Albany County contact tracer pleads: ‘Just be honest with us’
Six days a week, Watervliet woman is among those calculating pandemic risk
It was the first day of back to inperson school in September, and parents and students at Watervliet Elementary School were celebrating a much-awaited return after nearly seven months of pandemic shutdown.
Lara Madison, who lives nearby, saw parents and students gathering around the school’s sign to take group pictures marking the moment.
None of them were wearing masks. And Madison’s brain synapses began firing. “The first thought in my head as I was driving by them was, ‘I wonder how many of these will be on my
Watervliet
caseload in a week,’” the 47-year-old said.
Every time Madison leaves the house it is like this. She cannot look at someone without calculating risk because it’s what she does six days a week as a coronavirus contact tracer for the Albany County Health Department.
There are up to 30 people a day doing contact tracing for Albany County — reaching out to people who have positive COVID-19 tests and trying to ascertain from phone interviews where they contracted the disease and who else they might have infected Madison, who began by doing inperson outreach to patients in the first months of the pandemic, is now training to manage a team of tracers. But she is still doing tracing work once a week, volunteering to work on Sundays to help take the increasing caseload off her colleagues.
At first, when the pandemic began in March, tracers were trying to reach out to everyone who tested positive. She, along with an army of county employees who included DPW and probation workers, would visit patients and ask them to come to the window to make sure they were OK. The inperson component ended in June.
Things became more manageable over the summer as new daily coronavirus cases in Albany County sometimes dropped into the single digits. After she received contact tracing training in July, Madison would spend up to 45 minutes on the phone with a patient tracing everywhere they had gone, and everyone they had been with.
“And then college resumed, and then all the college kids went back to school. And then all the college kids didn’t make the best choices,” Madison said. Some students contacted by tracers were cagey about their whereabouts, not wanting to give away their friends so as to help them avoid quarantine.
Madison remembers one student who said she and 25 people had watched a movie together — insisting the gathering was not a party. And when Madison asked her for contact information for anyone at the “movie night” the student suddenly couldn’t remember anyone who was there.
But now — like an overflowing emergency room — tracers have to triage who gets called first, Madison said. Since Thanksgiving week, Albany County has often seen daily case counts of more than 100 new positives a day. Priority calls go to positive cases of people older than 50 ( because they themselves are older or have elderly parents), or younger than 18 (so that tracing can happen in school populations).
“I want to talk to every patient,” she said. “It’s just not possible right now.”
The Albany County Health Department says it uses CDC prioritization protocol, and its goal is for tracers to call every COVID-19 positive person.
Most people Madison reaches out to either want to help her find those who they might have exposed to infection or they are terrified that they are now positive and have questions.
But there are some people — and Madison says they are in the minority — who ignore her calls and do not respond to her texts. And there are others who are “incredibly hostile.”
“‘I’m not telling you anything and you can’t make me and you can go (expletive) off,’” Madison recounted one caller telling her.
“When you get somebody who is abrasive or doesn’t believe you or doesn’t care or tells you, ‘You can tell me what you want but I’ll do whatever I want anyway.’ It hurts my inner core that they take it so lightly,” she said.
“Every single one of us contact tracers has that kind of story,” she said. “That’s probably the hardest part for all of us.”
The transition to working at home for Madison is difficult, as it is for a lot of people. She hasn’t seen her 73-year-old mother, who lives in Florida, for a year-and-a-half. She lives alone, so the separation from the human interaction an office provides has been tough. On a Zoom meeting this last week, Madison’s colleagues laughed about one of their young sons who licked the icing off a doughnut and presented the soggy, wet confection back to his mother. It was a few seconds of much needed joy.
Madison is now seeing her significant other again, but they had decided to stay apart for about three months at first because he has underlying health issues and she did not want to put him at risk.
Most days Madison’s meals consist of granola bars or cheese and crackers, anything that can be grabbed while on the phone. She drinks tea to manage her increasingly scratchy voice.
As we wait for a vaccine and the winter months close in, Madison’s pleas to the public echo the same drumbeat as so many other health officials — get a flu shot, wear a mask, wash your hands, and “stay away from people.”
“We’re asking for something very simple,” she said. “Just because it’s Christmas doesn’t mean you need to go shopping.”
One day she might get back to doing other work in the health department. Before the pandemic, she worked with pregnant women and new moms. Until then, Madison will continue one of her daily routines, which involves leaving her makeshift dining room table office after 4:30 p.m. and driving up and down the Northway, playing music loudly. It is a break from her house where the work never seems to end — and the only safe place she feels she can be where she won’t be exposed to the virus.
“For people reading this article or reading (about) this process, what is so very important is, just be honest with us,” she said. “We want you to be honest with us so we know where there is a risk.”
When you get somebody who is abrasive or doesn’t believe you or doesn’t care or tells you, ‘You can tell me what you want but I’ll do whatever I want anyway.’ It hurts my inner core that they take it so lightly.”
— Lara Madison