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So You Want to Be a Contact Tracer? So You Want to Be a Contact Tracer?
(14 days later)
When Jessica Jaramillo calls someone to talk about the coronavirus, she usually starts with something like this:When Jessica Jaramillo calls someone to talk about the coronavirus, she usually starts with something like this:
“Hi, my name is Jessica. I’m calling on behalf of the San Francisco Department of Public Health. I’m part of a contact-tracing team, and our job is to reach people who have come into close contact with someone who has been diagnosed with Covid-19.”“Hi, my name is Jessica. I’m calling on behalf of the San Francisco Department of Public Health. I’m part of a contact-tracing team, and our job is to reach people who have come into close contact with someone who has been diagnosed with Covid-19.”
Ms. Jaramillo, 41, a San Francisco Public Library district manager in ordinary times, has made dozens of such calls so far, all in Spanish. She began contact tracing, or “seguimiento de contactos,” this month.Ms. Jaramillo, 41, a San Francisco Public Library district manager in ordinary times, has made dozens of such calls so far, all in Spanish. She began contact tracing, or “seguimiento de contactos,” this month.
She is one of more than 11,000 people across the United States who are calling people with advice about containing the spread of Covid-19, according to a survey conducted by NPR. (That number has most likely grown since the survey was first conducted in April.)She is one of more than 11,000 people across the United States who are calling people with advice about containing the spread of Covid-19, according to a survey conducted by NPR. (That number has most likely grown since the survey was first conducted in April.)
Estimates for the number of people needed nationwide for contact tracing range from 100,000 to as high as 300,000.Estimates for the number of people needed nationwide for contact tracing range from 100,000 to as high as 300,000.
The work is mostly phone-based and can be done from home. The jobs can be full- or part-time, often with an hourly wage of $17 to $25; some include benefits. They differ from one place to the next in part because training and recruiting efforts have largely fallen to state and local governments (and some of the programs have already run into problems, both practical and political).The work is mostly phone-based and can be done from home. The jobs can be full- or part-time, often with an hourly wage of $17 to $25; some include benefits. They differ from one place to the next in part because training and recruiting efforts have largely fallen to state and local governments (and some of the programs have already run into problems, both practical and political).
As communities begin to open up and more people venture outside their homes, the job is expected to become more crucial — and more difficult.As communities begin to open up and more people venture outside their homes, the job is expected to become more crucial — and more difficult.
“If you can do contact tracing, you can get ahold of this before it runs through a community like wildfire,” Ms. Jaramillo said. “Then you’re saving someone’s grandmother, or their uncle.”“If you can do contact tracing, you can get ahold of this before it runs through a community like wildfire,” Ms. Jaramillo said. “Then you’re saving someone’s grandmother, or their uncle.”
As a public employee who had signed up to be a disaster service worker, Ms. Jaramillo was ready to serve her community in the event of, say, an earthquake. She did not expect a pandemic.As a public employee who had signed up to be a disaster service worker, Ms. Jaramillo was ready to serve her community in the event of, say, an earthquake. She did not expect a pandemic.
Ms. Jaramillo’s phone conversations unfold according to the needs of the people on the other end of the line. If they need testing for Covid-19, she can refer them for an appointment. If they have symptoms, she might recommend isolation. If they worry about survival in quarantine, she can connect them with food-delivery services.Ms. Jaramillo’s phone conversations unfold according to the needs of the people on the other end of the line. If they need testing for Covid-19, she can refer them for an appointment. If they have symptoms, she might recommend isolation. If they worry about survival in quarantine, she can connect them with food-delivery services.
And if they worry about privacy, Ms. Jaramillo assures them that their information is secure. Her training involved a primer on the federal regulations protecting confidential health information, and she works with encrypted software. Ms. Jaramillo and other San Francisco contact tracers do not share the names of people who have a Covid-19 diagnosis with the people they call.And if they worry about privacy, Ms. Jaramillo assures them that their information is secure. Her training involved a primer on the federal regulations protecting confidential health information, and she works with encrypted software. Ms. Jaramillo and other San Francisco contact tracers do not share the names of people who have a Covid-19 diagnosis with the people they call.
