Simone Bruch had a warm glow upon returning home from work the other day.
A contact tracer for the Jefferson County Health Department, she had succeeded in convincing a local senior citizen to quarantine to prevent the spread of COVID-19. And to support him during this time, she had connected him to hot-meal delivery through Meals on Wheels, as well as arranging for grocery delivery to his house.
“That’s the best part about my job,” Bruch said. “It’s good to feel like I am part of something, to be helping individual people and protecting the health of the people in the county,” she said.
Bruch is one of a team of contact tracers serving Jefferson County. They’re in charge of contacting people who have been exposed to COVID-19 and tracing those people’s contacts so that they can alert them and stop the disease before it spreads to even more people.
Every day, a few more positive tests come in involving Jefferson County residents. Whether they got tested in Jefferson, or Madison, or Waukesha, the test results come back to their home county.
The local contact tracer then tries to reach the person with the positive test and from there, to build a list of contacts from the last couple of weeks who might have been exposed to the disease.
Occasionally, another county will contact Jefferson County to have the local officials work with a contact they have uncovered.
“Most importantly, we want people to know that our contract tracers are helpers,” said Gail Scott, director of the Jefferson County Health Department. “They’re here to help people through this.
“We hope people answer their phone, with the assurance that our Jefferson County contact tracers will afford them the utmost respect,” Scott said.
Bruch said that generally, the tracers start with a telephone number, and they’ll try that three times before moving on to a text or email.
“When we reach someone, we immediately identify ourselves and say that we’re calling from the Jefferson County Health Department,” Bruch said.
If the person picks up, contact tracers will ask for their date of birth to verify that they’ve reached the correct person. However, they never would ask for personal information such as a Social Security number or banking information. If someone asks for that type of information, it’s a hoax and they should report it.
If someone doesn’t answer immediately, Bruch said, she’ll leave a voice mail explaining who she is and what she’s doing, and urging the person to call back.
“For the most part, I’d say we’ve been pretty successful,” Bruch said. “A lot of people screen their calls immediately, but most of the time they’ll call us back within 10 minutes.”
Bruch and Scott said that Jefferson County has experience good cooperation with this effort, especially in comparison to other areas of the country.
New Jersey, for example, has had a hard time getting many residents to call their contact tracers back.
“I think, in Jefferson County, there’s a better understanding of what we’re doing,” Scott said.
While some counties are having their contact tracers visit people’s homes, that’s not the procedure in Jefferson County.
“Our contact tracers won’t come to your door,” Scott said.
Asked how people can help the county’s contact tracing effort, Scott said it is important for people who have been exposed to follow health department requests to isolate or quarantine.
“When we ask someone to quarantine, it’s for the public good,” Scott said. “We realize it does impact a lot of aspects of people’s lives: work, school, day care ... But we want to stop the spread of COVID-19.”
“My goal is to try to stop the disease at the household level, “before it spreads to co-workers, then to their homes and outward from there,” Bruch said. “We don’t get personal joy from telling people to stay home.”
Bruch said she feels a little like a detective, tracing the path of the disease as it moves through the population.
“It’s fascinating to see the path it takes,” she said. “Say there’s a wedding on a weekend, and no one seems really affected right away.”
Later, she said, the patterns emerge, as the disease moves from person to person, household to household.
“We can see where it started, and hopefully at the end of the day we can say — this is where it ends,” she said.
As classes open for the fall term, the Jefferson County Health Department is working with all the different schools and districts to develop a seamless contact- tracing strategy in the event that COVID-19 touches a school population.
“We have been working on that all summer and are finalizing that process as we speak,” Scott said. “In fact, I just had a meeting about that this morning.
“We have never done this before, so we do expect to be refining the process as we go along, but our goal is to identify contacts as soon as possible,” the health director said.
If a local resident is confirmed as having COVID-19, the health department is asking them to isolate for 10 days. On the 10th day after their symptoms subside (or after 10 days, if people are asymptomatic), people are cleared to go back to their regular routine.
