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Larimer County contact tracers seek to understand and slow spread of coronavirus

Kevin Duggan
Fort Collins Coloradoan
Published 12:00 AM EDT Jul 13, 2020

Erika Cathey tries to be a calming voice during a hectic time.

Cathey calls Larimer County residents who test positive for COVID-19 to check on how they are doing and provide information about how to care for themselves.

But she’s also looking for information.

Cathey is a contact tracer. Her job is to ask a series of questions to discern where the person who tested positive — the case — might have been exposed and with whom that person had close contact in recent days.

She asks for names and phone numbers.

She then calls the contacts to let them know they potentially have been exposed to the coronavirus and what they should do about it, such as getting tested and quarantining for 14 days. The identity of the case is kept confidential.

Then she asks the contacts for their contacts. And the process goes on.

In this photo illustration Erika Cathey, the case contact and monitoring task force lead at the Larimer County Department of Health and Environment, demonstrates how she performs contact tracing investigations in an office at the Larimer County Department of Health and Environment in Fort Collins, Colo. on Wednesday, July 8, 2020. Currently, Cathey is carrying out these investigations from her home.
Bethany Baker / The Coloradoan

A single case can result in dozens of phone calls, she said. Most contacts name three to five other contacts.

Before the pandemic hit, Cathey’s job as an environmental specialist with the Larimer County Department of Health and Environment was to inspect restaurants and child care facilities.

Switching to COVID contact tracing was “quite a departure” for her, but she enjoys the work.

“I talk to a lot of people. A lot of them are pretty frantic and worried,” she said. “And we get to provide them answers the best we can.”

Coronavirus: The latest updates from Larimer County and Colorado

Following protocol

As is the case with many diseases, a positive test result for COVID must be reported to the state health department by the testing lab or health care provider.

The state then notifies the local health department, which will call the case within a matter of hours.

People who are sick with COVID must isolate themselves for 10 days, and they must show improvement and be free of fever for at least 72 hours before they may resume their normal activities, Cathey said.

Someone who was exposed to the virus through close contact with a confirmed COVID case is expected to quarantine for 14 days. Testing for the virus is recommended even if the person doesn’t have symptoms, such as a cough, fever or shortness of breath.

A close contact is defined as being within 6 feet of a person for a cumulative 10 minutes, said Kelsey Lyon, lead of the health department’s outbreaks task force.

In an employment setting, that could mean having an extended conversation, a shared desk space or multiple short conversations throughout the day.

Testing and contact tracing are important tools for containing the spread of the virus, said Tom Gonzales, Larimer County public health director. If people know they have been exposed, they can take proper steps to prevent exposing others.

“It’s really the primary way we are able to keep outbreaks to a minimum and keep our economy going,” Gonzales said.

Some people are reluctant to speak with contact tracers out of fear of getting themselves or someone else in trouble, he said. Some don’t understand why they are getting a call from a governmental entity.

Public health officials aren’t out to punish people, he said. They are only interested in tracking the disease, slowing its spread and keeping the community safe.

Little pushback, so far

Cathey said in her experience, most people are receptive to calls from contact tracers, although some are hesitant to give names and numbers for friends and family.

Tracers depend on getting that information to do their jobs, she said.

“We can’t help their family and friends understand their level of exposure or their risk or their next steps if we don’t get that name and phone number,” she said.

Cathey is the lead for the health department’s case contact and monitoring task force. The task force has 22 members, including health department employees, CSU students and some volunteers.

A team member is on duty every day, including weekends and holidays. Translators are readily available to assist Spanish-speaking residents.

Testing: Increased demand strains resources

When a contact tracer encounters a confirmed case who was exposed to COVID in a work setting, the information is shared with Lyon and the outbreak task force.

An outbreak is defined as two or more confirmed cases in a single facility. The team focuses on businesses, long-term care facilities, shelters and neighborhoods with communal spaces, such as apartment buildings and mobile home parks.

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When an outbreak is identified, company management is given guidance on how to address the situation. Employees who had close contact with a confirmed case are asked to quarantine for 14 days.

As of Friday, Larimer County has had 15 outbreaks since the start of the pandemic. All of the affected businesses and health care facilities have been cooperative, Lyon said.

The health department and businesses have the same goals, she said: Keeping employees and residents safe and the facilities running “as optimally as possible.”

Coronavirus: Larimer County doctor’s office, pool company and restaurant report COVID-19 outbreaks

“When you hear about businesses closing, it’s not us closing them down because they are not compliant,” she said. “Sometimes they just have to close down because there aren’t enough staff to continue running the business when we have to quarantine all those close contacts.”

When the outbreaks team is alerted to a potential problem location, it “hits the ground running hard” and advises quarantining and testing of all close contacts even if they are not symptomatic, Lyon said.

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In doing so, the goal is to ensure there is less chance of the disease spreading in the business or facility and into the community. An asymptomatic person with COVID can unknowingly infect another person, who can infect someone else, and so on.

“If we just send the positive people home without diving into the contacts, it could end up becoming a continuous and rolling outbreak and lasts for months at a time,” she said.

Health department spokesperson Katie O’Donnell said the Larimer County business community has taken the pandemic seriously and has been “proactive and transparent” about dealing with COVID cases.

“It’s not the same across the state,” she said.

Kevin Duggan is a senior columnist and reporter. Contact him at Support his work and that of other Coloradoan journalists by purchasing a digital subscription today.

This content was originally published here.