COVID-19 CONTACT TRACING Updated April 21, 2020
REFRESHER WHEN Is It Safe CASES NO LONGER STRONGER HEALTH PUBLIC HEALTH To Come SPREADING WIDELY CARE SYSTEM CAPACITY Fewer unlinked cases, falling Able to withstand increase of Test patients and trace Out Again? case rates, contact tracing cases without risking health contacts immediately, isolate keeping up with case reports care worker and patient lives the ill, quarantine contacts REFRESHER HOW Do We Lift MEDICALLY VULNERABLE PRIORITIZE PREPARE TO TIGHTEN THE Physical CONTINUE TO SHELTER SOCIETAL BENEFIT FAUCET IF CASES SPIKE Potentially, those with Day care, maybe schools Re-institute physical distancing Distancing prior illness will be (protecting the vulnerable), (stay-at-home) if cases increase protected – but we don’t infrastructure, partial safe and may overwhelm health care Restrictions? know this yet re-opening, sanitizer/temp checks or public health capacity 2
FOUR KEY STEPS FOR PUBLIC HEALTH CONTACT 1 TRACING Initial notification of confirmed and presumptive case. Immediate notification with full locating information for patient and provider 2 Contact tracing of Interview patients , walking through entire infectious period infected patients has hour-by-hour and recalling everyone they were in contact with been used on a massive during that time. Provide instructions on and facilitate isolation and treatment. Identify as many contacts as possible. scale successfully in China, South Korea, and Singapore. 3 Locate and warn contacts that they have been exposed , interview them to find out if they have symptoms, test if they do (and It’s time to scale up in some situations, if they don’t), arrange for care if ill, quarantine if contact tracing in the not. United States. 4 Quarantine and monitor contacts. Daily report on symptoms and temperature for 14 days after last contact while patient was infectious. Consider testing at end of quarantine. 3
CONTACT TRACING KEY QUESTIONS ? ? ? Isolating Building the corps Reporting and Privacy Concerns How will your public How to provide health experts create your for voluntary How will you get all reports battalion of this corps of isolation and immediately and allay sensitive, trained, quarantine concerns about confidentiality effective contact tracers? outside of home? and privacy? ? Mandating Isolation ? Resources and Quarantine What community resources will Is mandatory monitoring and isolation of be available for non-hospitalized the sick required? Mandatory monitoring cases and their contacts? and quarantine of the exposed? What telemedicine/phone bank resources do you have? 4
RESOURCES FOR ISOLATED CASES AND QUARANTINED CONTACTS Need incentives to manage isolation and quarantine with strong wraparound services EXAMPLES AND IDEAS Financial support Care packages Core resources could include could include such as • Masks • Daily check-in phone calls • Stipend from government to • Thermometers • Instructions of how to keep space clean those without sick leave or • Food, laundry, pharmacy services for those sharing space who need to take care of child • Health education materials • A hotline for counseling, information, or elderly dependents • Passwords for on-demand movies, social services, and medical support • Work with employers to e-books, learning channels • Garbage removal provide support, with possible • Access to high-speed internet & laptops • Access to telehealth and care if ill tax credits • Hand sanitizer & alcohol-based cleansers • Relocation to safe and desirable place, • Encouraging note from the mayor if requested 5
LESSONS 1 2 3 Embrace Support THINK BIG!! Accountability Public Health! and Learning! Daily public dissemination of key metrics on testing, Massive (100x) expansion of This is a public health isolation, contact tracing, care force to support, track, emergency. Only public quarantine. Learn and care for every case and health can lead us out of it. continuously to improve contact fast and well. continuously. 6
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