Fighting COVID-19’s spread through contact tracing

Public Health Flight staff work to limit illness
Col. Heather Perez (left) and nurse Lisa Parsons work Aug. 4 to trace contacts of individuals who have been identified as COVID-19 positive. They support the 88th Medical Group’s Public Health Flight at Wright-Patterson Air Force Base. (U.S. Air Force photo/Capt. Stephanie Croyle)

Col. Heather Perez (left) and nurse Lisa Parsons work Aug. 4 to trace contacts of individuals who have been identified as COVID-19 positive. They support the 88th Medical Group’s Public Health Flight at Wright-Patterson Air Force Base. (U.S. Air Force photo/Capt. Stephanie Croyle)

When an individual associated with Wright-Patterson Air Force Base tests positive for COVID-19, a key team in the 88th Medical Group’s Public Health Flight does what it can to trace that person’s close contacts to prevent further spread. It takes cooperation from the entire base family.

The team of four highly skilled nurses begins that aspect of its work when it receives notification from the 88 MDG’s laboratory of a positive test generated from the testing lines outside the emergency room, said Dorene Holt, epidemiologist/community health nurse. The individual’s health care provider of record notifies the patient first to provide direct medical instructions based on their past medical history or risk factors, she said.

Following that, the contact tracing team calls the COVID-19 positive individual for an initial interview and uses a guidance questionnaire tool to determine if they have had close contacts with anyone that they could have exposed to COVID-19. Most people have an idea who or when they may have been exposed to a positive person.

If a person tests positive after travel, the team member finds out where they went and how they traveled there, such as by passenger car or airplane. Nurses determine whether the individual has been in a healthcare facility so affected people can be notified; whether the individual has been in a congregant, large-group setting, such as crowded church services, a birthday party, study groups or gyms where numbers of people are gathered; and where the individual has traveled two weeks prior to symptoms developing. Forty-eight hours before any symptoms developed is the target time for contacts that they may have had an exposure to them.

In a work setting, people who eat lunch together are at a higher risk due to proximity and their saliva generating possibly infectious droplets that can travel up to 10 feet, Holt said.

“If they ride in a car without their mask on to pick up food, they may be exposed. Close contact is defined as being closer than six feet for longer than 15 minutes with or without a mask, according to the CDC (Centers for Disease Control and Prevention).

“When we are doing contact tracing, that is what we are looking for,” she said.

“A lot of times people say, ‘I know where I got this – so-and-so’s brother had the virus and I didn’t know it,’” Holt said. “Most of the time people have a good idea where they were in contact with someone who had it.”

The contact tracing team member then calls the contacts most at risk to advise them to monitor for symptoms and isolate or quarantine themselves. Spouses are the No. 1 people most at risk, she said, due to sleep arrangements and not wearing masks. Children also may be at increased risk due to age, ability to social distance and whether they wear a mask.

When Holt is conducting an interview, she asks to speak to the patient and spouse or partner via speaker so she can educate both at the same time on isolation/quarantine rules and provide other key information and tips from the Ohio Department of Health’s coronavirus.ohio.gov website.

If an infected individual feels he or she needs in-person care, the contact tracing team member provides information on how to safely approach emergency care so other patients who are seeking emergency care for other reasons aren’t exposed.

Positive test results are reported to the individual’s county of residence public health agency, Holt said.

“We contact the people who have an affiliation with Wright-Patterson Air Force Base,” she said. “They include service members and their families, employees and beneficiaries. But say a person who was infected and didn’t know it at the time held a party – the list of their non-base-affiliated guests would be provided to the county public health agency for help to contact to protect off-base neighborhoods and communities. We have strong relationships with our off-base county partners.”

Positive test information is added to Public Health’s tracker and base Unit Control Center tracker.

“The Public Health Flight works very closely with commanders and supervisors to support COVID-positive team members and develop plans to get them back to work in a safe and timely manner,” Holt noted.

The Public Health Flight’s tracking tool was developed by Capt. (Dr.) Stephanie Croyle, public health officer and epidemiologist, so information could be collected to assist base leadership, she said.

“We were tasked with tracking persons under investigation but didn’t have computer software to do that effectively,” Croyle said. “So, we developed a program to track so we could have live data updates anytime a commander asks for the latest information. That focused on our beneficiaries – people coming to our hospital tent lines to get tested – but we also distributed to our installation mission partners a directive to track their unit’s members. That way we can also report our non-beneficiary members and have that information for a bigger, more accurate assessment of the base’s current health status.”

Croyle said she wished to thank the mission partners for assisting the Public Health Flight with its mission.

“We have appreciated the amount of support from our mission partners on the base so we could achieve this and be able to give live status reports of the people who work on or visit Wright-Patt,” she said.

“We have a limited amount of time with contact tracing to make a difference,” Holt said. “It’s important work that needs to be done. The best tools we have right now are masks/face coverings, frequent hand washing, cleaning high-touch surfaces and social distancing.

“The Public Health Flight’s role is to keep everyone safe and healthy,” she said.

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