Lane County well-prepared for 'test-and-trace' strategy for coronavirus

Contact tracing has been a commonly used practice in the medical community for a long time. But it is now a key strategy in tracking the spread of coronavirus in the area.

Posted: Apr 15, 2020 7:54 PM
Updated: Apr 16, 2020 11:43 AM

EUGENE, Ore. -- As the battle against coronavirus continues, contact tracing, or contact investigations, have become a key part of a strategy known as "test and trace."

But tracing isn't new or unique to coronavirus specifically. Lane County Public Health, like many health agencies, has used the strategy for things like sexually-transmitted diseases and infections or the measles. So when the time came to collect data on COVID-19, they were ready then and are ready now.

"Whether it's a pertussis outbreak, it's a single measles case or if it's a (norovirus) outbreak at a long-term care facility," said Cindy Morgan, Lane County Public Health communicable diseases supervisor. "Our main goal is to stop the transimission in our community."

Tracing is pretty straightforward. Lane County Public Health is notified of a positive case and then a team of nurses work to track where a positive case could have spread and to whom. But unlike STDs or STIs, something different is happening with coronavirus tracing. Typically, the stigma of transmitted diseases leads to questions of willingness to tell tracers about partners or points of contact.

"I think people are eager to talk about their experiences," Lane County nurse Alice Kirby said. "There's a whole lot of emotions and stories and in some ways people are eager to tell their stories."

With the data gathered, it helps epidemiologists forecast out into the future.

"As we get more data and clean it up and have the ability to summarize it and do analyses on it, our models get stronger," said Lane County Public Health epidemiologist Katharine Carvelli.

With the infrastructure to trace already in place, the group is balancing coronavirus with other communicable diseases as well. Even though that's meant an operation that's running seven days a week.

"No," said Kirby. "We can't drop the ball and we can't lose sight of those either."

On its face, a term like contact tracing might read like something ominous. But in reality, the team at Lane County Public Health is tracking solely this: who was a person infected with COVID-19 around and who is at risk for contracting the illness. '

"All of the conversations we have with them is not only HIPAA protected but because of the work that we do is even more protected than that," Kirby said. "So the data that we keep in cooperation with the Oregon Health Authority is highly sensitive."

Cindy Morgan, who is the county's communicable disease supervisor, said that the investigations are more information gathering than anything authoritative.

"I think so many times individuals think contact investigation means we have the ability to quarantine or isolate someone," Morgan said. "That's typically not a tactic that we use."

And the hope is that the information gathering empowers those to self trace or be more open to talk with the public health.

"Our tactics are to inform people that they may have been exposed to an illness," said Morgan. "Educate them on how they can prevent that and give them steps to do. Usually call us back if they develop symptoms so we can then direct you on how to best protect your health and the health of your community."

Public health officials have told KEZI that the data points they accumulate only are for those that test positive for the illness. But there is a catch 22: without more tests, there are fewer data points, which means forecasting data may be slightly more difficult. Even with the low number of data points in Lane County, social distancing guidelines have been doing their job and making the jobs of public health officials easier.

Now, instead of a positive case of coronavirus potentially coming into contact with dozens, if not hundreds of people, they are more restricted, which can signal a potential turn in the fight against COVID-19, even if it means making this our new normal for a little bit longer, officials said.

"We really need a good understanding of how and what is a contact," Kirby said. "How long does somebody need to be with somebody? Or if the guy running down the trail with his dog and has COVID-19, did he infect everyone he passed along the way? So that, along with the ability to test, is going to be really important for us to understand this up until we get a vaccine."

More testing, even in those that aren't showing symptoms, will go a long way in helping tracers and those that compile that data.

"Being able to test more freely in people who are asymptomatic is able to do a lot towards us understanding where we are in Lane County right now," said Carvelli.

And until there is a vaccine, it will require more of what we're doing right now.

"We will use the tools we have right now which is social distancing, wearing a mask, and if you can't social distance, testing and contact follow up," Morgan concludes. "Those are the tools we have right now."

Of course all of this data is for researchers to see a clearer picture as to what kind of virus COVID-19 is, how it behaves, and how to beat it. If the "test-and-trace" strategy continues to ramp up, it could mean social distancing for a longer period of time. But what it also means is that when public health officials feel confident giving the all clear, it will truly be all clear.

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