Getting back to work — 5 of 7: Contact tracing

For appreciating the ripple effect, we could start with the beginning of Love Actually: the evidence is all around us. Our partners in beating this pandemic is all around us. What we each do individually is as important as ever.

Contract Tracing — building a web, creating a safety net

Like using PPE and washing our hands regularly, becoming familiar with contact tracing as a public health strategy will be important for all of us. As LMT’s in particular, it’s good for us to understand because our work with clients constitutes “contact.”

Terms and Times Frames
Let’s remember the terms used for difference phases of any disease and how they relate to each other. Here’s a nice graph that helped clarify things for me:

We know COVID-19’s longest incubation period is 14 days (average is 5 days). Also, people are most contagious just as symptoms begin. That is when our contacts are most risky. When our measures of social distancing, wearing masks and hand washing are most important. Because of this, contact tracing orients around the time you were exposed and when your symptoms arose.

Steps of Contact Tracing
There are several phases to successful contact tracing:
• start with a new suspected or confirmed case (initial layer); then…
• ask that person to identify anyone with whom they had contact in the last 14 days (second layer); then…
• inform the second layer that they have been exposed (the identity of the first layer person is kept confidential); then…
• complete a health screening, resource screening and education of these second layer people
• require them to self-quarantine for 14 days, while being monitored at home (temperature and symptom checking); then…
• ask the second layer people who their contacts were in the last 2 weeks. And on, and on.

If a person in the second layer develops symptoms, they are already engaged with public health officials. Getting them appropriate testing and care is an easy next step.

To make this self-quarantine viable, contract tracing is part of a multi-pronged strategy that includes what are known as ‘wrap around services.’ These services include public health sector support to navigate quarantine with land lords, employers, family members, etc. This is standard public strategy that has proved successful against other diseases like ebola, MERS, earlier SARS viruses, and small pox.

The important thing: what constitutes a contact?

I’ve seen 2 definitions of a ‘contact’:

• being within 6′ of someone known to have the virus for at least 10 minutes
• being within 6′ of someone known to have the virus for at least 15 minutes

My take on the difference: if the space we share is quite enclosed with poor airflow, 10 minutes is my comfort zone. If I’m in a very large with great air flow, 15 minutes is my max. (Of course, as this is implemented and/or you are contacted the public health officials will have their own parameter. Do what they ask.)

In either case, my memory is fuzzy at the best of times. These days I’ve noticed that it’s harder for me to stay clear about what happened on which day. So, I’ve started a simple log of when I see people–friends coming over for a garden tour, dropping off a jigsaw puzzle and saying hello, etc.

What doesn’t need to be tracked: grocery store, getting gas, or most errands. The spaces are large and mostly managed for 6′ distances. Outdoor meet ups, walking together, or casual interactions with strangers. (Evidence is quite consistent that being out of doors significantly decreases the risk of transmission.)

So far, most of my events wouldn’t constitute a “contact.” But I’m hoping to get into the habit of noting my contacts before we open up. We’ll all be doing more things that constitute contact (hair cut please!) so naturally our risk of transmission will go up. I want to make sensible containment decisions and be ready to participate in contract tracing as effectively as possible.

••••••••

We might as well press ‘play’ and finish up Love Actually, because if you haven’t had a good cry in a few days, the final moments of the film are another reminder: “Where would I be without you?”

Great articles:
Amid the Corona Vira Crisis, A Regimen for Reentry, Atul Gwande, New Yorker, 5/13/2020.

Experts Explain How Contact Tracing Will End the Coronavirus Pandemic, Nina Bai, University of California San Fransisco website.

Also: CDC website has downloadable flyers about contact tracing.