Public Health

What is contact tracing and how does it work?

Alyssa Orcuilo23 May 2020

Written by Alyssa Orcuilo, Jacqueline Slobin, and Khang Vuong.

We are living amidst a global pandemic. While it is already hard to navigate the uncertainty, it is harder having to live with fear of getting the Coronavirus COVID-19, and how to notify family and friends if you might have it.

In the absence of a working vaccine, preventing the virus from spreading is the best defense we have to contain and slow the spread of the Coronavirus COVID-19 pandemic. But contact tracing alone is not the magic bullet, we need multiple layers of defense - contact tracing, social distancing, public testing - to effectively manage the Coronavirus pandemic. 

The best way to explain contact tracing: imagine you are living in a spider-web-like network of human and that each interaction you have with others could put you at risk for getting the virus, contact tracing ‚Äútraces‚Äù that chain of interaction as far and it could to the person who initiated the spread within your social network. 

Contact tracing is a web network of human contact

What Is Contact Tracing?

Contact tracing is a key strategy for preventing further spread of COVID-19. With contact tracing, public health staff are to work with a patient and assist them to recall everyone with whom they have had close contact during the timeframe while they may have been infectious. Because the United States is in need of immediate action, it‚s necessary for communities to expand and train a large contact tracer workforce and work collaboratively across public and private agencies to halt COVID-19 transmission. 

What contact tracing is

How Does Contact Tracing Work?

  1. Public health staff warns the exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible.
  2. In order to protect patient privacy, contacts are only informed that they may have been exposed to a patient with the infection. They are not told the identity of the patient who may have exposed them.
  3. Contacts are provided with education, information, and support to understand their risk, what they should do to separate themselves from others who are not exposed, monitor themselves for illness, and the possibility that they could spread the infection to others even if they themselves do not feel ill.
  4. Contacts are encouraged to stay home and maintain social distance from others (at least 6 feet) until 14 days after their last exposure, in case they also become ill. They should monitor themselves by checking their temperature twice daily and watching for cough or shortness of breath. 

To the furthest extent possible, public health staff should check in with contacts to make sure they are self-monitoring and have not developed symptoms. Contacts who develop symptoms should promptly isolate themselves and notify public health staff. They should be promptly evaluated for infection and for the need for medical care.

How Contact Tracing Works

What Tools Are Being Used To Trace Contact?

According to the CDC, contact tracing tools will fall into two main buckets: case management and proximity tracking

Case management tools collect data on cases and contacts via COVID-19 data systems, and users can provide updates on their symptoms. Additionally, there is an automated notification system that follows up with users. 

Proximity tracking tools are effective when there‚s wide adoption -- using GPS or bluetooth, users are alerted if they have been near a case and are urged to maintain social distance for 14 days. However, many proximity tracking tools are still under development due to privacy and confidentiality issues. 

The UK, Singapore, Australia, and India are all in the process of rolling out national contact tracing apps to better maintain cases. As for the US, companies have started developing their own contact tracing apps. Apple and Google are working together, and on May 4th they announced that they would not be utilizing GPS location services in the app.

What Apple & Google Proposed

Who is Qualified To Conduct Contact Tracing?

It‚s important to note that contact tracing is a specialized skill and individuals must be trained in order to work with patients and contacts. More information regarding this is coming soon.

I heard there are a lot of openings. Can I get a job as a contact tracer?

Furthermore, there is now a new segment of the job market opening up for contact tracers. Contact tracers are responsible for interviewing cases and contacts to advise effective quarantining when appropriate. This is a fully remote role that can pay $17-$22 dollars per hour including benefits. While nurses and those with a public health background are preferred, communication skills are the priority for this role. There are big hiring efforts across many states in the US, but only a few currently meet or are expected to meet the estimated need. 

Is My Privacy Protected?

Although privacy can be a concern when tracing past contacts, the CDC is taking several steps to ensure that a level of privacy is being maintained throughout the process. When being trained to become a contact tracer, individuals complete online modules in HIPAA, privacy, confidentiality, data security, and the ethics of data collection. Additionally, the app proposed by Apple and Google takes privacy into account as well. The app‚s services can be turned off at any time, if you test positive, your identity and personal information will not be shared with your contacts, and it does not collect your location data. Access to the individual information on the app will not be shared with Apple or Google, and will only be given to public health authorities. 

Sources:

https://www.cdc.gov/coronavirus/2019-ncov/downloads/digital-contact-tracing.pdf

https://www.cdc.gov/coronavirus/2019-ncov/php/principles-contact-tracing.html

https://www.reuters.com/article/us-health-coronavirus-usa-apps/apple-google-ban-use-of-location-tracking-in-contact-tracing-apps-idUSKBN22G28W

https://www.tracetogether.gov.sg/

https://www.wired.com/story/india-covid-19-contract-tracing-app-patient-location-privacy/

https://www.theguardian.com/world/2020/may/06/critical-mass-of-android-users-needed-for-success-of-nhs-coronavirus-contact-tracing-app

https://www.health.gov.au/resources/apps-and-tools/covidsafe-app

https://www.businessinsider.com/how-to-apply-contact-tracer-work-remotely-with-benefits-2020-5

https://www.npr.org/sections/health-shots/2020/04/28/846736937/we-asked-all-50-states-about-their-contact-tracing-capacity-heres-what-we-learne

https://covid19-static.cdn-apple.com/applications/covid19/current/static/contact-tracing/pdf/ExposureNotification-FAQv1.1.pdf

https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/list-requirements-for-protecting-health-info.html

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