How do you track a disease when so many of its carriers can be asymptomatic? How do you find out when someone was infected? Where? And by whom?
The COVID-19 pandemic created an immediate need for a large number of contract tracers – those who would start with a sick person and work backwards to see how they were infected.
Who did the County Health Department turn to?
“We are trained to research,” Barbara Metzenbaum told Valley News Group. “And we are trained to question without judgment.”
Metzenbaum has been a librarian for over 15 years, and until the pandemic was head librarian at the Woodland Hills Branch Library.
When COVID hit, she was called to be a disaster service worker. “When you sign up to work for the City of Los Angeles,” she explained. “You actually sign something that says you are willing work in another capacity during a disaster. Everyone working for the city or county signs it.”
It was an easy transition from librarian to contact tracer.
“I’m 72 and not willing to go and be a disaster service worker someplace where you physically had to be there. I wouldn’t be comfortable with that,” Metzenbaum said. “Contact tracing used a lot of my normal skill set.”
There are 2,600 tracers working in the County of Los Angeles. They are part of a team with a supervisor, and are all trained in national requirements for anyone dealing with medical issues. They all spent several weeks learning what to ask, what to say – and how to say it. “We watched films. We had test Q&A sessions. We took a customer relationship management course from Microsoft Team,” she related.
The first step in the actual process is making the call. After the county gets notified that someone has been diagnosed with coronavirus, the disaster team is notified and a contact tracer is assigned to the case.
“When you call someone who has taken a test and was tested positive, you end up asking a lot of personal questions,” said Metzenbaum. “You want to be fairly nonjudgmental and gentle, but our purpose is to find out who they were in touch with before they were asymptomatic – and after they got their test.”
She said many people already know, because they got a call from the person who exposed them. “Those people have been terrific, most kind and helpful,” she said.
Then there are those who are rude, and don’t want to hear the information. “A few say it’s a hoax,” she related. “There are a lot of asymptomatic people out there – so they don’t really believe it.”
Most people, however, are worried and happy to give out the information.
Contract tracers ask whom they have been with two or three days before they tested positive or had symptoms. “We actually have a quarantine calculator which puts in when the person was tested and what day they started showing symptoms,” Metzenbaum explained. “We then tell them the isolation period – approximately 10 days if they continue symptoms. If they live with a family it could be up to 24 days.”
The infected person is then asked to contact the people with whom they were in touch with, and also give the contact tracer their phone numbers. “We contact them to make sure they know they were exposed. We can’t tell them who told us because of HIPPA violations, but we can ask them to self-quarantine and give them websites with further information.”
A lot of people who are contacted panic because they feel they can’t stay home because they have to go to work. “We give them the county resources that can help them with financial help, food and medical help,” said Metzenbaum.
The biggest roadblock she faces, however, is those that don’t answer the phone. Each contact tracer uses their own extension to call out. “It’s just a random number on your phone. It doesn’t say Department of Health calling, so a lot of people won’t answer just a general phone number.”
If they do answer, Metzenbaum says she has a script to read to find out what they have in terms of symptoms, how long, were they hospitalized, etc. “Some of us have now been doing this so long we can ad lib,” she said. “But we make sure we get all the information.”
When they don’t answer, it’s concerning. The contact tracer has run into a dead end. They could be at risk and not know it.
“The nice thing to do if you’re ill,” she said. “is call each person you’ve been with and let them know you’ve tested positive. Ask them to self-quarantine and get tested themselves. It could save their life.”
Many of those currently trying to save lives are librarians,.For now, they are one step in the fight against the pandemic. Collecting information. Distributing resources. Helping others.
At some point, when the scare is over, they will return to their regular jobs – where they are used to doing exactly the same.