Public health reactions evolve as the pandemic progresses

Contract traces have existed since at least the early 20th century and continue to be one of the most important infectious disease reactions in healthcare.

Melissa Graben, director of infectious diseases at the McLean County Health Department, said it is more important to track who has been infected, as few people are immune during COVID-19. Stated.

The interview has been edited for clarity.

dig: Traditionally, when we do contact tracing, it is a disease that we are familiar with the process of disease. We know a lot about them. We do a lot with sexually transmitted diseases, gonorrhea, chlamydia, the community may remember when we had a mumps outbreak, contact tracing we do with mumps There were many things that happened. But the difference is that there are far fewer people who are less susceptible because they have the vaccine. In contrast to no one having immunity and everyone being at risk, we were only trying to actually identify and quarantine those sensitive people. ..

WGLT: The other part of the problem is that you need to get the call answered first. What was the success rate of getting people to answer if you were shown as a contact tracer, or if you didn’t answer the phone without knowing exactly who the person was, and you didn’t know your ID? ??

dig: I think it’s interesting. That’s the tendency I’ve seen as a nurse for 15 years and no one answers the phone anymore. They want voice mail or text messages. They always respond to text messages and voice emails. Callbacks are the problem right now. When I heard that the health department was calling, I saw COVID reduce the callback rate. It’s always been a kind of struggle, but especially when they now know what’s on the other side of the phone, or when they think they know what’s on the other side of the phone. , They may not want to call back.

WGLT: How often do people have to deal with false information that gives you fake numbers or give you something useless?

dig: Unfortunately, that happens. You may have been given the wrong phone number or the wrong contact information. There aren’t many people who give a name just because they want to annoy someone, or “I hate it so they gave it a name.” These instances rarely occur. Not only that. “I’m going to give you a fake name and a fake phone number, so I think you have contact me and will send you in the wild goose chase.”

WGLT: To what extent is skepticism about many of our public institutions involved in this? We naturally resist wanting to cooperate from time to time, as there is an agenda that knows what they are looking for and what they are trying to do. how much is it?

dig: A good part of that is that we are a government agency. There are parts of the community that are inherently distrustful of the government.

State software helps collect data

The McLean County Health Department (MCHD) praises the new software program from the state that it uses to process contact tracing. According to Graven, the program is free to the county and is easy to use, helping government agencies collect more data and develop targeted public health responses. Graven said the Salesforce program can also help track other infections and food poisoning, but it’s unclear whether the state will provide access to the program after a pandemic.

Be late

McLean County has been rapidly hiring more contact tracers in recent weeks, but it’s not enough to keep up with the late summer surge in coronavirus cases. MCHD will hire more than 20 new tracers this summer and will introduce about 10 more. Graven said the recent reduction in new cases of coronavirus has helped somewhat.

dig: I’ve heard from staff that they feel like they can breathe a little because they know there are more people in the house to help. They don’t seem to report 100, 200 cases every day, and 15 and 20 are seen, so you can get to work with the view that it’s a little more manageable. I don’t think anyone feels like we’re catching up yet.

The tracers of our program are very type A kind of people. They want to be good at their job and want to contact people as soon as the results enter our queue. They feel a little defeated because they can’t reach them as fast as we want. They manage their expectations, their own need to be perfect, and ensure that everyone is contacted as soon as possible. It’s not what we’re trying to change to them, it’s great quality, but it puts them a lot of pressure. It’s very difficult to turn off COVID and it’s hard to relax knowing that many people are still calling.

WGLT: Have you ever had a time when contact tracing became a very difficult battle and the virus spread to the community in vain? Have you ever approached that point, or is it possible to approach that point?

dig: definitely. Contact tracing is most effective during the epidemic acceleration phase. This means you can get in the case, quickly identify, contact with your contacts, and quarantine your contacts.

Because of that, there was a lot of opposition to us, such as testing and test turnarounds. If it takes 5-6 days to get the test results and then another 1-2 days, it’s already late anyway. We are nearing the end of quarantine. But yes, contact tracing may not work because it is so popular in the community that it is when you start seeing mitigation efforts coming.

Role play

WGLT: This role-playing issue is in managing the pandemic, such as deciding whether the school will reopen, such as when Bloomington and Normal limit the crowd and adopt their own emergency orders to perform additional surveillance. Another question to ask in the public sphere about the role of the health sector is business.You may be asked why the health department does not make or receive these calls [the] Do you want to lead them? After all, the health sector has expertise. Can you explain what role the health sector plays in these decisions made by other government agencies?

MCHD Administrator Jessica McKnight: We are definitely here to provide guidance, and that guidance is also what we receive from the Illinois Public Health Service. That is the person we refer to for our guidance and they refer to the CDC. We are responsible for bringing that guidance to the local level and seeing what is happening in the community and how to implement it here. We’re not necessarily saying “the town should, should”, but we definitely have those conversations, share guidance with community partners, and they’re planning. So participating in their discussion. First.

WGLT: We’ve been in a pandemic for six months and we don’t see a definite end. Even now, not everyone has all the answers, and certainly no one had the answers in March. What lessons have the health sector learned since then? (Are you there) Have you done it differently because you learned about the effects of masks? I had a question in March. Being outside was a big difference from being inside. But is there anything else at the local level that is clearer than it was then?

McNight: I think the only thing that is really clear is what we don’t know. Things are changing. It’s a lesson learned that it’s difficult and it’s hard to instill that confidence in an expert when it seems to be turning, but it’s science. That means we are doing what we need to do. Looking at the medical field 100 years ago, it’s very different now because of what we’ve learned.

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