“Initially, we recommended that all people who have been in contact with someone who has COVID-19 get tested,” Scott said.
People should know, however, that tests are not 100-percent definitive. Now the health department recommends isolation for close contacts whether or not they test positive.
Scott noted that a negative test does not necessarily mean a person is clear of the disease.
After a person is exposed, it generally takes several days before COVID-19 really has had a chance to build up in the body, Scott said, and if someone goes in for a test during this build-up period, they might see a false negative.
“A lot of people think if they test negative, they don’t have to stay at home,” the health director said. “We’re asking them to isolate regardless.”
Bruch said that she recently received a call from someone she had contacted a week or so before. The woman had not recorded any symptoms, and her last scheduled day of quarantine coincided with a family birthday party.
“Can I go?” the woman wanted to know.
Bruch recommended that she not take the chance, saying, “You could still be asymptomatic.”
Fortunately, the caller graciously acceeded.
“This disease has so many gray areas, which makes it hard to deal with,” Scott said. “We (humans) prefer black-and-white and easy answers.”
With no cure in immediate sight, Scott said, contact tracing remains a vital tool in preventing the spread of the virus.
“We especially want to protect our most vulnerable residents,” she said.
She noted that the county really doesn’t want it to get a foothold in skilled nursing homes, where it can seriously impact the vulnerable population there.
Nor does it want to see the coronavirus spread to essential businesses whose operations could be crippled, or to health-care providers or first responders who have so many responsibilities right now, both virus-related and non-virus-related.
“We really want people’s lives to be as normal as possible, but that means taking some steps,” Scott said.
Along with employing a robust contact-tracing effort, she emphasized the need for people to continue to wear facemasks, practice social distancing, wash their hands and be vigilant about sanitation.
Even as the number of coronavirus cases drop, there always is a possibility of a second surge, especially if people drop some of the precautions they’d been taking during the height of the pandemic so far.
“We want to protect those with diabetes, heart disease and lung disease, those 65 or older, and other vulnerable populations,” Scott said.
“We have seen spread (locally) in family gatherings,” she added. “We would urge people to continue to take care. Perhaps younger people will do OK, though age is not a total protection.”
However, she said, many older folks and those with comorbidities still will be at high risk of severe illness or even death.
It’s disheartening to talk with folks whose family member — elderly or not — has died of the disease, Scott noted.
Answering some people’s commentary that these people were old or ill and were going to die anyway, she said that these deaths were not inevitable.
“COVID is what caused them to die,” she said. “Diabetes is a serious illness, but people can live with it for many decades and do well.
“When a person with COPD (Chronic Obstructive Pulmonary Disease) is walking down the street and gets shot, we don’t say they died of COPD. They died from a gunshot wound.”
Scott noted that COVID-19 affects so many areas of the body, it can just overwhelm multiple systems, and even those who do not die of the disease can see continued complications and disability, even months out from their original diagnosis.
The health director quoted a friend who survived the disease, but who recommends, “Do whatever it takes to avoid this.”
“We don’t even know what all of the long-lasting effects are going to be,” Scott said.
It’s occasionally challenging to convince people to take the needed precautions to stop the disease from spreading.
Bruch told of contacting an older man who lived alone. When told he had to isolate, he said he didn’t really have any food at home and needed to go to the grocery store.
On a fixed income, with no computer, the man saw no other path to filling his cupboards.
But Bruch stepped in for him, quickly connecting him to Meals on Wheels and grocery delivery, helping him make out his grocery list and making sure he got what he needed within a few hours of time.
“I talked to him for 20 minutes,” Bruch said. “It was a little bit of a back-and-forth. He was very adamant about how COVID was not that big of a deal, but in the end. he took action,” she said.
She said it felt good to help a valued older member of the community and by helping him, prevent the spread of a serious disease that could harm others.
“That was a ‘proud mama moment’ for me,” Scott said. “I’m very proud of what Simone was able to accomplish.”