Contact tracing is an important part of our COVID-19 response. Contact tracing involves tracking down all the people who may have been exposed to the virus and working with them to keep themselves and others safe. This helps prevent the spread of the virus by ensuring people who may be at a higher risk can take appropriate precautions and seek early healthcare if necessary.
We chat with Liz Macdonald, Communicable Disease Clinical Nurse Specialist who gives us a glimpse into life for contact tracing teams at the frontline of the COVID-19 response in Wellington.
What work were you doing before the COVID-19 outbreak?
We are public health nurses who work in the disease control team at RPH. Our work routinely involves following up all notifiable diseases in our region through case management and contact tracing. We are experienced in contact tracing for other diseases such as measles, but obviously COVID-19 is a new disease with its own challenges. With COVID-19 we're all learning something new on a daily basis.
What does an average day look like?
Most days begin with a morning team meeting where we review changes and share updates that will influence our work. Since COVID-19 is a new virus and evidence around best practice is continuing to emerge, things are changing by the day. We review cases from the previous day and establish any outstanding work required around these cases. As results come through from the laboratory (usually three times each day), we allocate any new cases to a public health nurse, who begins the case investigation and contact tracing work.
How does contact tracing work?
Contact tracing aims to establish a potential source of infection, and to look for close contacts who had interaction with a case while they were considered infectious.
After we are notified of a COVID-19 case we start with a phone interview. Details we need to know are the history of illness, travel, any contact with a known case. We establish when the case would have been infectious and therefore could have shared the virus with others around them. This is the period of time we are most concerned with, and it is for this time we want to know all of their activities – where, when, with whom? Individuals who have had close contact with the case during this period are then followed up by us - provided with education about their exposure, the need to quarantine and then are followed up daily to review their health status.
What is the hardest part about contact tracing?
It's a pretty time-consuming job. Sometimes it can be tricky for a person to recall all the activities they did and places they visited over the past days and weeks, especially if they are unwell. Sometimes it can take multiple phone calls to ensure we cover off all the potential places and people who may have been exposed.
What is the most interesting thing about your job?
The contact tracing aspect of our work is really interesting. It sometimes feels like you're both public health nurse and private investigator as you work to track people down, and attempt to identify links between cases.
Sometimes people choose to share entertaining anecdotes and we find out about the interesting lives people lead. We prefer people to over-share so we can get the most accurate information, but sensitivity and the individual’s right to privacy are always front of mind.
What responses are you getting from people you are tracing?
Most people are really helpful and co-operative because they don’t want others to have their health and wellbeing compromised. If people are not as forthcoming, sometimes all they need is a more detailed explanation of why we have so many questions and need all the details.
What would you like the public to know about Covid-19?
Three things – Stay home, testing is vital, and please do be kind.
It’s the most vulnerable in our community who will be the hardest hit by this virus. By staying home, we help to reduce its spread and to keep these people well.
Testing is so important. COVID-19 can present similarly to our usual colds and flus. The classic symptoms as you will have read and heard many times are cough, sore throat, shortness of breath, high temperatures, runny nose, loss of smell. However, symptoms are variable and if you have any concerns at all please talk to a health professional and please get tested. We will have many negative test results, but testing is how we will identify the positive cases and how our team can then be in touch with you in order to contact trace and stamp it out.
Also, people should continue to access health care services when they need them. GP clinics and pharmacies are still open. Call for an ambulance in an emergency. If you need medical attention for any health concern please seek help promptly.
And finally, nobody asks to get COVID-19. There are some reports of behaviour certainly not resembling the ‘be kind’ mantra. It is really important that we support and not victimise anyone we know with COVID-19. It could one day end up being any one of us or our family members in this positon.