The University of California, San Francisco, has been working with both the city and the state to train hundreds of workers like Ms. Jaramillo.The University of California, San Francisco, has been working with both the city and the state to train hundreds of workers like Ms. Jaramillo.
“Contact tracing is not a silver bullet,” said Dr. Mike Reid, an assistant professor at the U.C.S.F. School of Medicine.“Contact tracing is not a silver bullet,” said Dr. Mike Reid, an assistant professor at the U.C.S.F. School of Medicine.
But he said the “old school” approach of San Francisco and other health departments — which is based on education and empowerment, not tracking apps like the ones Google and Apple are working on — can bring communities together and build capacity to handle future crises.But he said the “old school” approach of San Francisco and other health departments — which is based on education and empowerment, not tracking apps like the ones Google and Apple are working on — can bring communities together and build capacity to handle future crises.
In a time of isolation, there’s something appealing about a job that calls for human connection. And for some, the work is a way to punch back at a pandemic that has pummeled the national economy.In a time of isolation, there’s something appealing about a job that calls for human connection. And for some, the work is a way to punch back at a pandemic that has pummeled the national economy.
But even if hundreds of thousands of people are hired as contact tracers, it would put barely a dent in unemployment; more than 36 million jobless claims were filed in the United States over the last two months.But even if hundreds of thousands of people are hired as contact tracers, it would put barely a dent in unemployment; more than 36 million jobless claims were filed in the United States over the last two months.
And the opportunities vary from state to state; Massachusetts and California were among the earliest to adopt widespread Covid-19 tracing programs.And the opportunities vary from state to state; Massachusetts and California were among the earliest to adopt widespread Covid-19 tracing programs.
Kevin Williams, 27, a writer and driver in Columbus, Ohio, thought he would give contact tracing a shot after the state’s Department of Health announced last week that it was hiring at $18.59 per hour.Kevin Williams, 27, a writer and driver in Columbus, Ohio, thought he would give contact tracing a shot after the state’s Department of Health announced last week that it was hiring at $18.59 per hour.
“If they call me back and I get an interview, then great,” he said. “I really don’t have a hell of a lot of options right now. But also, I just don’t feel like these jobs are real. Are they actually contact tracing, or do they just want to look like they’re doing the right thing?”“If they call me back and I get an interview, then great,” he said. “I really don’t have a hell of a lot of options right now. But also, I just don’t feel like these jobs are real. Are they actually contact tracing, or do they just want to look like they’re doing the right thing?”
He did not hear back, and by Tuesday, the job posting on the Health Department’s website had been removed. Over 9,000 people applied to do contact-tracing work with the state, according to the department.He did not hear back, and by Tuesday, the job posting on the Health Department’s website had been removed. Over 9,000 people applied to do contact-tracing work with the state, according to the department.
And although Ohio officials have called for 1,700 contact tracers, those were to be deployed largely by local health departments. The state job Mr. Williams applied for had been seeking only 100 people.And although Ohio officials have called for 1,700 contact tracers, those were to be deployed largely by local health departments. The state job Mr. Williams applied for had been seeking only 100 people.
Oscar Baez, 33, a Foreign Service officer, had better luck. He was evacuated from his post in Jerusalem in March and returned to Boston, where he grew up.Oscar Baez, 33, a Foreign Service officer, had better luck. He was evacuated from his post in Jerusalem in March and returned to Boston, where he grew up.
Mr. Baez, who is from the Dominican Republic, has used Spanish, Portuguese and Arabic to communicate with the people he calls in the Boston area.Mr. Baez, who is from the Dominican Republic, has used Spanish, Portuguese and Arabic to communicate with the people he calls in the Boston area.
“This is an opportunity to go on offense, track down exposures to this virus and limit the spread,” he said. “It requires heart.”“This is an opportunity to go on offense, track down exposures to this virus and limit the spread,” he said. “It requires heart.”
