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The Last Line of Defense: How Contact Tracers and COVID-19 Patients Can Stop the Spread Together

Part Three

The thing that you’ve been hoping would not happen ever since you first heard of the coronavirus last winter, has happened. You’ve tested positive for COVID-19. Assuming you’re well enough to be home, next comes days of self-quarantine and close monitoring of symptoms. (If you’re a Penn Medicine patient, you may be enrolled in COVID Watch so you can stay connected with care and have a resource for information and follow-up if your symptoms get worse.)

And you have an important role to play in stopping the spread of COVID. Over the past few days on the Penn Medicine News Blog, we’ve provided two 24-hour snapshots of what happens in the process of getting tested for COVID-19 and then in the laboratory processing of a COVID-19 test sample. Now, the final step: contact tracing. After you get a positive test result, whether or not you have symptoms, you can help the public health effort to stop the spread of COVID-19 by thinking through where you’ve been and with whom you’ve interacted in the last week and sharing that information with a contact tracer when they call.

Who Are Contact Tracers?

As key players in the COVID-19 pandemic response, contact tracers are people who call those who have recently been diagnosed with COVID-19 to in person over the recent days. Contact tracers can then use that information to counsel people who may have unknowingly been exposed to the virus to quarantine, thereby eliminating opportunities for further viral spread.

“People have suggested we’re like detectives, but we’re really not,” said Nawar Naseer, a PhD candidate in the Cell and Molecular Biology Program at the Perelman School of Medicine, who helps manage the team of tracers at Penn Medicine. “We want everyone involved to remember that we’re not trying to snoop, get anyone into trouble, or learn personal details about someone’s life. We’re largely volunteers, trying to help keep your community and the people you care about healthy.”

If you’re a Penn Medicine patient and are tested through the University of Pennsylvania Health System, you’ll be contacted by one of about 20 Penn contact tracers after receiving a positive COVID test result. The size of the team shifts based on the scale of the pandemic, so during the current rise in cases, they are adding to their ranks. This group is mostly made up of volunteers, and they have been tracking COVID-19 since March, in partnership with the Philadelphia Department of Public Health. The endeavor was spearheaded by Carolyn Cannuscio, ScD, an associate professor of Family Medicine and Community Health. Penn Medicine’s contact tracing team has helped the City of Philadelphia establish its own COVID-19 contact tracing program — so you may go through a similar process if you’ve been tested outside of Penn Medicine.

When you receive a call from a Penn Medicine contact tracer, you will probably be speaking with a graduate student who has had specialized training to help stop the spread of COVID-19 through conversation and information. Penn contact tracers are individuals across the Penn community including students from Nursing, Medicine, and Social Work. They’re taught about the specifics of the disease and how to maintain strict confidentiality.

Tracers cannot cure patients or turn back the clock. But like plugging the hole in a leaky bucket, contact tracers can act quickly to minimize the effect one person’s illness can have on an entire community.

When you receive a contact tracing phone call, the person calling you will help you get the most out of your conversation and assist you in decreasing the spread of SARS-CoV-2, the virus that causes COVID-19. In addition to answering the call, there are some extra ways you can help them.

How to Plan for Contact Tracing Before Receiving a Call

If you’ve tested positive for COVID-19, it’s important that anyone who has been in recent close contact with you take precautions to prevent further spread. They should assume they might also have the virus and self-quarantine for 14 days from the time of their last exposure to you. They should stay in strict quarantine regardless of their test result—yes, even if they test negative. You should plan to discuss these contacts with a tracer, and it’s also okay to tell your contacts before you hear from a tracer. Reaching out to your friends, family, colleagues, and anyone else you know who has been in close contact with you over the previous seven days will not disrupt the contact-tracing process, Naseer said. “Calling the people you know yourself before you hear from us can really speed up the process since we have to first receive your contact information from the health system, call you, and then call your contacts,” she said. “We will still follow up with your contacts ourselves to provide additional guidance and resources, but quickly letting others know they should quarantine and get tested may prevent transmission.”

After that, check your phone for clues about places you may have been but have forgotten. Your recent texts and even photos or videos on your phone or on social media may jog memories of recent activities.

“This year has been anything but normal, so we all are living outside of a routine,” Naseer said. “Doing a quick scan can give you a refresher and help you feel more confident that you’ve thoroughly thought through who may have been exposed to the virus.”

