Back in November, with COVID-19 cases surging and the state’s contact tracing corps overwhelmed, officials implored people testing positive to reach out on their own to the people they might have infected.
But, now Alaska’s contact tracing effort is rebounding after several months of hiring and several weeks of decreased daily cases.
At the moment, once contact tracers are notified of the new positive, they’ll reach out within the day, said Tim Struna, who heads up the section of public health nursing for Alaska. It takes on average statewide around three days between the time someone might pull into a drive-through testing site and get their nose swabbed to when a contact tracer calls them.
“It’s a profound change,” Struna said of the contact tracing program’s recent improvements.
Jordan Loewe said she used to have time to really talk with people.
As a public health nurse in Anchorage, over the summer she’d have a chance to get a full interview with someone who recently tested positive for COVID-19. She could answer any lingering questions, ask about their home or work lives and get a sense of who they’d recently been in contact with.
Public health experts say contact tracing — calling an infected person to see who got close to them, then calling those close contacts — is a crucial part of controlling the spread of the virus before vaccines become widely available.
But come fall, COVID-19 cases in Alaska swelled. Slowly, Loewe said, contact tracers began shaving down the interviews. State officials say it got to the point where it could be a week or more before people with positive results heard from a contact tracer — if they heard from them at all.
“In my mind it sort of shifted towards damage control,” Loewe said of the recent surge.
There were days when Loewe said she questioned whether they were even making a difference. Numbers weren’t improving despite their continual work.
‘We knew we just could not get to everybody’
Back when the system was overwhelmed, the state had to begin prioritizing who would receive a call from a contact tracer. It wasn’t possible to keep up with the onslaught of new cases each day. So, the state health department decided that rural residents and those in communal living arrangements would move to the top of the list because of contact tracing’s necessity in those settings, Struna said.
“We knew we just could not get to everybody,” Struna said. “And so we had to make sure that the folks that we were getting to, we felt would have the greatest impact.”
That meant that a young person in Anchorage who tested positive for COVID-19 during a case surge might not have heard from a contact tracer at all if they were too busy to reach out within 10 days, after which that person would be past their isolation period and likely no longer contagious.
A ‘ragtag group’
But now, with many more contact tracers on board, the turnaround time is much swifter. And while the new workforce includes a variety of organizations and groups, nearly half of the new contact tracers are in place through a partnership with the University of Alaska Anchorage, Struna said.
The university’s group of contact tracers grew from 60 people in September to 250 this week, said Annie Thomas, project manager for the UAA team. The workforce is made up of people from all over Alaska, Thomas said. The entirely remote group of workers includes former doctors, retirees, nurses, EMTs, teachers and librarians as well as people who were affected by closures in other sectors.
“It’s a fun, kind of ragtag group that really almost makes up the face of Alaska,” Thomas said.
The rest of the state’s contact tracers include contracted workers, National Guard members and school nurses, along with state and municipal health department employees, according to Sarah Hargrave, Southeast regional public health nurse manager.
The contact tracers now number somewhere in the neighborhood of 500, Hargrave said. That makes a difference because contact tracing helps break a “chain of infection,” and if there are delays in reaching out to someone who’s potentially contagious, it’s a major impediment in helping stem new spread, she said.
To be sure, not everyone answers the phone or willingly participates in the contract tracing efforts. But Hargrave said a majority of those involved in the process are receptive while only about 2% decline to participate after picking up a contact tracer’s call.
Similarly, with faster testing turnaround times and quicker calls to those who test positive, nurses are reporting fewer frustrating phone calls in Anchorage, said Christy Lawton, public health division manager in Anchorage, on Friday.
“I haven’t heard the nurses, at least on my end, share what used to be a daily occurrence of kind of ending up with some unhappy people or less cooperative people,” Lawton said.
People’s attitudes have definitely improved over the phone, said Loewe, the public health nurse. Still, she wishes people better understood the role of contact tracers so they might be more willing to share their contacts and help contain the virus.
A shift to vaccines
With a more solid workforce, the state’s public health nurses — who did the brunt of the state’s contact tracing before the pandemic — can now turn to other public health tasks in their communities like the statewide rollout of a COVID-19 vaccine. Roughly 70% of the state’s public health nurses are now working primarily on vaccination, Struna, with the state, said.
Despite the progress among vaccines and improved contact tracing, Loewe stressed that the whole community needs to continue working to mitigate the pandemic. There’s still a lot of time for another outbreak.
“I would definitely not say we are out of the woods,” she said. “But we are making progress.”
Daily News reporter Zaz Hollander contributed.