Containing the spread of COVID-19 without a vaccine comes down to three tenets: test, trace, and isolate.
Bria Graham Glover, MPH, CIC, infection control epidemiologist at 网红爆料, Baltimore (UMB), is the primary contact tracer for campus.
A team at the 网红爆料, Baltimore (UMB) that is behind the UMB COVID-19 Hotline and the SAFE on Campus daily symptom monitoring system is ensuring those three steps are being followed for faculty, staff, and students.
Contact tracing is a small but detailed and complex part of their jobs, and it鈥檚 one that nobody had experience doing before in a pandemic.
鈥淚t is not a solid science. It is ever-changing, evolving,鈥� said Bria Graham Glover, MPH, CIC, infection control epidemiologist at UMB. 鈥淲e鈥檙e learning as we go.鈥�
Graham and Deborah Knepp, BSN, RN, COHNS, COHC, occupational health nurse, are part of a team led by Marianne Cloeren, MD, MPH, FACOEM, FACP, associate professor at the 网红爆料 School of Medicine, that鈥檚 making sure people with COVID-19-compatible symptoms are not coming to campus through the use of SAFE on Campus and the UMB COVID-19 Hotline.
They鈥檙e navigating guidance changes from different agencies and having a sizable portion of faculty, students, and staff being affiliated with more than one institution or workplace. So far, nothing has stopped this team from completing its jobs.
鈥淲e couldn鈥檛 keep open without them. That鈥檚 the bottom line,鈥� said Steven Deck, DM, MBA, ARM, CIH, CSP, CHMM, director of Environmental Health and Safety at UMB. 鈥淚t鈥檚 as important as electricity. Nothing could happen without it.鈥�
What constitutes close contact? Per Centers for Disease Control and Prevention (CDC) guidelines, close contact means 鈥渟omeone who was within 6 feet of an infected person for at least 15 minutes starting from two days before illness onset.鈥� However, there are so many other factors in regard to location, activity, and mask-wearing.
That鈥檚 why UMB relies upon the expertise of its infection prevention professionals in making decisions about who should be contacted and who should be required to quarantine.
How Contact Tracing Works
Contact tracing at UMB starts when someone reports a positive COVID-19 test to the University via SAFE on Campus or working with the COVID-19 Hotline.
Knepp implored the UMB community to pay attention to the SAFE on Campus emails after their form is completed each day because instructions could say to call the COVID-19 Hotline.
A nurse case manager from the COVID-19 Hotline will call the person to see if they were on campus, involved in experiential learning off-campus, involved in clinical work, or were in contact with other people, said Cloeren, who oversees the operation of SAFE on Campus and the COVID-19 Hotline.
颅If there appears to be a potential exposure risk, the case manager will contact Cloeren鈥檚 team to get to work.
鈥淲e don鈥檛 start contact tracing until we know that you are a positive case. Sometimes there鈥檚 a delay,鈥� Graham said. 鈥淪ometimes you may call the hotline because you have symptoms and want to get tested. So we might not find out that you tested positive until a few days later, and then we鈥檒l start the contact tracing.鈥�
Once the call is made to the COVID-19-positive patient, the team will start asking questions to retrace the person鈥檚 steps. Graham finds it best to start with the previous day and work backward.
鈥淚t turns more into a conversation, and I feel like that鈥檚 the best way to get all the details as opposed to asking yes-or-no questions,鈥� Graham said. 鈥淭he main point of the conversation for contacts are how long, what kind of personal protective equipment were you wearing, and how close were you to someone. Then we get into what kind of activities were you doing, and where did those activities take place.鈥�
More than likely, a person with a positive case or high-risk exposure will have to answer the same contact tracing questions multiple times.
鈥淚t鈥檚 especially complicated for us because we are one of possibly four entities that are contacting these people asking the exact same thing,鈥� Graham said.
Someone could spend 20-40 minutes on the phone with each of the 网红爆料 Medical Center or other clinical employer, the Maryland State Department of Health, and their local health department, in addition to UMB.
It can be overwhelming remembering who was told what.
鈥淚 keep them on track asking guideline questions, and I tell people it鈥檚 OK if you don鈥檛 remember exactly what you were wearing or how close you were,鈥� Graham said.
Truth and Confidentiality
Overall, students, faculty, and staff being contacted are doing a great job of detailing information.
鈥淭he employees, for the vast majority of them, are wanting to solve problems,鈥� Knepp said. 鈥淭hey don鈥檛 want this to be an issue on campus. They鈥檙e devoted to what they do and are cognizant of their role in the grand scheme of things.鈥�
It can complicate the process if you tell everyone that you tested positive.
鈥淪ometimes that actually leads to some problems because we have all these people who probably didn鈥檛 have a significant exposure worrying about it,鈥� Cloeren said. 鈥淚t鈥檚 easier to identify and notify the people who are high-risk, and it鈥檚 hard to identify the whole universe of low-risk contacts that people might have.鈥�
Being truthful and forthcoming is the utmost importance regarding potential exposure. The COVID-19 Hotline is a safe space to be honest with the circumstances of an exposure.
鈥淲e鈥檙e not going to use the information against you; we鈥檙e trying to not get you in trouble,鈥� Graham said. 鈥淲e are just trying to gather enough information so we can safely isolate anyone who may have come in contact with you.鈥�
However, not being honest will cause problems. For example, if the exposure was at an academic or social gathering and a person is trying to hide that there was a gathering and how many people were there, it can delay exposure notifications.
鈥淚t does get dicey if they are adamant about their privacy and don鈥檛 give us the information that we need to do the job,鈥� Graham said.
Keep Your Distance and Keep Your Mask On
What鈥檚 the best piece of advice for UMB to avoid COVID-19 exposure on campus?
鈥淎ll of us say it together: Stop eating together in break rooms!鈥� Cloeren said.
Colleagues can let their guard down with a co-worker in a lunchroom, take off the mask and chat, and then spread the virus while talking. Reminder: UMB employees should eat alone with their door closed in their office and should not eat with others indoors on-site.
Another reminder the team wants to share: Wear a mask and physical distance. It鈥檚 not an either/or proposition.
鈥淚n another exposure situation, people are thinking that if they鈥檙e both wearing a mask, they can sit a couple feet away from each other and work on the same computer screen for hours,鈥� Cloeren said.
When it comes to masks, Cloeren also encourages people to wear a surgical mask if possible.
鈥淲earing a cloth mask is not considered sufficient protection by the CDC for someone not to be to quarantined,鈥� she said. 鈥淚f the person who is positive is wearing a cloth mask, that is relatively OK, because it鈥檚 thought to capture the cough, sneeze, and aerosols, but if person who is positive is not wearing something over their face and their colleague wore a cloth mask, then they would still be exposed.鈥�
