I have focused my full attention on this pandemic and have set aside my usual responsibilities.
The pandemic has made people more aware, and hopefully more appreciative, of the role of public health in preventing and controlling the spread of diseases.
I learned about public health during my undergraduate years, when I was majoring in biological sciences. Then, when I was getting my master of public health degree, an epidemiologist gave a guest lecture on food-borne disease outbreak investigations. That really sparked my interest in infectious disease epidemiology. In fact, I’m currently writing my Ph.D. dissertation on the same topic that the epidemiologist spoke about in that lecture I attended.
Someone does not necessarily have to be an epidemiologist to be a contact tracer. For the purpose of contact tracing during this pandemic, the qualifications for a contact tracer vary by local health departments. For example, our department accepts applications from people with at least a high school diploma, and we are looking for people from the communities hit hard by the pandemic.
Training is provided and includes information about COVID-19: its signs and symptoms, incubation and infectious period, testing, and strategies for prevention and control (social distancing, quarantine, and isolation). Training also includes case-investigation interview, follow-up, and notification techniques, among other resources and instruction.
It’s essential for contact tracers to be able to make cold calls to patients and their close contacts. For that, they need good communication skills, empathy, and cultural sensitivity to work with a community that has a diverse population. Some patients or contacts can be distrustful of unknown callers who are asking for their personal information, so you need to know how to make them feel comfortable.
You also have to think on your feet. Patients ask us a lot of different questions, and we need to use our knowledge for different scenarios that we come across.
Before the COVID-19 pandemic, my work was not particularly stressful. However, when we had to start fielding thousands of calls from the public, schools, and healthcare professionals looking for guidance or needing reassurance, it was difficult to disconnect after work. Everyone, including family and friends, wanted to discuss the pandemic because it was constantly in the news.
I am privileged to be working on the forefront of this pandemic. And I enjoy being part of public health, helping communities stay safe and prevent the spread of diseases.
I am constantly learning, and I work with a great team. My colleagues are supportive and bring their own expertise and perspectives.
Despite the evolving nature of the COVID-19 pandemic and many unknowns, working with the local community has been a rewarding experience overall.
Steven Marcroft, "Contact tracer," Career Outlook, U.S. Bureau of Labor Statistics, July 2020.