Contact tracers on job in Arkansas

Pandemic ramps up recruiting, training for crucial work

FILE — The Arkansas Department of Health logo is shown in this 2019 file photo.

More than 200 trained professionals are manning work stations to track down and contact Arkansans who may have been exposed to the coronavirus.

They are doing so to curtail the virus's spread.

The process is known as contact tracing, and it is being carried out mostly by the Arkansas Department of Health. Those doing the calling include nurses, faculty members, students and volunteers, health officials said.

Contact tracing has been heralded by state officials and public-health officials across the U.S. as a key to safely reopening the economy.

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"This is our most effective defense against the virus," Gov. Asa Hutchinson said Thursday during a news conference. "It limits the spread."

Contact tracing works by interviewing a person who is infected. A nurse typically conducts that interview.

The patient is asked to identify anyone the patient has been in contact with and then those people are contacted, warned about their possible exposure and interviewed. Those same at-risk people would be given instructions on how to isolate themselves for 14 days.

Those people in quarantine are set up with the Situational Awareness and Response Assistant, also known as the SARA alert program, which is an automated call system. Whether by phone, text message or email, those who are quarantined get calls each day to see if they become symptomatic. If they do show symptoms, those patients are given instructions on what to do.

"The contact is enrolled in that robocall system," said Dr. Jennifer Dillaha, an infectious-disease specialist for the Health Department. "They are contacted every day."

The agency has always had a contact-tracing program in place, but it had to be expanded quickly during the pandemic. Contact tracing often is used to contain sexually transmitted diseases, said Dillaha, who is medical director for immunizations and outbreak response for the Health Department.

Since the coronavirus emergency, trainees have had to be quick studies.

"Some of them have worked in areas totally unrelated to this," Dillaha said. "It's really a developed skill. It's not really knowledge-based. It requires [good] coaching to teach someone to talk to a patient and interview their contacts."

Interviewers rely on scripts. They ask questions ranging from symptoms experienced to whether the patient has called a health care provider. Patients are also asked how many children they have, how many people live in their home and what kind of vitamins or supplements they take, if any.

Across the country, particularly in places where the virus is more rampant, more people are being recruited into the field of contact tracing. That's being done so not just because of the number of infections, but because unemployment is reaching historic levels. That means the pool of applicants has never been deeper. A Google search for "contact tracing jobs" on Friday yielded 106 million results.

Dr. Namvar Zohoori, the deputy state health officer and chief science officer at the Health Department, as well as a professor of epidemiology at the University of Arkansas for Medical Sciences, said one of the auditoriums on the UAMS campus has been transformed into a call center with up to 65 work stations.

Those 30 or so people at the Fay W. Boozman College of Public Health at UAMS who are working in concert with those 200 or so at the Health Department, Zohoori said. Additionally, UAMS plans to train 200 or more people as infections continue to rise. As of 5 p.m. Saturday, there were 4,463 confirmed cases and 98 deaths, according to state statistics.

"Other than social distancing and other things we do personally to protect ourselves, contact tracing is probably the most important thing we can do," Zohoori said. "From a public-health perspective, contact tracing is one of the main pillars of defense that we have."

The pursuit of more contact tracers will continue for the foreseeable future. Zohoori said there are talks of contracting with an outside agency to hire additional manpower. He declined to be more specific.

"It takes a lot of people to do this," he said. "Not only do you need to do it, but you need to do it fast. It's very resource-intensive and right now we are in an urgent situation."

In spite of the urgency, not everyone who is contacted has been willing to participate.

According to an Axios-Ipsos survey, about 50% of Americans would voluntarily participate in a contact-tracing program if it was administered by government health officials. That drops to 30% if it meant participating in a similar program conducted by a tech company.

It's a surefire sign that people are skeptical about the protection of their privacy, said Quentin Rhoads-Herrera, a cybersecurity expert with Critical Start in Plano, Texas.

"Contact tracing in general is a great idea, not only for the covid-19 pandemic, but for all pandemics," Rhoads-Herrera said. "The biggest problem with the adoption of it is that there are so many different implementations across the country and across the world. It's clear not all of them are taking into consideration the security and privacy of the individual."

He added that state governments are conducting their contact tracing in a very centralized way and that raises questions about whether personal information is being stored in databases for long periods of time.

Danyelle McNeill, a spokeswoman for the state Health Department, said a person's information is "purged" from the alert system after the 14-day quarantine concludes.

Dillaha said contact tracers expect to encounter people reluctant to participate. They are told to be patient, but persistent.

"The important thing is to treat everyone with respect," she said. "We really try hard to win their trust. Sometimes we can't reach people because they don't want to be reached. Other times, they come around."

SundayMonday on 05/17/2020