Contact tracers don’t work alone. The process starts with investigators who reach out to people with Covid-19, and those conversations yield contacts for tracers.Contact tracers don’t work alone. The process starts with investigators who reach out to people with Covid-19, and those conversations yield contacts for tracers.
Updated July 7, 2020
The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
After those calls are made, there is follow-up work to be done to help people find resources like food pantries and financial assistance.After those calls are made, there is follow-up work to be done to help people find resources like food pantries and financial assistance.
“We’re asking people to quarantine when they may not have baby formula for the next day, or they might not have food to feed a family of eight,” Mr. Baez said. “So how can we ask them to stay home if they don’t have financial assistance and social support?”“We’re asking people to quarantine when they may not have baby formula for the next day, or they might not have food to feed a family of eight,” Mr. Baez said. “So how can we ask them to stay home if they don’t have financial assistance and social support?”
Mr. Baez found this job through Partners in Health, which has helped Massachusetts officials recruit and train more than 1,700 people. That’s only a fraction of the more than 41,000 who have applied through the organization.Mr. Baez found this job through Partners in Health, which has helped Massachusetts officials recruit and train more than 1,700 people. That’s only a fraction of the more than 41,000 who have applied through the organization.
John Welch, a director of operations with Partners in Health, said he was impressed with the range of people who wanted to help. They included retired health care workers, furloughed public employees and former hospitality workers.John Welch, a director of operations with Partners in Health, said he was impressed with the range of people who wanted to help. They included retired health care workers, furloughed public employees and former hospitality workers.
“If their computer skills are lacking a little bit, we can help boost that,” he said. “But what’s really important in the middle of an epidemic is empathy.”“If their computer skills are lacking a little bit, we can help boost that,” he said. “But what’s really important in the middle of an epidemic is empathy.”
Contrace Public Health Corps, an organization helping health departments across the United States recruit tracers, received more than 50,000 applications in recent weeks, mostly from women, said Steve Waters, the chief executive.Contrace Public Health Corps, an organization helping health departments across the United States recruit tracers, received more than 50,000 applications in recent weeks, mostly from women, said Steve Waters, the chief executive.
While a college diploma is not always required, Mr. Waters said the best candidates have a bachelor’s degree and some background in health care services.While a college diploma is not always required, Mr. Waters said the best candidates have a bachelor’s degree and some background in health care services.
Diversity is important, too.Diversity is important, too.
“Cultural literacy is key to developing trust with someone you are cold-calling, particularly in minority or distressed communities, which are some of the worst hit,” Mr. Waters said.“Cultural literacy is key to developing trust with someone you are cold-calling, particularly in minority or distressed communities, which are some of the worst hit,” Mr. Waters said.
Nationally, the coronavirus is infecting and killing black people at disproportionately high rates, reflecting longstanding inequalities in resources and access to care. The virus has also brought deadly disease clusters and economic crises to Native American reservations across the United States.Nationally, the coronavirus is infecting and killing black people at disproportionately high rates, reflecting longstanding inequalities in resources and access to care. The virus has also brought deadly disease clusters and economic crises to Native American reservations across the United States.
Ms. Jaramillo’s Spanish fluency has been particularly helpful in California, where over 50 percent of the people known to have been infected are Latino.Ms. Jaramillo’s Spanish fluency has been particularly helpful in California, where over 50 percent of the people known to have been infected are Latino.
And Mr. Baez, whose diplomatic career has taken him to countries including Haiti, China and Brazil, is now putting his skills to use in the neighborhood where he grew up, speaking to immigrant families much like his own.And Mr. Baez, whose diplomatic career has taken him to countries including Haiti, China and Brazil, is now putting his skills to use in the neighborhood where he grew up, speaking to immigrant families much like his own.
“I see the date they tested positive, and it’s at the same community health center that I went to for physicals as a kid,” he said. “Every single day is different. I’m hearing many, many individual stories that are depressing, inspiring and uplifting all at the same time.”“I see the date they tested positive, and it’s at the same community health center that I went to for physicals as a kid,” he said. “Every single day is different. I’m hearing many, many individual stories that are depressing, inspiring and uplifting all at the same time.”