When Stacy Gregg hears about a positive case of COVID-19 in Jackson County, she and her staff start making calls. They ask about the person’s symptoms and make sure the patient knows what COVID-19 is. Then they move on to contact tracing.
“Figuring out where you’ve been, who you’ve been with, who are the people that we’re most interested in,” Gregg says. “And then talking about how they would like us to contact those individuals.”
Gregg is the clinic manager at Jackson County Public Health where she oversees the communicable disease team.
These days in addition to doing investigations on sexually transmitted diseases and food-borne illnesses, staff at Jackson County Public Health are busy tracking cases of COVID-19.
Rural counties throughout Oregon and California are requesting that Governors Brown and Newsom allow them to reopen businesses, even as COVID-19 continues to spread. Without a vaccine, a crucial public health tool to manage the disease is contact tracing.
From their initial positive case, disease investigators’ contacts can balloon to 30 or more people, usually household members or coworkers. The goal is to break the chain of transmission.
“If they are listed as a contact, they’re going to be asked to do things like monitor for signs and symptoms and take their temperature twice daily,” Gregg says. “And if they develop a little bit of a sore throat or a little bit of a cough, that they immediately withdraw from those activities.”
While it might sound simple, contact tracing is one of the best tools available for reducing the spread of COVID-19. Without a vaccine, communities will have to learn to live with this new coronavirus, and manage its spread.
Oregon Gov. Brown says the state will need at least 600 more contact tracers than currently work in local public health departments.
“With this overarching strategy of testing and tracing in place, we will safely be able to begin the process of reopening Oregon,” Brown said during a press conference on Friday.
California Gov. Newsom has plans for many times that number.
“We believe that we have the capacity to build an army of tracers, beginning with a goal of 10,000,” Newsom said in April.
Gov. Brown said a staged reopening could start in some parts of rural Oregon as early as May 15. Gov. Newsom has not yet laid out specific reopening dates.
In Jackson County, the public health department has eight staff members who currently do contact tracing, Gregg says. And since the county has just 49 positive cases, they’re able to thoroughly troubleshoot problems with people who will be asked to stay at home.
“What’s the plan for you getting your groceries while you’re home sick?” she says. “Or who’s going to take care of your pets, because we’re recommending that you distance yourself from your family and your pets and those kinds of things.”
Further south, Humboldt County’s public health department has gone from their usual three public health nurses and investigators to over a dozen.
“There are investigators that work in social services and environmental health and law enforcement,” says Hava Phillips, the supervisor for Humboldt’s communicable disease program. “We’ve been really fortunate to have folks volunteer from all of those different fields to be willing to help us out with disease investigation.”
Still, contact tracing is just one part of the fight against COVID-19. The other, arguably more important piece is still testing, since health workers need to be able to first identify positive cases before tracing who those individuals came in contact with.
In April, Oregon was doing about 9,000 tests each week, according to data from the Oregon Health Authority. But during a Friday press conference, State Health Officer Dean Sidelinger said Oregon is nearing its goal of performing 15,000 tests per week, the current public health estimate needed to safely reopen businesses while also limiting the spread of the virus.
In the meantime, some counties are moving ahead on their own.
Last week, Tex Dowdy, the sheriff of California’s far northeastern Modoc County announced they would start their own reopening, with an emphasis on “personal responsibility.”
“For our county it looks so much different than other counties in the state,” Dowdy said. “We don’t have multiple chairs within a barbershop or a salon.”
Modoc County hasn’t recorded any positive cases. Now, they’re asking residents to take precautions like six-foot social distancing, frequent hand-washing, and having people over 65 continue to self-isolate in order to reopen all businesses.
Stacy Gregg with Jackson County says contact tracing is just one more tool.
“It has an important place in reopening because I think it’s going to allow us to track this virus,” she says. “Hopefully control it.”
