Contact Tracing
Contact tracing is done when a person tests positive for COVID-19. Contact tracing is a time-tested public health tool that effectively prevents the spread of contagious diseases.
The Alaska Department of Health and Social Services (DHSS) and its community partners have been using contact tracing for other types of infectious illnesses such as tuberculosis for quite some time. Every contact tracing investigation for a positive COVID-19 case is different, but they all start with contacting the patient who tested positive.
COVID-19 Response Jobs and Volunteer Opportunities
There are many ways to become involved in Alaska’s COVID-19
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for contact tracing:
What you can do to help
With cases rising DHSS is asking that if you test positive you call your close contacts as soon as you are able to do so. The quicker someone knows to isolate or quarantine, the better chances we have as a community to keep the spread of this virus in check.
A close contact is any individual who was within 6 feet of an infected person for at least 15 minutes starting from 2 days before illness onset (or, for asymptomatic patients, 2 days before the positive test was collected) until the time the patient is isolated.
People can also help by keeping their social circles small and
keeping track of all contacts. If you are a parent of a teen or a young adult, make sure you talk to them about limiting their contacts, masking up in public and staying six feet apart.
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What is contact tracing and how does it work in Alaska?
Contact tracing is a core disease control measure that is used worldwide to help prevent the spread of contagious diseases. The process of contact tracing is as follows:
Public health case investigators work with positive cases to identify all individuals who may have been in contact with the person during the timeframe they were contagious. For COVID-19, this is considered the two days prior to symptom onset for symptomatic cases or two days prior to the sample collection date for asymptomatic cases. These people are known as “close contacts.”
When possible, the positive case provides the names and contact information (phone numbers, email addresses) for the people that were in close contact with him/her during the infectious period. Case investigators may also have to work with employers if a positive case attended work while infectious but cannot remember who they came into close contact with.
The contact tracer then communicates with the close contacts, letting them know of the potential exposure. Close contacts are not told who the case is, just that they were potentially exposed. Close contacts are asked to quarantine for 14 days since last exposure to the positive case and to look for symptoms of COVID-19 disease during their quarantine period.
Contact tracers also provide instruction, education and support to ensure that the close contacts do not infect additional individuals if they become ill themselves.
Contact tracers check-in with identified close contacts to inquire about symptoms and provide support to ensure they have what they need to remain quarantined for 14 days from last exposure.
Contact tracers will also ask people in quarantine if they have left their quarantine location at any point or if they have had any visitors. This information is important because, if the close contact becomes a case, then anyone they might have infected will need to be contacted.
Case investigators and contact tracers are trained in HIPAA regulations and DHSS ensures private information of positive cases and close contacts is kept confidential. All users who have access to the disease surveillance system maintained by DHSS, where information from case investigation and contact tracing is kept, sign a confidentiality statement acknowledging restrictions on access.
To date within Alaska, case investigators have contacted 95% of the positive cases within two hours of the Section of Epidemiology being notified of a positive test.
When are exposure locations publicized?
When an individual who tests positive for COVID-19 has interacted with many people in a congregate setting (e.g., a bar or restaurant) but they are not able to name everyone they were in close contact with, health officials may alert the public about exposure locations to protect the public’s health. In these cases, DHSS would issue a broader public health notice indicating the location and time when people may have been exposed.
Who conducts contact tracing for COVID-19 in Alaska?
When the Alaska Section of Epidemiology is notified of a positive test result, there is a network in Alaska for contact tracing. The network includes the Division of Public Health (Section of Epidemiology and Section of Public Health Nursing), Anchorage Health Department, Maniilaq Association, North Slope Borough, and other partners (full list below)5.
How is Alaska expanding capacity for contact tracing?
Right now we have a statewide workforce of approximately 235 people available to work on contact tracing; this represents a significant increase from a workforce of approximately 75 prior to the start of the COVID-19 response. Our goal has been to expand this workforce to have a total of 500 and expect many of these additional staff will be on-call until they are needed. This goal was based on national estimates for Alaska; we continue to assess our data to understand workforce needs, and would anticipate adding more if we find this number is not enough. We also continue to work to improve the efficiency of our current workforce.
The purpose for considerably expanding the number of people who have been trained is to assure that Alaska will have sufficient numbers of contact tracers available to respond to changing needs. As mentioned above, contact tracing is done by both state and local health officials now and into the future. As part of the COVID-19 response, an expanded group of partners is adding to contact tracing capacity.
In addition to Alaska DHSS staff, partners contributing staff include the Anchorage Health Department, Anchorage School District, Maniilaq Association, North Slope Borough, CDC Arctic Investigations Program, Yukon Kuskokwim Health Corporation, Alaska Native Tribal Health Consortium, Fairbanks Memorial Hospital, he Alaska National Guard/Air National Guard, the University of Alaska Anchorage, College of Health, and Kenai Peninsula Borough School District. Additional partnerships with the Juneau School District, Fairbanks North Star Borough School District, and Matanuska Borough School District to engage their school nurses are in progress, as are partnerships with additional community health centers. The partnership with the University of Alaska Anchorage, College of Health has added virtual training capacity and expansion of the contact tracing workforce.
Expanding from several dozen contact tracers to several hundred across many more partners has required us to build the appropriate infrastructure to support this larger workforce in the areas of training and onboarding, information management, and security and confidentiality. Building that infrastructure took more time than anticipated, and limited the number of partners who could be fully involved until it was available. Now that it is in place, we anticipate adding future contact tracers much more quickly than we have so far.
DHSS continues to explore options to engage partners to expand capacity in a way that is scalable and responsive to actual needs in Alaska while maintaining high training standards and coordination of efforts, and meeting benchmarks for quality and timeliness.
How is Alaska funding contact tracing?
DHSS is maximizing use of federal grants to support all aspects of the COVID-19 response, including contact tracing. Another priority is to maintain sufficient flexibility in funding to respond to different needs across the response as they arise.
How is Alaska using technology to support contact tracing?
DHSS has implemented the DiMagi/CommCare application to manage information for COVID-19 cases and contacts, coordinate work among our staff and partners involved in contact tracing, and allow us to measure and improve the quality of our contact tracing efforts. This coordination has allowed development of a single staffing center to assure that contact tracing resources are shared throughout the state and will be able this statewide workforce to respond to “hot spots” that have previously sometimes left communities overwhelmed as local resources are exhausted.
DHSS has not implemented proximity tracking tools. Proximity tracking tools have generated interest across the United States, and propose to aid contact tracing by using smartphones to determine possible proximity to persons who may have COVID-19.
We continue to explore technology applications to coordinate our work and maximize our capacity while protecting the privacy and security of Alaskans and their data.