“I’ve Never Worked Harder in My Whole Entire Life”: Inside an Exhausting Day as a Contact Tracer
I am a public health nurse who specializes in communicable diseases for my local county's health department in Asheville, N.C. Before the pandemic, we were doing a lot of contact tracing for other reportable diseases like whooping cough, but since the pandemic started, all five of the communicable disease nurses in my county are doing COVID-19 tracing all day long now. We even had one woman come out of retirement to help us do all the normal work that we can't get to.
Since the beginning of March, our staff has been working seven days a week. The job is so hardcore and never really stops.
Here's how it works: We'll get a report of an original case of COVID-19 from either a lab or a doctor's office. Then we'll call that patient on the phone (we call them the case patient), go over all of their symptoms, and really try to identify when their symptoms started. That's the most important thing. That doesn't mean, when were your symptoms full-blown? It's more like, when did you start feeling off at all? When was the first day that you were like, gosh, I'm feeling drained?
So if someone says, "I don't know, maybe Monday, but definitely Tuesday morning." I'm like, we're going with Monday! Then there's a really specific definition of who needs to be contacted: Anyone who was within six feet of the case patient for 10 minutes or more between now and 48 hours before their first symptom started.
If they have been staying home and practicing social distancing, and only going out for essential things, then the list should only be the people they live with. But sometimes this list can be ginormous—like crazy big, like a hundred people. If that happens, the whole team has to drop what they're doing and everybody then has to turn to the contact list for that one case patient.
So we call all of those people. But we keep things super private when we're calling the general public. We would never say their name. We do encourage the case patient to reach out to their close contacts as soon as possible, but when we make calls from their list, we just say something like, your name popped up on a list of close contacts of an individual that tested positive for COVID-19. Sometimes, they'll be like, Oh, you mean Betty Sue? Yeah, she just called me.
Even if they are asymptomatic, we recommend that they get tested. That recently changed. It used to just be that we would recommend testing for those who were symptomatic. But since testing is becoming more widely available now, it's kind of just across the board. If you're a close contact, go and get tested.
But because we don't know if they have COVID-19 yet, we also tell them they have to be placed in quarantine for 14 days from their last exposure with the individual. That means they can't be going to work. They can't be going to the grocery store. No social distance happy hour. Nothing.
Then, we also follow up with the case patient throughout their entire isolation. There's no exact number of times we have to call them, but we need to be checking in with them frequently enough to know when they start having a normal temperature and assess their symptoms. This helps us know when it's appropriate to take them off isolation and deem them no longer contagious.
The job is really, really time consuming. We're on the phone all day every day. It's also tough to have to repeat the same information over and over and over. Every single day, I'm explaining to someone why the quarantine period is 14 days. So it can be like really monotonous in that regard. But at the same time, every single case patient's situation is so different. You're talking to people you never thought you would be talking to, and reaching out to businesses that you would have never normally interacted with. So, in that way, is kind of interesting that you're getting to talk to all of these different types of people.
Some states have already hired tons of contact tracers to do just this job. In North Carolina, it's all still being done by local health department staff like me. But the North Carolina State Health Department just implemented a contact tracing program and they hired hundreds of people. That should be starting within the next couple of weeks. They've also developed a software that's specific for contact tracing. That'll help us out a lot.
It's really exciting, but I just feel like my bandwidth is completely maxed out right now and learning a new system will definitely be tough. I'm looking forward to having a more streamlined approach to it. Right now, every communicable disease nurse has their own little Excel spreadsheet that they're typing their notes into. We all have own little ways of doing it.
It's been really, really hard to turn off the job at the end of the day. I'm so focused, that by the end of work, I'm still kind buzzing a little bit, you know? Sometimes I get calls all throughout the night, too, because none of the people I leave voicemails for know what time I'm finished. If my work phone rings in the middle of the night, it's like oh my god! I've been trying to get in touch with this person for two days, so I do feel like I have to answer it and rush to my spreadsheet.
I've never experienced anything like this in my life. I've never worked harder in my whole entire life.
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