Monday, Sept. 28, 2020
Brie Smith will be practicing occupational therapy in the future, but right now she’s helping students stay healthy through her job as a contact tracer at Virginia Commonwealth University.
“For me, patient care is very important. Working as a contact tracer helps me get what I want out of a job. I also feel like I’m making a positive impact in the Richmond community as well as the VCU community,” said Smith, a second-year doctoral student in occupational therapy in the College of Health Professions.
As a student contact tracer, Smith is a part-time employee of the Virginia Department of Health even though she’s working at VCU.
“We are an arm of VDH,” said Lori Dachille, director of emergency preparedness in the VCU Police Department. Dachille also supervises the day-to-day operations of VCU’s contact tracing. “We also have full-time VCU employees that serve as liaison to VDH and supervise the day-to-day operations of contact tracing.”
Smith finds that most students are understanding and willing to participate in contact tracing.
“Having the ability to know if they become symptomatic is very important,” she said. “In some cases, it can be a challenge getting them to understand how important contact tracing is.”
Targeting a need
Contact tracing involves finding people who may have been exposed to an illness such as COVID-19 and providing guidance on how they can prevent spreading it to others.
“The definition of exposure from the VDH and Centers for Disease Control [and Prevention] is 15 minutes or more within 6 feet of a COVID-positive person,” said Michael Cimis, director of environmental health and safety at VCU. “You can also be exposed through bodily fluid transfers, sharing utensils and living with, or caring for, a COVID-positive person.”
Contact tracing is used “regularly by health departments for other contagious diseases such as tuberculosis,” said Margaret Roberson, M.D., director of VCU Student Health Services.
“Public health officials will ask persons diagnosed with COVID-19 who they have been in contact with and where they spent time while ill in case they may have potentially spread the disease to others,” Roberson said.
Any information shared with public health officials is “kept confidential so your personal and medical information will be kept private,” Roberson said.
Cimis and his team began talking about contact tracing in April, recognizing the university might need additional resources. “We made up our mind that we needed to find a solution. We didn’t know what the solution would look like,” he said.
After talking with the Virginia Department of Health, VCU decided to establish a contact tracing unit on campus under the department’s oversight.
“We knew this would be challenging and if things changed at VDH we wanted to be aligned,” Cimis said. “We were the first organization in the state to come into an agreement with VDH to do contact tracing in this way.”
Student contact tracers were hired and full-time VCU employee supervisors were designated after a vetting process. Everyone received Virginia Department of Health and medical privacy laws training as well as training on the health department’s Sara Alert system, which does public health monitoring and reports individuals exposed to or infected with COVID-19.
“We are dealing with a virus unlike flu. We don’t have a vaccine yet,” said Frank J. Tortorella, M.D., director of VCU and VCU Health System Employee Health Services. “Contact tracing and case control are two elements to minimize the number of people that get COVID. It also helps protect people with a greater risk of complications.”
The inner workings
The contact tracing unit is housed in the emergency operations center at VCU Police headquarters, but it is not a VCU Police function, Dachille said.
“It’s in a secured facility and we are in a large room so we can socially distance,” she said.
Staff includes eight health department part-time student workers and five VCU full-time employees who serve as supervisors. The center operates seven days a week from 8 a.m. to 8 p.m. Students work in four-hour blocks.
Contact tracers receive new contacts — people who may have been exposed to COVID-19 — from the Sara Alert system and follow up with them as well as prior contacts still under a mandatory 14-day quarantine. Conversations with contacts normally last about 10 to 15 minutes. Tracers monitor the contact’s health, provide them with resources and ask if there is anything they need.
“We do have a script that highlights what we are supposed to ask to get pertinent information,” Smith said, adding she makes people aware of Virginia’s COVIDWISE app as another contact tracing tool.
The number of new contacts varies day to day. “It all depends on testing,” Dachille said.
We are dealing with a virus unlike flu. We don’t have a vaccine yet. Contact tracing and case control are two elements to minimize the number of people that get COVID.
The identity of the person with COVID-19 is not revealed to contact tracers.
“We do know the time frame you are potentially exposed. It’s important to note that not all contacts we call are sick or will become sick,” Dachille said.
“The vast majority of contacts we speak to do not become a positive case. They remain asymptomatic,” Smith said.
Most new contacts already know they have been exposed. “People are being good about letting others know they tested positive because they feel a sense of responsibility,” Dachille said.
COVID-19 is believed to spread mainly by close contact through respiratory droplets from the infected person when they cough or sneeze.
“We know that COVID-19 can be spread by people who are not having symptoms, or before their symptoms begin,” Roberson said. “By having people identified as contacts stay home and stay away from others while they quarantine, we can help prevent the spread of disease.”
Keeping the campus safe
At seven months into the pandemic, it’s human nature that some people become fatigued with having to follow best practices to fight COVID-19. People aren’t likely to change their attitude until the disease touches them in some way. “When you know someone who is affected by it, then I think you change your behavior,” Tortorella said. “It takes you being a near miss.”
Behaviors such as keeping a 6-foot distance, masking up and hand washing are important to breaking the chain.
“It’s important to wash your hands often, disinfect high-touch surfaces and stay home if you are ill,” Roberson said. “Flu season is coming, so remember to get your flu shot.”
Cimis is pleased with VCU’s contact tracing efforts to date.
“I’m impressed with our student contact tracers. They are efficient and diligent,” he said. “It’s been amazing how they are getting people to open up to them. They have picked it up quickly. And it’s working.”
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