Contact tracing: A key to local COVID response

Angela Martinez-Hernandez a recent graduate of Oregon Coast Community College’s medical assistant program, is one of the people working as a contact tracer for Lincoln County Public Health. (Courtesy photo)

LINCOLN COUNTY — “I know it is a scary situation, and I knew I could help.” That was the first reaction of Angela Martinez-Hernandez, a Newport native, after learning of the major COVID-19 outbreak in her hometown. Within days, she was making her first calls as a contact tracer for Lincoln County Public Health.

     Martinez-Hernandez is one of 25 contact tracers, working almost exclusively with Spanish-speaking people who have direct contact with a known positive case. Within the same week of receiving her first 13 people to contact, she had celebrated a milestone in her own life: graduation from Oregon Coast Community College’s medical assistant program.

“I was a former medical interpreter, translating English to Spanish, so I knew I could help and really wanted to,” she remarked, explaining the opportunity came when contract tracing coordinator Ellen Franklin emailed her with the offer.

Franklin, who normally works in primary care at Lincoln County Health and Human Services, had been tasked with managing the contact-tracing team for COVID-19. That team was assembled with the help of a variety of sources, including OCCC, the Confederated Tribe of Siletz Indians and the Oregon Health Authority. She is now the channel through which tracers receive their contact lists, training updates and any other needs.

Martinez-Hernandez and other tracers are calling anyone who has been identified as a close contact with a known positive case. To be considered a close contact, the individual must have been within 6 feet of someone who tested positive for 15 minutes or more.

“If they are being called, they need to quarantine for 14 days from the last exposure date,” she explained. This means 14 days from the last time they had contact with the positive case. A call like this may be the first time the individual is notified of the need for isolation, although all receive a letter by mail, as well. Of her original 13 contacts, all were sharing a residence with a known positive case, and some were children.

Those initial calls are equal parts fact-finding and education. They typically take around 30 minutes. 

“We explain that we are contacting them because they have been in contact with someone who tested positive, and we want to monitor their symptoms and gather information. We provide them with a lot of information on how to isolate or quarantine at home,” Martinez-Hernandez explained.

Contact tracers also answer a lot of questions, both during the initial call and in the daily check-ins that follow. For the next 14 days, those contacts receive a call or text, depending on their preferences. These daily check-ins are used to ask about any symptoms and make sure the individual’s needs are met, including those that would require travel outside the home.

“Contact tracers develop a relationship with all of these people,” County Public Health Director Rebecca Austen explained. “They call every day, and if someone begins having symptoms, we get them lined up for testing. Even before that, we have put them into isolation, and that is how we will get our arms around this and stop the spread of the virus. That’s why we tell them we will make sure you get whatever you need.”

Groceries, diapers, medications, a thermometer, cleaning goods and even pet supplies are some examples of the needs that can be met.

“We ask every day and are able to fill out a smart sheet about their necessities and how urgent the need is,” Martinez-Hernandez said. Those forms are forwarded on to an essential needs coordinator at the county who arranges for those deliveries. In many cases, individuals have family members who can drop off needed supplies, but the option is always presented.

Housing options are also presented. If someone is unable to isolate from others safely, Lincoln County has arranged for hotel rooms. County officials say the need for this option has not been great, but it is an available resource, and the costs would be covered by grants and federal support.

Fernando Garza, of Lincoln City, is also a contact tracer. He said one of the challenges is convincing people they must remain in quarantine for 14 days. He recalled one situation where, after three days, the individual was asking if they could spend time with family members outside the home.

“Guess what? Three days is nothing,” he told them, cautioning against it.

The difficulty for many goes beyond time with family and is often about lost wages or concerns about explaining to an employer that they cannot come to work.

Franklin explained that anyone in quarantine receives a letter that can be presented to an employer, although there may be a day or two lag time as letters are sent out.

“I want employers to understand that we are working through these cases the best we can,” she said. “If an employee tells you they have been exposed, please show some understanding if they don’t have their letter yet. We are actively trying to keep people quarantined so this does not spread.”

Tracers are also able to provide resources for covering rent or replacing lost income as a result of quarantine.

People like Martinez-Hernandez and Garza continue to provide a lifeline to those who are isolating at home. For many, that contact is appreciated.

“A man I called today was just thankful I was keeping track of him and his family,” Martinez-Hernandez said. “Although they have no symptoms, they are thankful to have someone calling and checking.” Since starting this work in early June, some of her first contacts have now completed their quarantine, at least one person converted to a positive case and another batch of contacts have been added to her caseload as local response continues.

Mindful that some people may be fearful about a call from a stranger, Lincoln County Public Health reminds everyone that contact tracers will never ask for social security numbers, immigration information or bank account numbers. Many contact tracers are working from home and using their own telephones. Anyone wishing to verify that a contact tracing call is legitimate is invited to call Franklin at 541-265-0585.