Contact Tracing

The novel coronavirus is spread through contact with an existing virus being expelled by an infected host.

According to an article on WebMD, “COVID-19, the illness caused by the coronavirus, starts with droplets from an infected person’s cough, sneeze or breath. They could be in the air or on a surface that you touch before touching your eyes, nose or mouth. That gives the virus a passage to the mucous membranes in your throat.”  This information has been duplicated through various sources easily found on the internet, but the information is not yet complete. Most reputable health sites will stress that more information is needed.

Once infected, the human immune system responds to the infection, and within two to 14 days a wide variety of symptoms can result. These symptoms can include any, or a combination of fever, cough, shortness of breath, fatigue, chills (sometimes with shaking), body aches, headache, sore throat, loss of taste, loss of smell, nausea and diarrhea. But one inherent problem is that an infected person might not show any of these symptoms within the two-week time frame or might not show any symptoms at all. Another problem is that many of the symptoms of the disease are typically associated with other known conditions and diseases. So, tracking the path and spread of the virus by symptoms alone is at best problematic, and at worst unreliable.

Contact tracing, on the other hand, offers a more direct approach along a clearer path. Chris Crum, the Public Health Director for the Greenup County Health Department, said contract tracing is a means of determining how widespread the infection can or has been spread. Currently the state and local health departments are working together to determine the best procedures, Crum said. But currently they are focusing on when an individual tested positive and adjusting the time frame around when that individual exhibited the first symptoms.

The time frame, depending upon symptoms, could be as long as three weeks. Once determined, the health department notifies the people with whom that individual has been in contact during that time frame. Due to HIPAA regulations, the health department does not reveal the name or any other information about the individual who tested positive. And after notifying them, they request those contacts follow self-isolation procedures until determining whether they have been infected themselves.

“Some people can be asymptomatic or never show symptoms even though they are infected,” Crum said. “But they can still spread it by being a carrier. And that’s why we have tried to increase our testing capacity to where those people who might be asymptomatic can be tested and we can see where it might have been spread.”

Crum said that currently the health department isn’t testing for COVID-19. But they might at some point in the future if needed. The CARES Act is covering the cost of the tests (nasal swab). Testing is being done at King’s Daughter’s Medical Center, including asymptomatic individuals, and Primary Plus in South Shore is testing asymptomatic individuals as well.

“Primary Plus just received a $933,000 grant to increase testing capacity,” Crum said. “And I just got word that both KDMC and Primary Plus will be doing antibody testing in the future. So, we will be fully capable with regards to testing.”

Crum said that this capacity for testing, something many areas might not be fortunate enough to share, frees the health department to focus on their own strengths.

“We are fortunate with the hospitals and the health care providers we have,” Crum said.

The testing being performed by area hospitals and health care providers, including Southern Ohio Medical Center, is one factor that has allowed the health department to stay ahead regarding contact tracing. Another factor is the relatively smaller numbers — compared to other counties in the state — of individuals who have tested positive for COVID-19. Generally, Crum said, the health department knows the results of the tests even before the hospital or health care provider who administered it.

“There is a CDC disease surveillance system that we check every day to see if there have been positive cases reported. But all the health care providers are really good about sharing information,” Crum said. “We get reports every day on the number of tests being done from KDMC, Primary Plus, SOMC and even from Cabell Huntington. So thankfully we are getting a constant flow of results. Fortunately, its almost all negative.”

“But with any of the positive results, we start contact tracing immediately. We start to find out where they’ve been and who they have been in contact with. Right now, the pace that the positives came in made it possible to do all of that in house,” Crum said. “We had 13 positives, and now we have 13 recovered.”

Spaced out over the past several months it was manageable, he added, but if there is a big surge of positives Crum said they will need to use some of the 700 people the state is supposed to employ for contract tracing.

Crum said he believes everyone should be tested, both to help with understanding the spread and helping to control the pandemic. The most important reason people should get tested, he said, is not for themselves, but for their family, friends and community to protect them from getting sick or worse. Crum said it is the most practical way to understand more about the disease, but more important than that reason is a very human reason.

“I just call it being a decent human being,” Crum said. “Being more concerned about others that yourself.”

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