On April 22, 2020

State ramps up contact-tracing teams to contain Covid-19

By Elizabeth Gribkoff/VTDigger

As Vermont reports a slowdown in the number of new Covid-19 cases, officials say the Department of Health will have 48 people by the end of the week tracking down individuals who may have been exposed to the novel coronavirus.

Public health experts say the epidemiological detective work known as contact-tracing can help slow the spread in places like Vermont that have lower case counts. And it will play a key role nationwide as states ponder when to safely start lifting social distancing measures, with CDC director Robert Redfield saying last week that  “very aggressive” contact-tracing would be needed to prevent new outbreaks.

Vermont Health Commissioner Mark Levine said even as the state considers measures like serological testing to determine who could be immune to the virus, the focus “at this stage of the virus” is on containment.

Serological testing for antibodies in the blood might, one day, prove that a person has been exposed to the virus and now has immunity, but those tests are at least months away from being validated and widely accessible, Levine said at the press conference, Monday, April 20. “And a vaccine is widely cited as being 12-18 months away.” Without those tools, testing and contact-tracing are currently the only proven methods to box in the virus as the economy slowly begins to open.

Daniel Daltry, program chief of the HIV, STD and Hepatitis C program for the state health department, said the department has pulled in people from the drug and alcohol and environmental health divisions, as well as district nurses, to ramp up health surveillance capacity.

When someone tests positive for Covid-19 in Vermont, a DOH contact tracer will first reach out to that person’s doctor to go over the patient’s history and strategies to prevent exposure to health care professionals. The contact tracer will then call the patient, first going over how they’re feeling before asking about the onset of their symptoms and who else they might have exposed.

The aim is to find out everyone who the infected person had prolonged enough contact within the 48 hours before the onset of symptoms to put them at “medium to high risk” for contracting Covid-19, he said. Daltry said the department bases that risk assessment off CDC guidelines, adding that “you really have to sit down and talk with somebody to find out the particulars of the exchange or situation.”

Health department contact tracers will then call those potentially infected individuals to coach them on what to look out for, how to isolate, and how to get tested if they develop symptoms.

Daltry said the department continually evaluates whether they have adequate staff to conduct contact-tracing, with the goal of interviewing people within 24 hours of their positive Covid-19 test result coming back.

“We’ve taken some incredible steps here early on to try and cross-train in order to do as much contact-tracing as possible,” said Scott on Monday. The Vermont Department of Health has a list of 40 law enforcement officers from around the state who can help with their coronavirus response efforts; around 10 have been drawn on so far to help with travel monitoring and outbreak response, said Vermont State Police spokesperson Adam Silverman earlier this week.

Dr. Joshua White, chief medical officer at Gifford Medical Center in Randolph, said that ideally, the U.S. would track down everyone who’s been in contact with someone who tested positive for Covid-19 and get them tested to “put an end to any sort of chain of transmission.” White added that contact-tracing is critical for Vermont to quash outbreaks that will inevitably pop up until a vaccine is developed.

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