When you have your mental list of places you’ve been and people you’ve seen (even those people you may have called as soon as you tested positive), put that list on paper or write it down digitally so you can quickly refer to it during your call. Add people’s phone numbers to the list. This will make your conversation with the tracer more efficient.

Answering the COVID-19 Contact Tracing Phone Call

Thanks to telemarketers, we’ve been conditioned to not answer the phone if we don’t recognize the caller. If you have tested positive for COVID-19 as a Penn Medicine patient, you can expect to receive a call from a Penn contact tracer, and the number will come up on most caller-ID services as “Penn Medicine.”

“Our team believes that being identified as Penn Medicine has been reassuring to many of the patients we have called. In many cases, they have longstanding ties to, and trust in, our health system,” Cannuscio said. Roughly 75 percent of people have answered calls from the team, a success rate that is higher than what many other contact tracing teams report. The City of Philadelphia also put out information on their website so that their citizens can know when a contact-tracer from the city is making the call.

A Penn contact tracer may ring you a couple times back to back if you don’t answer the first time just to suggest they’re not telemarketers and that their call is urgent. But if you miss the call, don’t answer, or choose to let the caller leave a message, a tracer will leave a voicemail message.

“When we call and leave a message, we just say that we’re from Penn Medicine and that we would like to speak to them urgently,” Naseer said. “We don’t say that we’re contact tracers or even suggest that we’re calling about COVID-19. We leave our own individual phone number for you to specifically call back the exact tracer who called you, and then we ask that you do call back as soon as possible.”

If you answer the phone but do not have at least 20 minutes to talk, let your tracer know. They need to be able to go through a list of questions and topics.

“We appreciate honesty from those we call about their availability and truly do need about 20 uninterrupted minutes to successfully converse,” Naseer said.

No one is required to talk to a contact tracer, but by doing so, you’re “performing a service for your community,” Cannuscio said. “It’s an honorable thing to do, and research shows it really can significantly decrease spread.”

Penn contact tracers only access the necessary patient information for their job, and that information is secured in a HIPAA-compliant application. Patients can breathe easy knowing that by talking to a tracer, their information will remain private.

Apart from gathering helpful information, the tracer can also offer helpful information.

“Tracers can connect you with resources if you feel you cannot safely get food or other necessities,” Naseer said. “And if you wish, we can also provide you with documentation for your employer indicating that we recommend isolation or quarantine and staying home from work.”

How Contact Tracers Use Your Information after You Hang Up

If you were contacted by a Penn tracer, he or she will leave you with a number so you can call that specific tracer back directly if you have any questions or remember a person or place you went that you forgot to mention on your call. When you end your call with the contact tracers, the tracer will compile your list of contacts and share that with his or her manager. The supervisor may look for trends, like recurring places where multiple COVID-positive people have been recently. (The Penn team can alert municipal or city health departments if they suspect a specific location is largely contributing to COVID-19 spread.)

After going over the caller’s notes, a senior member of the contact-tracing team then assigns a different tracer to call those people you interacted with in person over the last 7 days. The new tracer is not given your name or any of your information. In order to protect your privacy, all the tracer will know or say to the people they call is that they were in close contact with someone who has tested positive for the coronavirus. While they literally do not have details about the COVID-positive person, the caller can share resources and offer advice on self-quarantining and testing. That person will then hopefully stay home and away from others whom they could infect.

While the medical community works to test, care for, and inform the public, contact tracing is an important line of defense to stop the spread of disease. And just like the first line of defense — prevention, including wearing masks and social distancing — it’s an area where the responsibility to really decrease the spread of COVID-19 falls on everyone. Successful control of the pandemic is truly a partnership between public health professionals and the community. If you get called by a contact tracer, please answer, knowing that you are helping to control the pandemic.

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This blog is written and produced by Penn Medicine’s Department of Communications. Subscribe to our mailing list to receive an e-mail notification when new content goes live!

Views expressed are those of the author or other attributed individual and do not necessarily represent the official opinion of the related Department(s), University of Pennsylvania Health System (Penn Medicine), or the University of Pennsylvania, unless explicitly stated with the authority to do so.

Health information is provided for educational purposes and should not be used as a source of personal medical advice.

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