Contact Tracing’s Role in Re-Opening Wisconsin
On April 20th, Governor Evers released the Badger Bounce Back plan – a phased and data-driven plan for re-opening Wisconsin’s economy. The plan calls for a number of criteria to be met in order to move the next phase of re-opening the economy. One of them is a requirement that public health officials have the capacity to conduct contact tracing on everybody exposed to a person who tests positive for COVID-19. Testing for COVID-19 without contact tracing would not be successful in controlling the spread of the virus.
Contact tracing means interviewing a person who has tested positive for COVID-19 to identify everybody they were in contact with while they were sick and for two days before their symptoms started. Staff then reach out to each person on that list to tell them they may have been exposed to COVID-19 and what steps they should take next to protect themselves and others. A person is considered exposed if they were within six feet of somebody for a prolonged period of time, or if there was direct contact with the secretions of a person who has tested positive for COVID-19, like if a person was coughed on.
When a contact tracer is speaking with a person who was exposed, they ask them about any symptoms they may be experiencing and ask them to self-isolate for 14 days to see if symptoms develop. If symptoms do develop within 14 days, the person should call their health care provider to see if they should be tested. If no symptoms develop after 14 days, the individual can stop isolating. More details about what a contact investigation looks like can be found on Public Health Madison & Dane County’s blog.
So what does the Badger Bounce Back plan mean by “adequate capacity for contact tracing”? The ultimate number of contact tracers needed depends on the number of positive COVID-19 cases and how much physical interaction each person has had with others. It’s more achievable when people are staying at home as much as possible and a person who has tested positive for COVID-19 has only had contact with a few other people. It becomes a much bigger job when a person has been in contact with dozens of others from work, family, the movies, a party, etc
The Governor’s goal is to increase the number of contact tracers in Wisconsin to 1,000, from a baseline of around 400 (these 400 people were following up on other infectious diseases before COVID-19).
At a time when some fields must consider cutting hours or jobs, many public health departments are looking to grow their ranks of contact tracers. The position requires special training, and the jobs are typically filled by people with a public health background. Nursing and other similar fields may also have workers with similar training and easily transferrable skill sets. In Milwaukee, for example, public health officials are training staff from the Office of Violence Prevention and public school nurses to work as contact tracers.
In Dane County, public health has been contact tracing since our very first case on February 5th. Since then public health has greatly ramped up its capacity, moving from a handful of contact tracers to dozens over the last few months. Public Health is hiring four additional contact tracers with support from federal Coronavirus Aid, Relief, and Economic Security (CARES) Act funding, for a total of 34. This capacity gives us the ability to be in touch with hundreds of people per week. We’ll monitor the numbers carefully and are prepared to ramp up if needed.
In addition to contact tracing, we need adequate support for people isolating or in quarantine. Many people are able to self-isolate in a section of their home not occupied by others, and that is great if they can. But for others who cannot (for example, all must share one bathroom) and for those who are homeless, we must be able to provide adequate facilities. Places like Lowell Hall and some area hotels are providing space for people who need it now, and Public Health is working to establish processes to help address any needs people in isolation or quarantine might have.
Contact tracing is one of several gating criteria of the Governor’s Badger Bounce Back plan. Another is that we have the ability to test everybody with COVID-19 symptoms. You can learn more about that in one of my blog posts last week. Other criteria note that we must have enough personal protective equipment to keep exposure to a minimum; we need to see a 14-day sustained decline in the number of new cases and new hospitalizations. And finally, the Badger Bounce Back stipulates that hospitals have adequate capacity to accommodate all COVID-19 patients in need of care.
Progress is being made on all of these fronts. And with continued cooperation from everybody to stay safe and at home as much as possible, we’ll continue moving forward. You can follow Dane County’s status and progress on COVID-19 on our website, and follow Public Health Madison & Dane County on Twitter, Facebook, and Instagram for more good information.