What Does a Contact Investigation Look Like? A Behind the Scenes Look at Our Public Health Response to Coronavirus
This blog post is accurate as of 8:45 AM on February 12, 2020. Please visit our coronavirus page for the latest information.
Last week Public Health Madison & Dane County confirmed there is one person who has tested positive for coronavirus in Dane County. In the time since then, our staff have been busy conducting contact investigation and monitoring activities, following up with travelers from China, coordinating with partners, returning messages from our information line, developing communication materials, and conducting media outreach. This is in addition to the normal work we do, like inspecting restaurants and seeing clients in our clinics!
We have gotten a number of questions about how we conduct contact investigations, and we wanted to share more information about what that looks like.
Contact Investigation and Monitoring
A contact investigation, also called contact tracing, is a common public health practice in which we interview a person with a disease. We ask them about places they have been and who they may have been in contact with. We are very familiar with contact investigations because we do them on a daily basis for diseases like tuberculosis and chlamydia.
For coronavirus, contact monitoring is very similar. It starts with us interviewing a person with a positive test for coronavirus. We ask them about places they have been, and we ask them to list people who may have had close contact with them. CDC considers a close contact someone who was within about six feet of someone with coronavirus for a long period of time or had direct contact with infectious secretions of a person with coronavirus—like they were coughed on.
This is the point where we put on our disease detective hats. We gather contact information for all the people who may have had close contact with a person who has coronavirus. For example, if a person told us they went to a party at a friend’s house, we would contact the friend and get a list of every person who attended the party. We would follow-up with each of those people.
For the people on an airplane who may have had contact with a person who has coronavirus, federal authorities send us information from the flight manifest. We contact the people who were within six feet (about two seats) in every direction of the person who has coronavirus.
Hollywood often depicts this contact investigation process as complicated—think of bulletin boards with hundreds of strings coming off a central patient. While following up with contacts is time intensive, it’s rather straightforward for us. Remember we do this every day for certain communicable diseases! One of the hardest parts of a contact investigation is getting people to answer their phones. Given HIPAA privacy concerns, we can’t leave specific information on a person’s voicemail or answering machine. (If you’re ever concerned if it is indeed Public Health contacting you, you can always call our main line—608-266-4821—for assurance!) In most contact investigations, we reach people by phone. If necessary, we will follow-up by email, text, and letter, multiple times until we get a response from a contact.
Once we connect with these contacts, we let them know they may have been exposed to coronavirus. We tell them about the symptoms to watch for. If they meet certain criteria—for example, they rode in a taxi with a person who has coronavirus—we make sure they isolate themselves. In all of our contact investigation and monitoring experience, the vast majority of people follow isolation instructions because they want to do the right thing and protect others from getting sick. If a contact does not want to follow isolation instructions, state laws give us the legal authority to mandate isolation.
Keep in mind that isolated people may not necessarily be sick. We follow-up with contacts daily to see if they have symptoms and make sure they are isolating as appropriate.
We also make sure anyone who is isolated has the supplies they need to stay at home. For example, we can arrange to deliver groceries or schoolwork. We ask people if they will have any trouble meeting their needs during isolation. If they have concerns, we address them.
Travel Investigation and Monitoring
As of this posting, travelers from China are still being routed through certain airports where they are screened for symptoms. If they have symptoms and were in certain parts of China, they aren’t allowed to travel further. Healthy people who were not in the Hubei Province are allowed to continue to their final destination. At the airport, travelers from China receive information about monitoring for symptoms and isolation information. They are told the health department will contact them.
Federal authorities send us the contact information of people who have traveled from China and list a Dane County address as their residence or final destination. Like with contact investigation and monitoring, we call them to let them know they may have been exposed and give them instructions about monitoring symptoms and isolation.
For both contact and travel investigations, we continue to monitor people until the Centers for Disease Control and Prevention (CDC) advise us to stop based on the latest science.
Researchers and public health professionals are hard at work to study the virus, including teams at the University of Wisconsin-Madison. Novel viruses can be scary, but we have highly-trained staff with decades of experience who are working long hours to keep our communities safe.