SPOKANE COUNTY, Wash. — Health leaders in Spokane County are sharing more about the process of coronavirus contract tracing, which is a way to monitor contacts of infected people.
Contact tracing is another step toward re-opening the economy and lifting social distancing restrictions in the state.
By the end of the week, nearly 1,400 people will be trained statewide and ready to help with COVID-19 contact tracing, Washington Gov. Jay Inslee said on Tuesday.
The plan is to alert people who came into contact with someone infected by coronavirus within 24 hours of contact.
Contact tracers include those serving with the National Guard, Department of Licensing, and state and local health officials.
Participation in any contact tracing is voluntary, said Amy Reynolds with the state's Department of Health. She said the state hopes people will cooperate to help protect the health of loved ones and others who may have been exposed, but a patient has the right to refuse to share information with contact tracers.
Anna Halloran, an epidemiologist with the Spokane Regional Health District said contact tracing employees or volunteers will interview a person within 24 hours of their positive coronavirus test result.
The interview, in part, will establish that person's close contacts, along with information about any medical evaluations the person may have had, their place of employment, or gatherings they had been to before their diagnosis.
The vast majority of cases so far have been contacted within 12 to 24 hours, she said.
A close contact is anyone who spent at least 10 minutes within six feet of the infected person while they were sick, Halloran said. The general contagious period for COVID-19 is two days prior to symptom onset and 10 days afterward.
All close contacts will be asked to quarantine for 14 days from the time of their last exposure to the infected person.
“When someone is quarantined, it breaks the chain of transmission, and that’s why we think contact tracing will hep with disease containment," Halloran said.
Halloran also emphasized that privacy is of the utmost concern to contact tracing employees and volunteers.
“Public health is bound by the same exact laws that health care providers are to keep information private," she said.
Close contacts will not receive the name of the person who tested positive for coronavirus unless permission is granted. Additionally, contact tracers will not ask for information that is not relevant to their investigation, including Social Security numbers or marital states.
Most of the recent coronavirus cases in Spokane County have been associated with other known outbreaks or family clusters, Halloran said.
“We have had a couple of workplace clusters, but for the most part it’s been long-term care and family clusters that we’ve seen," she added.
EWU students volunteer to help with contact tracing
Halloran said public health leaders are ramping up their contact tracing efforts for the expected rise in coronavirus cases that could come with reopening.
Eastern Washington University is starting a contact tracing training program that is coordinated through the health district. The program includes undergraduate and master's students in public health, and EWU is open to including Washington State University and University of Washington students.
Zoom training for the program begins on June 1, with small groups of four to six students, said Dr. Pam Kohlmeier.
“We’ll have approximately 20 volunteers ready to go by June 15," Kohlmeier said, adding that 50 trained volunteers will be ready by July 15.
All volunteers will go through HIPPA certification training before beginning their contact tracing training, in an effort to help protect confidentiality, Kohlmeier said.
Contact tracing in restaurants, schools and child care centers
Under new rules from Gov. Inslee, restaurants in Washington that will partially reopen during Phase 2 must keep a daily log of all customers to help with possible contact tracing.
“I think with the air exchanges in restaurants, with fans being on, it’s possible that some infectious particles could be blown over to other tables," Halloran said of the decision.
Halloran also spoke about contact tracing in child care centers and schools. She said the investigations in the latter setting are "really time-consuming."
“When a case is identified in a child care center, we will contact the child care director and ask for a list of the children and their parents’ contact information," she said. "And we will contact each of those individuals to let them know about their exposure, we’ll ask the school to do that, and then ask them to quarantine.”
In a school, contact investigations depend on the setting and a number of factors, including classes students were attending.
“We really rely heavily on the school nurses and administration to tell us who may have been close contacts with a case," Halloran said.
Quarantine can be enforceable, but health officials hope people will 'do the right thing'
Spokane County Health Officer Dr. Bob Lutz said the self-quarantine rule for those who are infected or in close contact with a case can be enforceable by law, but public health leaders hope it doesn't come down to that.
“As I hope people have concerns and considerations of other community members, they will do the right thing. They will self-isolate and self-quarantine," he said.
Lutz added that he is also looking at a policy wherein he would strongly urge people to wear masks in indoor public settings, such as one recently issued in King County, to curb the spread of coronavirus.
While Lutz said the number of cases in Spokane County continues to be low, he wants it to stay that way and is encouraging people to use good judgment.
“People are getting overly optimistic and doing things that they shouldn’t be doing, like gathering," he said.