Contact tracing is key to fighting COVID-19 in Illinois. Here’s how you can help.
Imagine picking up the phone to call a stranger who has just been diagnosed with coronavirus.
Faced with a potentially lethal virus and isolated in quarantine, they’re frightened, frustrated and confused. They have been asked to come up with a list of all the people they’ve been in contact with recently.
Then imagine it’s your job to contact every single person they’ve seen to let them know they might have contracted COVID-19 — and to convince them to quarantine, as well.
This is a contact tracer’s job.
While officials have focused the public’s attention on widespread testing, it is only half of the arsenal necessary for the fight against coronavirus.
While scientists develop a vaccine and treatment, contact tracing is the best hope Illinois has of slowing the spread of COVID-19, health officials say.
“What we have right now is limited testing and no treatment and no vaccine,” said Lisa Lee, a public health expert at Virginia Tech. “Until we do, we’ll use contact tracing feverishly to minimize transmission.”
How does contact tracing work?
If one COVID-19 patient infects three others before self-quarantining, each of those three could infect another three or more. The goal of contact tracing is to disrupt the exponential advance of the virus. Tracers reach out to those who may have caught the disease but aren’t showing symptoms and encourage them to self-quarantine.
Nurses at county health departments have taken the primary responsibility for contact tracing during the coronavirus pandemic.
Until Gov. J.B. Pritzker unveils his plan for Illinois’ $80 million contact tracing program, all of the state’s 102 counties will coordinate and pay for contact tracing on their own.
In St. Clair County, six full-time nurses and three part-time nurses work seven days a week on contact tracing, said Marsha Wild, director of infectious disease services. In Madison County, nine full-time nurses do contact tracing on top of other responsibilities, said Amanda Pruitt, the county’s director of health services.
A community needs 30 tracers for every 100,000 residents, according to recommendations from the National Association of County and City Health Officials.
Following that math, St. Clair County and Madison County will need nearly 80 contact tracers each.
Cost of contact tracing
It’s not clear how much state money will go to already-strapped downstate health departments.
“It’s either going to be the state or the federal government that reimburses (local health departments),” said state Rep. Nathan Reitz, D-Steeleville, whose district stretches across portions St. Clair, Perry, Monroe and Randolph counties. “But you just don’t know.”
Illinois could funnel money directly to health departments through a grant program for infectious disease control, Reitz said. Lawmakers have called on doubling funding for the Local Health Protection Grants, which totaled $18 million in 2019.
Some counties, such as Perry County, are still waiting for grant payments the state owes them.
Public health agencies nationwide suffer from insufficient budgets. At budget time, they’re especially easy for a local government to overlook when there’s not a crisis at hand.
A failure to pay for contact tracers will reveal “the fault lines in public health funding,” she added, which is why it’s “crucial” states such as Illinois and Massachusetts have undertaken the effort. In the Bay State, tracers earn $27 per hour.
Pritzker has yet to detail how the state will hire or pay workers, though he boasted on CNN Sunday that Illinois would have it set up “in the next few weeks.”
The governor walked back that comment Monday, saying the state will begin ramping up its efforts by the end of the month.
Privacy concerns
Contact tracing requires a combination of empathy, curiosity and persistence to convince people to reveal things they’d rather keep private.
Most of the time, a doctor has told a coronavirus patient to expect a call from the public health department, other times not, Pruitt said.
“Sometimes they’re ready, sometimes they’re in shock,” she said. “We have a special skillset where we’re able to establish that relationship right away. We work through those emotions.”
Establishing trust through empathy and communication allows tracers to help COVID-19 patients understand how important their cooperation is. But willingness to help varies.
“Let’s be clear that people’s health information is one of the top two things they want to be kept private. Money and health,” Lee said.
Tracers undergo training on health care privacy rules. Laws prohibit workers from sharing information outside the health department, but “that doesn’t mean people aren’t concerned about privacy,” Lee added.
That’s why contact tracing in Illinois will remain anonymous, the governor said. All a contact hears is that they could have been exposed — not to whom, how or where.
“Trust is the currency of public health,” Lee said.
Contact tracing has been employed since the “dawn of germ theory” in the early 19th century, when people realized they could catch diseases from each other, according to Lee. By the early 1900s, public health officials began using it in full force.
It was used during the 1918 influenza pandemic and the HIV/AIDS epidemic, and public health officials practice it continuously to track infectious diseases in a community.
Tech companies such as Apple and Google have proposed new ways to practice the centuries-old technique. Mobile phone applications could anonymously track and notify COVID-19 patients and alert those who come into contact with them.
Such surveillance, even with protections, raises privacy concerns. And tech doesn’t come with the benefits of old-school methods, namely, a human connection. A combination of old and new techniques could be key.
“Any amount of tracing and reduction of transmission is not going to stop everything, but it will help,” Lee said.
Can I be a contact tracer?
If someone is curious and able to empathize, contact tracing skills can generally be taught, Lee said. Applicants have to be organized and detail-oriented. They also have to be willing to undergo training to learn about the disease, privacy laws, local resources and the public health system.
Some schools are already gearing up training programs.
Public health undergraduate summer interns at Southern Illinois University Edwardsville start training next week from the Association of State and Territorial Health Officials, while a Chicago-area community college announced it would offer an online course.
But training in Illinois will be free, Pritzker said Monday, and no one should pay for a program. The state has yet to announce how people can apply for a contact tracing job, though they’ve outlined who they want to hire.
“You will not get hired based on a credential as a contact tracer, though we will be hiring health care workers, community health care workers, who already have some of the training required,” Pritzker said.
Regardless of your background, halting the spread of disease is a challenge.
“To make nothing happen takes a lot of work,” said Lee.
This story was originally published May 13, 2020 at 9:05 AM.
