December 6, 2021

How health workers track coronavirus cases

Cortland County Seal

Gov. Andrew Cuomo’s plan to bring the state out of its current suspension of activity includes the stipulation that every county have at least 30 contact tracers for every 100,000 people.

Cortland County already has sufficient staff to track down people who may have been in contact with someone infected with the novel coronavirus, said Cathy Feuerherm, the county’s health director, even though it has only six people assigned to that task.

Under Cuomo’s mandate, Cortland County, with a population of 47,581, would require 15 contact tracers — or 9 more than the six county health department nurses who now handle that work locally. But Feuerherm does not anticipate hiring new staff.

“My understanding is that these teams will be hired through the state … and dispatched where they need to go,” she said.

Considering the county’s low infection rate, it is unlikely the state will have to send additional contact tracers here, she said. The county has 32 positive cases — a number that has held steady for two weeks.

The county’s contact tracers track down everyone those 32 people had contact with — starting from 48 hours before they first started showing symptoms. This is standard procedure, following national Centers for Disease Control and Prevention guidelines.

The contact tracers work from the infected person’s memory, and, for the most part, the success of the tracing is “as good as someone’s recollection,” Feuerherm said.

However, it can also be supplemented by other evidence, such as work schedules, time cards and sign-in sheets.

Such materials were used to trace contacts at the Pyrotek plant in Cortlandville, where seven employees tested positive.

Contact tracers try to reach contacted people by phone, and if that fails, they go looking for them in person, Feuerherm said.

According to CDC guidelines, “To protect patient privacy, contacts are only informed that they may have been exposed to a patient with the infection. They are not told the identity of the patient who may have exposed them.”

Initially, contacts of the infected were tested only if they showed symptoms. Now, according to new state Health Department guidelines, the contacts are tested regardless of symptoms.

But contacts are also quarantined for 14 days. If they live with other people, they also have to stay separated from other people in their household, Feuerherm said.

County health workers are then required by the state to contact those in quarantine twice daily. County Health Department workers try to make one visual contact by videoconference, and another contact by text message.

Initially, county health officials had a problem contacting some people by videoconferencing, Feuerherm said. It turns out they had competition at home — either kids were taking online classes, or someone in the house was working from home, and the home internet connection was overloaded. However, once they figured out what was going on, county health workers rescheduled daily check-ups to avoid conflicts.

Before the COVID-19 pandemic, health officials would make contact for those infected with other communicable diseases in person. But the sheer scale of the pandemic makes this impossible, Feuerherm said, and requires electronic communication.

“You’re still laying eyes on, but you don’t have to travel 25 miles to the outside of the county and back,” she said. “It just allows us to do the work much quicker.”

These remote communications are indicative of what Feuerherm sees as a telehealth trend that will become permanent regardless of what happens with the pandemic. Who will want to sit around the waiting room of a clinic or doctor’s office in the future, when you’ll be able to do a 15-minute videoconference checkup on your lunch break?

“We’ll never go back from telehealth,” she said.