PEORIA — Contact tracing — the practice of identifying and notifying people who have been exposed to communicable diseases — has been a function of health departments forever, but never to the extent necessary to manage the COVID-19 pandemic.
"It is absolutely unprecedented in scope," said Amy Fox, administrator of the Tazewell County Health Department, during a phone interview recently. "We’ve had some large cryptosporidium outbreaks ... but that was something where we get people in, get people tested, they get on a treatment and they are done, right? This is just a different beast. It continues to perpetuate, as one person leads to another."
Unlike cryptosporidium or sexual transmitted infections, the things area health departments typically do contact tracing for, COVID-19 is much more widespread. Small health departments, who typically rely on their larger neighbors to pitch in when they are overwhelmed, aren’t getting as much help.
"Now everybody is strapped for time … everyone is working as hard as they can to keep on top of this," said Fox.
So far, Tri-County health departments have been dealing with the situation by reassigning workers from other duties to do contact tracing, a plan that has worked since the number of cases have been relatively few.
But with stay-at-home orders tapering off and the community reopening, officials at all three area health departments say they are planning to bring in more workers in case there is a surge in cases.
"As we’ve been on home isolation and not moving as much, we haven’t had as many contacts. So imagine if we’re all living our normal existence with these things like the salon, or a school teacher in a classroom, or someone who might be serving people over a counter and might see a lot of people over the course of a day. So we anticipate that the number of contacts that people have will also greatly increase," Fox said.
Peoria is planning to hire six full-time disease specialists, including a full time epidemiologist, said Kathryn Endress, director of epidemiology and clinical services at Peoria City/County Health Department. Both Tazewell County and Woodford County are still trying to determine how many extra people they will need. Both are concerned about being good stewards of their funding by not over-hiring.
"We want to make sure if we assign people to do this we have work for them to do," said Fox.
Woodford County, with a staff of only 10 — all of whom have been trained to do contact tracing, is looking into utilizing the Medical Reserve Corps for assistance in contact tracing, said administrator Hillary Aggertt.
While contact tracing is a key step to safeguarding vulnerable populations, contact tracers don’t employ investigative techniques like cell phone tracking, said Fox. Tracers are mindful of privacy and make every effort to not divulge the names of people who has tested positive for COVID-19.
"I think there are some misconceptions about contact tracing," said Sara Sparkman, a spokeswoman for the Tazewell County Health Department. "We’re not tracking people, we're doing this as an epidemiological study to know where the disease is going."
The goal is to make sure that people aren’t unknowingly passing the virus to others, Fox said. "We want to make sure people are adequately informed."
The only time an investigation might go a little deeper is if a COVID-positive person spent time in a public space while they were likely infectious.
"Think about your life, you might have been at the oil change place and sat with someone who you have no idea who they were," said Fox. "In that situation, there’s going to be some type of investigation that has to occur, but we won’t follow the cell phones that were at the oil change place. We’re not like NCIS."
Investigators only focus on direct contacts of people diagnosed with COVID-19, those who were closer than six feet apart for more than 15 minutes, said Fox. The goal is to get all close contact tested within 24 hours of notification.
While testing is key, it has to be done correctly to be truly meaningful, said Endress.
"The thing to remember is that it is a point-in-time test, and that incubation period is 14 days," she said. "So just because they are tested 3 days after they were exposed, if that test comes back negative it doesn’t necessarily mean they won’t be positive on day seven after exposure. So it’s something that is a valuable tool to have, especially now with the expanded testing capacity that we have, but we want people to remember that it is a point-in-time test."
Endress has a specific testing protocol she recommends to people who have been exposed to COVID-19.
"It’s challenging because we don’t want to deplete our resources, so I tell people to maintain quarantine for that 14 day period, and if they develop symptoms, that’s when they want to get tested. If they are asymptomatic, around day 7 is a good day to get tested, and potentially a week later at 14 days," said Endress. "Testing more than that is not warranted. Incubation is 14 days. If they haven’t developed any symptoms they can be tested at the end of the quarantine period to make sure they are not an asymptomatic carrier."
While health officials interviewed for this article expressed confidence in their ability to deal with COVID-19 going forward, they were not without concerns. As communities open up, individuals need to be mindful of their behavior because COVID-19 is still a very real threat in central Illinois.
"I'm glad that we did the shelter in place. I think it was the right move at the right time. I do think reopening as a slow progression is also the best way to reopen our local businesses, but do so in a way that maintains the health and safety of our community. I do think we will see a resurgence of cases, or sort of a surge, but if everyone maintains their social distancing and masking then hopefully that surge will be minimal," said Endress.
Fox issued a plea to the public to partner with their health department by maintaining all the health safeguards instituted during the quarantine.
"We can't just open back up and there not be any of those safeguards. There has to be that implied partnerships for us to get back into that ’normal world.’ If you go get a haircut, follow the rules. Wear a mask, wash hands when you get there and when you leave.
"Please continue to do all those safeguards that don’t take a lot of time that will help us keep the disease burden down in our community until we can get to some kind of medical intervention that can give us some immunity."
Leslie Renken can be reached at 686-3250 or email@example.com. Follow her on Twitter.com/LeslieRenken, and subscribe to her on Facebook.com/leslie.renken.