Carmen Bernu needs you to call her back.
If the Minnesota Department of Health epidemiologist, or someone on her team, has reached out to you recently, it’s probably because you were in close contact with someone who tested positive for COVID-19.
“We are all just really busy,” Bernu said Friday. Her job is to hunt down everyone who came in close contact with confirmed coronavirus cases.
“I’ve done contact tracing before, but nothing on this scale,” she said.
Bernu and her colleagues’ work is essential to Minnesota’s battle against the coronavirus. Getting everyone in close contact with a confirmed COVID-19 case to isolate themselves at home for two weeks will help slow the spread.
The state’s limiting testing — focused on the critically ill, residents of long-term care and health workers — makes the work even more important because it may help health officials understand how the coronavirus is traveling between individuals and in communities.
Contact tracing typically requires a ton of phone calls over a 24-hour period. The state Department of Health has dozens of staffers on several different teams working in shifts.
Patients who tested positive for the virus have anywhere from limited contact with family members to widespread exposure to as many as 70 people.
“I’ve been very surprised at how often people have been answering their phones,” Bernu said. “They know what is going on, and a lot of people are expecting our call.”
HOW THE INVESTIGATION WORKS
Kris Ehresmann, the chief epidemiologist for the Minnesota Department of Health, said as soon as they get a laboratory confirmed case they reach out to the patient for a case interview.
What staffers like Bernu are looking for are contacts at moderate to serious risk of contracting the virus. Family members and housemates are typically at the highest risk — they’re also easy to find and monitor because they live with the infected patient.
Harder to track down are people at moderate risk because they were within 6 feet of an infected person for 10 minutes or longer. Contact investigators are not looking for everyone an infected person might have passed on the street.
First and foremost, state health officials want people who were exposed to an infected person to stay home for two weeks. That means no trips to the store, so health workers also must make sure the quarantined contact has someone to bring them supplies.
If not, local public health officials will be called on to help out.
What contact tracers really want to know is if someone who was exposed to a case starts to develop symptoms. If they do, they may not be able to get tested, but knowing a contact has symptoms is almost as informative for health officials as a lab confirmed case.
“If one of the contacts develops symptoms, they would be epidemiologically linked,” said Ehresmann. “In a perfect world, everyone would get tested and it would be confirmed.”
But since that’s not possible because of test shortages, connecting cases through contact is the next best thing.
SHIFTING FOCUS
Ehresmann says there will come a time — hopefully not in the near future — when tracing all known contacts will no longer be possible given the number of cases and the state’s limited staff. But that doesn’t mean Bernu and other contact tracers will move on to other jobs.
Most likely, their work will shift its focus to hospitals, long-term care facilities and other places where there are a lot of high-risk patients. Understanding how COVID-19 moves through those types of facilities, and learning how to stop it, is important to keeping the number of serious infections and fatalities down.
Three of Minnesota’s four coronavirus deaths have been in long-term care, and statewide 17 of those facilities have confirmed cases. Without proper precautions, viruses can travel quickly in hospitals and long-term care facilities where there are a lot of vulnerable people.
“When someone is in a health care setting, you need to be evaluating the potential for any exposures within the health care setting and then making sure we are providing resources for for them to track possible exposures,” Ehresmann said.
