VDH Outlines Contact Tracing Initiative

by James A. Bacon

Virginia’s COVID-19 contact tracing program will be organized around case investigators, contact tracers, and regional surge teams, all of whose efforts will be supplemented by technology, said Virginia Department of Health (VDH) officials in a media teleconference this morning.

VDH had 129 people doing contact tracing for infectious diseases such as tuberculosis and STDs before the COVID-19 outbreak. The department has boosted the number to about 470 by reassigning departmental personnel, and could add another 1,300 through new hires, said Mona Bector, deputy commissioner of administration.

In a related initiative, VDH officials said the state is close to selecting a technology company that will enable Virginians to download a smart-phone app that will alert them if they have come into close contact with someone infected with the virus. The GPS-enabled app also will provide data that makes it possible to map hot spots.

“Contact tracing is a fundamental component of public health,” said Marshall Vogt, VDH Division of Immunization’s epidemiologist. “It’s something we’re very familiar with. It’s something we do day in and day out to prevent the spread of infectious disease.” New funding will enable the department to expand what it already does.

Building that capability will take time to hire new employees, train them, and get them into the field. “Our internal aim is to get this up and running within weeks,” not months, Bector said.

Aside from data managers and administrators, the new hires will fall into two broad groups: case investigators and contact tracers. The case investigators will work closely with people who have been tested positive for the virus. They will look at lab results, inquire about the settings where they might have acquired the disease, ask whom they might have been in contact with, and gauge the level of risk associated with the case. The job of the contact tracers is to track down the contacts and inform them of their possible exposure. VDH officials also referred without elaboration to regional “surge” teams that will respond to outbreaks.

Employees in the contact-tracing force will work at home, work in work centers, or go into the field, as needed. They will be equipped with laptops and/or tablets, mobile phones, and personal protective equipment. While a public health background is desirable for new employees, also crucial is an ability to communicate well and build trust. Bilingual ability is a bonus.

At present, public health officials are prioritizing certain categories of cases, mainly those dealing with nursing homes, public safety groups, and health  providers. The goal will be to respond to all confirmed cases. Individuals who have been exposed to COVID-19 carriers will be assessed to see if they have symptoms, may be tested themselves, may be referred to a health care provider, and may be asked to self-quarantine. If individuals are reluctant to isolate themselves, their contact tracers will explain why they should. In extreme cases, the state may compel them to quarantine themselves.

“We find that most people are very compliant,” said Vogt. If they aren’t, “there are processes in place” to issue orders.

The contact-tracer force will collect and analyze large volumes of data, and their efforts will be assisted by Artificial Intelligence. VDH also has been looking at a proximity tracking app. A major factor in choosing a provider will be the ability to protect peoples’ privacy.  

“We haven’t picked an app yet,” said Bector, “so we can’t provide details on what it can do.”