Exploring this Job
Visit the Centers for Disease Control and Prevention’s Web site, https://www.cdc.gov/coronavirus/2019-ncov/php/open-america/contact-tracing.html, to learn more about contact tracing. You should also visit PreventEpidemics.org, which offers country-level information on epidemic preparedness.
Ask your health teacher to create a contact tracing simulation in which you and your classmates play the roles of contact tracer, sick person, and friends and family of the sick person, or do this on your own with friends who have an interest in this career. The simulation will help you to understand the types of questions that you need to ask and understand the pros and cons of the job.
Talk to contact tracers about their jobs. Contact local public health organizations to see if they might be able to arrange an information interview with a tracer.
Contact tracing protocols vary by employer, but a typical assignment begins with the contact tracer being assigned a “pending first case” (i.e., a person who has an infectious disease such as COVID-19). The infected individual provides the contact tracer with information on whom (e.g., friends, family, store workers) they came into close contact with during a certain period of time (two weeks typically for those who have been infected with COVID-19) and places (grocery store, church, concert, etc.) they visited during this time. (The Centers for Disease Control and Prevention defines close contact as "someone who was within 6 feet of an infected person for at least 15 minutes starting from 48 hours before illness onset until the time the patient is isolated.") The contact tracer gathers as much information as possible about the infected person’s movements and interactions during the time period to determine the extent of possible infections and develop a list of people that they will need to contact.
The contact tracer then attempts to contact, usually by telephone (but also by e-mail or texts), anyone that the infected person had contact with. They track all interactions with contacts via a web-based client resource management platform. When communicating with contacts, they closely follow a script that tells them what to say and how to respond to various questions the individual might ask. To observe privacy rules, the contact tracer never reveals the names of those who have been infected.
Contact tracers at the San Francisco Department of Health say the following when making first contact: “You are being called because you have been identified as a close contact to a person with a confirmed novel coronavirus infection. Do you know who that person might be? If so, please state their name.” The contact will either provide a name or say that they are unaware of any friends, family members, or other contacts who have the disease. If the contact does not know anyone who has been diagnosed with COVID-19, the tracer would respond, “nonetheless, we would like to ask you some questions since we think you may have been exposed to the virus.”
The contact tracer then asks the person demographic-related questions, including their date of birth, race, preferred language, and if they live with the person who tested positive (if the person has provided the name of an infected contact). Other questions include:
- Have you been tested for COVID-19 and, if so, what were the results? (If they have not been tested and want to be tested, the contact tracer provides assistance in that regard.)
- Where do you live? (home, condo, nursing home, homeless shelter, correctional facility, etc.)
- How is your health? Are you experiencing shortness of breath, fevers, sore throat, rashes, etc.? Are you immunocompromised or do you have any underlying health conditions. (These questions are used to categorize people as “low risk” or “high risk.” Contacts who report being unwell are referred to health authorities for further assistance. )
If the contact has no symptoms, the contact tracer will ask them to quarantine for a set period of time if they haven’t already done so. They explain their state’s rules regarding quarantine, provide them with tips on identifying any new virus-related symptoms that may arise during the quarantine, and provide them with contact information to use should they become sick or have additional questions. They make sure that the contact has enough food and medications for the quarantine period, and if not, refer them to the local health department or social services agencies for assistance. Some health care agencies offer text-based systems in which the contact can sign up for to receive daily well-being check-ups and information on the virus.
The contact tracer continues to work through the list of contacts of the original infected person until everyone has been contacted. They touch base with all contacts during the process to ensure that they are honoring their promise to quarantine, to see if they are still feeling well or are receiving treatment for any health conditions, and to make sure they have all the resources necessary to maintain quarantine and overall good health. They keep detailed records, and report issues (including their inability to contact any of the infected person’s contacts) to their supervisor. If one of their contacts becomes ill with COVID-19, they start the contact tracing process over again with that individual’s contacts.