‘People are sick of this’ – an insight into the job of a contract tracer
Colm O’Reilly (23) works as a HSE contact tracer and says Covid myths and misinformation remain a problem
‘Iknew as soon as Covid came to Ireland that I’d end up working in contact tracing. I graduated from UCC with a degree in Public Health last June. I’m doing a part-time master’s in epidemiology and I’ve always been massively interested in pandemics, in a weird, morbid curiosity kind of way. I remember one of our lecturers talking about Covid back in December [2019]. At the time it was just this interesting thing over in China. Little did we know that half the class would end up working as contact tracers.
My classmates and I were approached by the HSE over the summer. The army trained us in because they had been doing contact tracing in the barracks since March. They set us up on Moodle — a virtual learning environment — to go over the scripts and the scenarios. Then we had one day on site and another week of online training. It was quite overwhelming in the beginning and really intense.
We do three 12-hour shifts [8am-8pm] and one four-hour shift each week. There’s a temperature check on the way in — we have to be incredibly careful because there’s 40 people working here every day and around 100 people on the roster. Then we have a morning briefing at 8.10am.
There are different types of contract-tracing calls. The calls to close contacts tend to be quite quick. On the other hand, if you’re telling someone they have Covid, you have to do a clinical assessment and collect their close contacts. Those calls can take 30-40 minutes.
Over the last two weeks, we were set a target of 30 calls a day minimum. I think my personal record is 60!
When we have to call a close contact, we start by explaining the criteria to them. We have to be incredibly clear because you’d be surprised by the amount of people who don’t know what a close contact is.
They’ll say, ‘She just popped in for a coffee for 15 minutes and she was at the other end of the table’, or ‘I wasn’t with that person’ or ‘I need to go to work’.
When you contact trace someone, you get a perfect picture of what their life is like: who they’ve been with, where they’ve been, what they’ve done. Still, I’ve no doubt I’ve been on calls with people who have not told me everything.
I can give them all the prompts and ask them all the questions but I can only do what I can do on the phone. There’s a level of social trust involved and, at the end of the day, we can only give them the public health advice and tell them what they should do. We can’t physically lock their door!
A lot of close contacts are worried about how this might affect their work or their career. They don’t want to be the one who brought Covid into the workplace and they don’t want to miss two weeks of work.
So many people travel for work and the attitude is ‘I need to get over there at all costs — public health advice be damned’. When a close contact or positive case is signalling that they intend to fly, we escalate it to the Health Protection Agency and they have processes that they follow. It’s baffling that some people are willing to put their families in danger for their work.
Myths and misconceptions are another issue. There was a huge misconception for a few months that if you were a close contact and you tested negative, you could then go about your business. But in reality, if you’re a close contact and you test negative, you still have to do the full 14 days of self-isolation. The amount of arguments I’ve had with people on the phone over this!
I’ve had one or two abusive calls. My manager told me on the first day, and it really stuck with me, that the attitude on the phone is a litmus test of the general mood of society: people are afraid, tired and just sick of this.
Other calls can be quite emotional. I remember a woman in her fifties with a huge level of anxiety who wanted to get a test immediately. I remember her saying that she couldn’t sleep and she didn’t want another night of not knowing what her story was.
Newborns can get Covid — I’ve come across that a few times — and their mothers are so worried. My background is not medical per se, so they’d be asking me questions and all I can say is, ‘Please ring your GP’.
One of the most difficult calls I experienced was one that I helped a colleague with. It was a lady with dementia living in a rural area. She was really confused and she kept asking who we were and whether or not she had Covid. We
were fairly wrung out after it.
I think we’ve become desensitised to the numbers but these calls remind you that they are people with families, jobs and justifiable fears. It really humanises the daily statistics we get.
When you work in contact tracing, you’re a few days ahead of everyone else in terms of seeing the trends. The average number of close contacts in October and November was around three. Then it started going up into double digits.
People were in more places in the weeks running up to the big spike. And those close contacts eventually translated into a higher number of cases.
The other week we had someone with 40-odd close contacts and I turned around to my colleague and said, ‘I don’t even know 40 people!’
We definitely knew a spike was coming and the thing I was really worried about was the amount of people flying into the country. We had a particular call for flights and the amount of them was insane.
We could see that more people were coming into the country — from the States, Dubai, Spain — and the people coming into the country were doing more things.
The spread is also within families and extended families, when cousins and aunts pop over for a cup of tea. Generally, if Covid comes into a family unit, everyone gets it. But we have seen instances of people from the same house going for tests at the same time and one tests positive and one tests negative. It’s crazy. At the same time, once it’s in the house, I think it’s just pot luck if you don’t get it.
The other problem is the small situations, the moments when people let their guard down for 10 or 15 minutes. It’s the situations where youpopacrosstheroadforacupofteaor you go for a walk with someone and you sit close to one another.
I don’t think people are wilfully doing things wrong and I don’t judge people when they have close contacts, generally. We’re a sociable culture.
But it’s worth remembering that even if you think you’re doing all the right things, it’s those tiny moments that are really driving the spread.”