Coronavirus Disease 2019 (COVID-19) is expanding our vocabulary with terminology most have rarely or never heard: social distancing, shelter in place, flatten the curve, and, most recently, contact tracing.
Although this term has only recently been in the news, St. Charles County Department of Public Health staff has conducted “contact tracing” on COVID-19 positive individuals since March 18, when Public Health became aware of the first positive test. That individual and the more than 450 additional residents who have tested positive since have been interviewed by Public Health epidemiologists and nurses to determine who they had been in close contact with and might therefore be at higher risk of becoming infected themselves.
Then the real work begins because, depending on each individual situation, contacts could be from one or two to dozens and all are interviewed. “Stay at home” and other orders/guidance have made it easier to do contact tracing. Public Health staff say heeding county and state orders has cut the average number of contacts in half – from 10 to five in St. Charles County. Presently, the rate of known infections for St. Charles County is less than half the rate for the city of St. Louis.
“I hope that stay-at-home orders can be relaxed sooner, rather than later,” says County Executive Steve Ehlmann. “When they are, it will be even more important that we continue contact tracing and that individuals observe their quarantine orders. Contact tracing will actually reassure people it is safe to leave home. Customers will return to restaurants and nonessential businesses only if they feel safe from exposure to the virus.”
St. Charles County Government officials want to do everything they can to ensure that the people with whom the public comes in contact are not infected or exhibiting symptoms of the virus, Ehlmann says. To date, Public Health has monitored 826 individuals who have completed their quarantine and there are 495 residents presently on quarantine.
“We cannot get our local economy going by simply relaxing the stay-at-home restrictions,” says Ehlmann. “We need to build confidence in consumers that they can leave their homes and remain safe. Until we have more testing available, contact tracing is a critical component to reassure our citizens that everything possible is being done to make sure those who are infected continue to stay at home. The virus doesn’t move itself, it is transported from an infected person to other people, so all of us need to continue to minimize our contact with others to minimize its spread.”
On a normal day, St. Charles County has two epidemiologists, but COVID-19 has meant the County needs to pull in various resources in order to keep up with the volume. Nurses in the department, school nurses, law enforcement detectives and volunteers – part time and full time – are now part of a 15-person contact tracing team operating twelve hours a day, seven days a week.
“If the number of cases increases,” says Demetrius Cianci-Chapman, St. Charles County Director of Public Health, “our team will have to stretch into the need. I anticipate that before the number of positive tests level off and start to decrease, we will need to quickly train more staff and volunteers to conduct case investigations, contact tracing, monitoring and quarantine management.”
Cianci-Chapman said that to date his staff have traced about 2,000 individuals. Contact tracing for all communicable diseases in St. Charles County before COVID-19 was something that only required four full-time staff.
The contact tracing calls often require answering numerous questions people have about the virus itself, symptoms, quarantining, social distancing, and more. The St. Charles County Department of Public Health’s 75 employees are working on the front lines of COVID-19, staffing the County’s COVID-19 Information Hotline; doing data entry and analysis; conducting investigations; sending letters to those who may have been exposed to the virus; and following up daily with all who have been quarantined or isolated. Just staffing the hotline takes 14 people for each daily 12-hour shift.
Contact tracing will continue as long as there are more cases; the Public Health Department urges everyone to avoid contact with others.