A year of COVID-19 driving people into their homes in fear of spreading the virus has gone by and the nation approaches a possible relief in vaccine rollout. The first responders and essential workers have been hard at work through this long year while the restrictions have been in place. Easily forgotten, the COVID-19 contact tracers, which were hired throughout pandemic, have not been reported about as frequently.

Not all contact tracers were the same. There were the people who made simple calls and those who did the footwork to check in with COVID-19 patients and the people with whom they had interacted. All across the country, tracers did have the same training model, one provided as a course by Johns Hopkins.

The beginning of the pandemic had the Governor Cuomo call for the state to have at least 30 contact tracers per 100,000 citizens. Some lower population counties, such as Jefferson, trained health workers already on staff in contact tracing. Other places and the state in general put out open hiring for contact tracers.

Colleges also had to start their own COVID-19 tracing efforts to be able to have safe in person classes. There needed to be a constant way to let anyone in a class know if they were at risk.

You Get A Call

After your COVID-19 test, your phone rings about it being a positive case. You will get called by the lab first, which spurs people to tell friends and family they have been interacting with.

The contact tracer will then call you. They will check to see if you have been informed of your positive test. They will ask if you have any symptoms. They will ask where you have been and who you interacted with.

You will be asked to quarantine and asked if you have everything you need in terms of food and medication. If you are on a college campus, you will have to follow its quarantine protocols.

If you have no way of getting necessities, they have numbers for services that can help you. They will go on to call the people and places you interacted with to ask them to quarantine.

If for some reason you do not agree to a quarantine or don’t answer the phone, the contact tracer will pass the case to their supervisor who will send someone out to physically check on you and ask you to quarantine.

Collegial Culture

After the summer of 2020, colleges across the state opened for a fall and spring semester in limited circumstances. In order to maintain safety on campuses, the colleges would have to take charge of tracking the virus across their campuses.

Imagine being a college student during a modern day pandemic. How do you stay safe? A majority of online classes are a start that most colleges took.

Some colleges were able to keep numbers down, like SUNY New Paltz. Associate athletic trainer Allison Lindsay and her colleague, Bryan Lurie, were asked by the school to head the contact tracing on campus at the beginning stages.

The school runs testing through Enzo Labs, a clinical reference lab with locations all over the tri-state area, which runs pool testing. After a positive test, the lab then contacts the school’s contact tracing team. The speed at which New Paltz can let people know is tied to the lab’s speed according to Lindsay.

Enzo Labs performs weekly testing on SUNY New Paltz campus.

Students at SUNY New Paltz who had positive tests or interacted with people with positive tests receive calls and a text message from the school’s system. Lindsay said that the adoption of using the text message system helped because “most students don’t have voicemail set up or it’s full,” which would get in the way of efforts to get a positive case into quarantine.

Lindsay attributes the success in keeping numbers down to how personal the contact tracers know the community they were calling. “When you say you ate at the SUB [student union building] I would know what that is and who to call where as someone calling from off campus wouldn’t,” Lindsay said, explaining why small knit groups are easier to trace. Lindsay also attributed it to students and faculty working within the health guidelines to lower cases.

Tracing the State

The beginning of the pandemic had many new sites talking about these available jobs in the pandemic. By what were they like and how well are they getting done?

Jefferson County has had over 6,000 total COVID cases since the beginning of the pandemic. . Compared to more populated Erie County which had over 87,000 positive test results since February 2020 or Orange County that had over 13,000 positive cases. Jefferson has a population of around 111,000, while Erie County has nearly 270,000 and Orange County has around 384,000 people.

In more rural places like Jefferson trained their health workers they already had on staff instead of hiring new workers. Lisa Lagos, a public health educator for Jefferson County, became one of the county's contact tracers. All different kinds of county employees got training. “We’ve had employees from The Workplace (the county’s training and employment department) trained, people from IT.”

These workers have been dealing with untold stress and resistance from the job. M., a former contact tracer explaining some emotional strain he experienced.

“I had to talk to a family where all the family had COVID, their kids, like teen-aged, both the parents were in the hospital and the grandparents were dead. I had to keep calling them but I just didn’t want to, because they were already going through so much.”

Experiences like these require a lot of empathy.

M. worked out of Madison County, which has had just over 4,300 positive cases of COVID since February, 2020. This is a much lower number than other counties in New York and is a smaller percent of the population infected over the year compared to Erie County.

The training for COVID tracers from Johns Hopkins taught them how to deal with people in grief. However, there is only so much that people can be trained for situations like these. Contact tracers have to work with a lot more empathy than many other professions.

There have been individuals through this pandemic that have made the jobs harder for contact tracers. M. let me know of an event where a positive case would not specify to the tracer which bank she worked at after their test but before she knew the results, so they had to call all the banks in the county.

In a December NPR article, a survey found New York, among many other states, did not have enough contact tracers to control its caseload.

The overall COVID-19 positive cases had their highest point last April where it then lowered in the summer. This was until right after the holiday season, where cases statewide hit an all time high attributed to interactions over Christmas and the New Years.

This rise led to many counties with low populations and thus low amounts of contact tracers asking for the state to provide assistance. M. mentioned how the amount of cases would lead to not being able to call people until the day before their quarantine would end because of the numbers that the limited contact tracers were working with.

During this time after New Years, Jefferson County also had an increased caseload. “At that point we reached out to the state health department and said yes, we would like some of your contact tracers to help out,” Lagos said.

Now with numbers down again there is less work for contact tracers. M said that when he left they had long stopped looking for new contact tracers where he worked.

What happens next with contact tracers as the vaccine rolls out?

The Connection

Campuses work with the counties they’re in to contain COVID-19. Lindsay, who contact traces for New Paltz, spoke about how the school set up their testing and tracing efforts with the county to best treat the area.

College towns are different from any ordinary town. People come from other counties and other states to attend colleges. This leads to higher population densities and people coming from areas with different COVID-19 rates.

Jefferson County has a SUNY community college. Jefferson has had fewer cases but also contains less people to test and less tests done.

Across the country, campuses are micro communities that have been tasked with self tracing to reduce the spread. Each campus has to keep track of its cases and be open with the people on campus to help keep them safe. This leads to strong guidelines that work and weak guidelines that fail, while contact tracing can’t stop this.

Has contact tracing worked? There is a terrifying toll on people doing this job that wouldn’t be seen on a college campus.

College campuses have isolated groups living on the campus that the schools can track. There are no grieving families on campus and there are no at risk children or elders living with them.

Moving Forward

Contact tracing as a philosophy has been around for decades. The use of it during this pandemic has been a light towards how it will need to be set up in the future.

Lindsay explained that as the school’s protocol for COVID-19 was built on previous emergencies; the next event will also have the benefit of being built with the experience of this pandemic.