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COVID Contact-Tracing Team Relies On Public Response, Openness In Fighting Spread

State Health Department official Cassandra Deffenbaugh

In the age of COVID-19, a phone call with a strange number on caller ID could be much more than spam.

It could be news vital to your health. Or to your family’s health. Or to a friend’s or co-worker’s health.

State contact-tracing specialists who follow the trail of virus infections in South Dakota rely heavily on phone calls to reach those who have tested positive for the disease, as well as those who might have been exposed.

So, Cassandra Deffenbaugh and other staffers in the state Department of Health urge you to pick up when a call comes in, especially if you have seen that “strange” number before.

“I know it can be challenging to pick up when it’s a strange number,” says Deffenbaugh, administrator of the Health Department’s Office of Disease Prevention Services. “But if you see a number that comes across a couple of times and you’ve been tested or maybe you have been in contact with somebody who has been tested, please answer that call.”

It could be one of about 130 workers in South Dakota trained to reach out to people who have been infected by the coronavirus or might have been exposed to the disease by someone who has tested positive.

Typically, if no one answers, the contract tracer will leave a voicemail saying they will call back. They might also say they have an important health matter to discuss and that a return call is important.

They use other outreach methods, too, but phone calls are still the most common, most effective method of contact-tracing work.

“The first point of contact is usually through a phone call,” Deffenbaugh says. “When we reach them, we talk about symptoms, and when they started. And according to CDC (Centers for Disease Control and Prevention) guidance, we go back to two days prior to when the symptoms started, then we identify contacts in those two days prior and up to the point of when we talk to them.”

Those contacts could include people living in the same house, those at work, those in social settings and anyone who has been in close contact with the infected person. Close contact is defined by the CDC as spending at least 15 minutes within six feet of the person.

Most people are very cooperative in providing information on their contacts, Deffenbaugh says.

“The people who we reach out to generally care about the people they have been around, so they are very helpful,” she says. “They are genuinely concerned about the people they may have exposed, so they’re good about providing us the appropriate information to get in touch with those people.”

People also seem to follow recommendations on self-isolating, too, even though that typically means at least 10 days of that isolation, an experience that most dread but are willing to accept.

“They have a genuine concern about not exposing people,” Deffenbaugh says. “It’s very few who are not following our guidance.”

It’s well-informed guidance by a network of contact-tracing specialists across the state who have a variety of different educational and training experiences. Some are registered nurses. Others have advanced degrees in public health. Still others have backgrounds in biology, sociology and psychology. Health Department employees work with other public health agencies and private health-care providers to coordinate the contact-tracing effort and follow the trail of the disease. Different skill sets and experiences add up to a more effective system.

“It’s not just one type or level of education that’s appropriate for this work,” Deffenbaugh says. “There are multiple facets and backgrounds involved.”

But persistence, attention to detail and people skills are all essential qualities. And sometimes so is physical and emotional stamina, since surges in infections mean upticks in demands in tracking the virus and the people exposed.

That’s nothing new, since the network of specialists was already tracking diseases such as E. coli, salmonella, HIV-AIDS, and tuberculosis in the regular course of disease control. The coming of COVID-19 has added consistent stress, with occasional surges, to the monitoring system and its staff.

“We’re certainly used to the work normally,” Deffenbaugh says. “But COVID has enhanced the need. And we’ve been able to ‘surge’ our staff to accommodate the need.”

Surging was needed during the blowup in cases tied to the Smithfield pork plant in Sioux Falls, and at smaller surges around Huron and Aberdeen tied to similar operations. It’s rare for the regular capacity for case tracing to be surpassed. With the addition of surge staff, the Health Department network has the ability to investigate up to 147 new positive COVID cases a day, and about six contacts for each.

That’s about 880 close contacts a day.

There’s only been about three or so days when we surpassed that,” Deffenbaugh says. “But we do have the ability beyond that to add on another 60 people to assist.”

Beyond that staff tracing system, DOH professionals can call upon the general public through news outlets to help with case identification and tracing work.

“Typically we’re looking at smaller, more manageable numbers of contacts. But when people have been in more social settings — grocery stores, restaurants, whatever it might be — and can’t identify all those people they might have been within 6 feet for 15 minutes or longer, that’s when the public notices go out.”

It’s pretty easy to get help from the mainstream media, because the public notices are both essential to health officials and the public and real news for media outlets.

All told, South Dakota has done pretty well in managing its COVID case load, mostly through voluntary adherence to social distancing standards and masks in situations where face coverings are recommended. Some of that is likely because of the scattered population base and to the fact that the summer temperatures allow people to spend more time outdoors, where spread is typically reduced.

Learning from the sometimes-brutal experiences in other states has been helpful, too.

“The individuals in our nursing homes have been well taken care of and they’ve taken some really effective precautions,” Deffenbaugh says. “I think we’ve had some time in seeing what has happened nationally to implement some of the precautious that other states didn’t have time for.”

Time and preparation are crucial. So is the official response once cases are detected and the contact-tracing team goes into action.

So, consider picking up the phone when that strange-looking number appears on the caller ID. It might be just another robocall or spam message. But it also might be news that’s crucial to your health.

Click here to access the archive of Woster's past work for SDPB.