“The first day was really hard”: Life as a contact tracer

As American states weigh the possibility of reopening services in the face of the covid-19 pandemic, the demand for contact tracing-helping track down and isolate potential carriers of the virus-will get even larger. We spoke to people working as contact tracers across America to understand what it's like, what they're seeing, and what might be coming next.

Jana De Brauwere, 44, San Francisco

When San Francisco's Department of Public Health asked if anyone in the library system would want to join the city's contact tracing program, I said yes right away. From the description, it seemed like a perfect match for our skills as librarians, as well as our mission: providing people with information that they and their families need.

I underwent a week of extensive training, during which I learned about the procedures, software, and privacy rules, and shadowed experienced contract tracers. My first shift started on Sunday, and I'll be working 20 to 25 hours each week on the program while continuing to perform other duties, remotely, for the library system.

The main job is to contact people who have been exposed to the coronavirus by a person who has tested positive. The majority of our contacts right now speak only Spanish, so a lot of the librarians have to use translators, which can take a lot longer. It's not my first language-that's Czech-but I do speak Spanish, so I've been able to take more of those calls and feel like I've been able to help. I probably call 15 to 25 people per shift, and conduct full interviews with four or five.

Some people are a little suspicious. I understand that, the mistrust of the government... but it's too bad."

Most of the people I interact with are really grateful that we're reaching out. They have a lot of questions that we can provide answers for.

Some people are a little suspicious. Some people hang up after I ask for their date of birth and address. I understand that, the mistrust of the government, having grown up under communism. But it's too bad. I feel like they can benefit from this information: how to quarantine themselves, how they can protect their families, and what kind of support is available.

Probably 50%, maybe 60%, of the contacts that I call on my shift don't answer. Some don't have voicemail set up. But I leave a message when I can, and several people called me back yesterday.

The first day was really hard. You're following the script, inputting data, and talking to people, all at once. It's more multitasking than I'm used to. But it's gotten easier, and there have been times where I feel like I've been able to build their trust. Sometimes you have to assure them you're calling to help them, you're working on their behalf; it's not the government trying to go after them.

It's been a positive experience for me because I've learned a lot of new things, and because I've seen how people can pull together in times of need. People from across departments, medical students, librarians, staff from the city attorney's office-all bringing different skill sets to the challenge.

Robert Bramson, 79, Massachusetts

Before this I was retired, but now I work 40 hours a week as a clinical investigator in Massachusetts. I call patients who have been diagnosed with covid-19 and ask a lot of questions: How do they feel? Do they have food? Can they isolate at home? Who did they have contact with 48 hours prior to their positive test? I enter this information into our computer system, and our contact tracers follow up with all the contacts named.

The tracking process is new, and confusion is expected. We make mistakes, but we learn."

I started in April, after the state put out the call for people with a health-care background to help track the outbreak. I had enjoyed practicing medicine for over 40 years, working at the Massachusetts General Hospital and the Children's Hospital in Boston, until I retired 10 years ago. I elected to answer the call to do infectious-disease tracking, but it requires an enormous amount of labor. The call was for 1,000 employees to track virus contacts; 25,000 people answered.

Our goal is to slow the spread of the virus to buy time for researchers to develop a vaccine or an effective drug treatment. The tracking process in Massachusetts is new, and confusion is expected as new hires like me learn how to do things. We make mistakes, but we learn. People work around the clock to make the process go faster, smoother. On more than one occasion I have heard a sigh of relief and a Thank you" when I told a patient that I would be calling back each day to check on their status. That Thank you" reminds me why I loved medicine.

Robert Bramson is the father of Elizabeth Bramson-Boudreau, the CEO and publisher of MIT Technology Review. Nobody in this article was paid for their contribution.

Jade Murray, 22, Utah

I'm currently working for a rural local health department in Utah-I just graduated with my degree in public health. My job is to check on individuals, monitor their signs and symptoms, temperatures, and then answer questions on their diagnosis or how their recovery process looks after the 14-day quarantine period that they're under.

Today I have about 20 cases, and it usually takes me about two or three hours a day to contact everybody, chat with them, and answer any questions they might have. The numbers are manageable, but one of the limiting factors there is that people are already not moving around as much as they would have done.

We don't really know if they're staying at home, or if they are still going out. You have to believe that they're complying."

The hardest thing can be getting people to keep giving responses over the 14-day period. And as far as getting them to comply with your recommendations, obviously they have their own autonomy-we can't control what they're doing. But we don't really know if they're staying at home, or if they are still going out because they still feel okay. You have to believe that they're complying; give them the recommendations and hope that they are taking those daily actions. I've had a couple of individuals that have pushed back, or where you can tell they're not really interested in giving me feedback. But I haven't had anyone reject us completely.

On May 1 we got our release to open the economy again, so businesses are allowed to be open to groups of 20 individuals or less. I think in this next coming month there might be more to do with the new positive cases. I would assume numbers could increase with the reopening of the economy; we have a game plan going both directions, but we're hoping for a positive outcome.