Shelby officials to recruit tracers

Effort being made to keep the county open

The Shelby County Health Department needs a favor from every county resident. If your phone rings and the number starts with “222” — pick it up. It may be a contact tracer on the other end of the line attempting to alert you of possible exposure to COVID-19.

One of the most critical parts of slowing the spread of COVID-19 within Memphis and Shelby County is isolating individuals who have tested positive for the novel coronavirus and the people they have encountered. That work falls on contact tracers.

The role is not only critical in slowing the spread of COVID-19, but also in the county’s “Back to Business” phased reopening plan. The success of the health department in tracking the outbreak could keep it from getting out of control. If it does get beyond the region’s ability to contain it, officials could have to consider ratcheting social distancing measures back-up.

At present, local officials are working to increase the number of contact tracers. Shelby County Health Director Alisa Haushalter is poised to present the Shelby County Commission with a proposal to add more tracers and support staff — people who check on people in quarantine and help them pay bills and get groceries among other tasks.

The health department has two shifts of 20 to 25 contact tracers now. They work seven days a week, Haushalter said.

Memphis Mayor Jim Strickland indicated Tuesday that Memphis may use some of the aid it received from the federal government to build out the area’s contact tracing ability.

That ramp-up isn’t just confined to Tennessee and Shelby County. Nationwide, states and cities are on a contact tracer hiring spree. The U.S. will need to add 100,000 contact tracers to keep the pandemic under control, according to a report from Johns Hopkins University.

“In the absence of a vaccine, we think this is really the big public health tool we have to control transmission of

COVID-19,” said Crystal Watson, one of the authors of the Johns Hopkins report and an assistant professor at the Johns Hopkins Bloomberg School of Public Health, in a news release. “We need to push hard for this.”

The same contact tracing-quarantine strategy has been used to contain Ebola, SARS, sexually transmitted infections and tuberculosis, among other communicable diseases.

Other countries that have successfully flattened their curves have paired widespread and accessible testing with a robust contact tracing effort. Some of those countries include New Zealand, Iceland, Taiwan, Singapore and South Korea.

South Korea has been highlighted by Dr. Manoj Jain, the infectious disease expert advising the city of Memphis, as a model for Memphis and Shelby County

to follow. He has described using testing and contact tracing to put the virus in a “box.”

So, where did you go to high school?

When a contact tracer arrives to the health department, the first thing they’ll do is a mandatory temperature check, said Lloyd Kimball, a 14-year veteran of the health department who, before COVID-19, worked as an investigator for the health department’s tuberculosis elimination team.

Provided their temperature is within normal range, they’ll then be led to a room with other contact tracers and start the day’s work of combing through case files, with each file representing a person who has tested positive for COVID-19.

“We need to know, who lives with them? Who works with them? Who do they regularly come into contact with?” Kimball said. The answers are not always easily obtained. One of the biggest hurdles contact workers face is communication norms in 2020. Many do not pick up their phones when they see an unfamiliar number, and if they do pick up the phone — they may not be receptive to the health department employee on the other end telling them they need to isolate for two weeks.

“We still need to get to them the information they need even if they’re resisting treatment,” Kimball said. “As a contact tracer and investigator, you have to show them that you’re a human being who is trying to help.”

Kimball said the work is perfect for individuals such as, say a recently unemployed server, someone who is accustomed to talking with strangers regularly with ease. “Something as simple as asking them what high school they went to can be enough of a common ground to start a report,” Kimball said.

Once a contact tracer successfully initiates a conversation, it usually takes an average of 20 to 30 minutes “if it’s an easy interview,” said Kimball.

“Some people are open and will share things, but that’s not always the case,” he said.

In the instances where an individual is reluctant or resistant to disclosing information, their case is often kicked over to one of the health department’s seasoned investigators.

Once the case is carefully reviewed, and answers are secured, the case then moves to a monitoring team. Members of that team, Kimball said, seek regular contact with those exposed to COVID-19 and ask daily questions about their overall health and symptoms, or lack thereof.

The job is repetitive, but it’s rewarding, said Kimball. And new contact tracers usually grasp the importance of their job quickly.

“I sometimes see in the faces of new people that they’re reluctant. Sort of a ‘what did I sign myself up for?’ type of thing,” said Kimball. “But once I start talking about how we’re protecting the county, the city and the state, you can see a change in them. You can see that sense of duty sinking in.”