How COVID-19 contact tracing works in Douglas County

Public health officials say there is one simple thing people can do to help stop the spread COVID-19: Answer the phone.

“I would say that is one of our biggest challenges to contact tracing,” said Kathy Ronchi, Douglas County public health officer.

The telephone is the quickest way Douglas County health officials can reach people who have tested positive and how they notify close contacts they may have been exposed.

People who can’t answer the phone should clean out or set up their voicemail boxes so health officials can leave a message, Ronchi said.

All laboratories testing for COVID-19 in Wisconsin are required to submit the results to the Wisconsin Electronic Disease Surveillance System, which automatically reports the results to the local health department where the individual lives.

In Douglas County, Ronchi and three public health nurses handle contact tracing routinely. The county recently hired two part-time contact tracers and trained environmental health staff to pick up some of the load, said Lisa Freier, Douglas County public health nurse.

When county staff have too many cases, they can get help from the state, Ronchi said.

The Wisconsin Department of Health Services established a team of 400 contact tracers to increase capacity in support of local health departments around the state.

Contact tracing is a public health tool that is used routinely, said Elizabeth Goodsitt, a spokesperson for the Wisconsin Department of Health Services. She said it’s work public health nurses do routinely for sexually transmitted or other infectious diseases.

“What is new in this space is mainly that large scale of cases and the speed at which the virus is able to spread,” Goodsitt said.

The surveillance system allows local health departments to assign contact tracing to the state team when local health departments are overwhelmed, said Traci DeSalvo, acting director of the Bureau of Communicable Diseases with the Department of Health Services.

When a positive case is reported, public health officials pick up the phone.

“We make contact with the individual immediately when we get the result,” Ronchi said. “Sometimes they’re not aware of their result yet, but because of the contagiousness of this disease, we make a call immediately or we attempt to make contact immediately.”

Ronchi said there have been one or two instances where health officials haven’t been able to reach someone by phone who tested positive for COVID-19, but a letter was sent.

“We make three attempts within that 24 or 48 hours,” Ronchi said.

When public health officials reach someone who tested positive for COVID-19, they ask for information about fever and other symptoms. That data is put into the county’s communicable disease reporting system.

“This is the way we do surveillance to end isolation,” Ronchi said. “It has to be 10 days and the last 24 hours with improved symptoms. If you’re still sick on the 10th day, you can’t be released from isolation.”

Health officials also conduct an interview to determine who that individual may have had close contact with to determine who may have been exposed to the virus. They ask a lot of questions, Ronchi said, wanting to know where they were and who they may have visited with in the 48 hours before they had symptoms, or in the 48 hours before they got tested.

When the state pitches in, they try to mirror the same quick turnaround of local health departments, DeSalvo said. Currently, it takes them one or two days to complete interviews.

She said information gained is sent back to the health departments through the surveillance system.

Anyone who has spent 15 minutes within six feet of an individual who tests positive for COVID-19 is considered a close contact and is notified they must quarantine for 14 days and monitor for fever and symptoms, Ronchi said.

A negative test for COVID-19 during quarantine doesn’t shorten the timeline.

“That only means they haven’t developed the disease yet,” Ronchi said. “It doesn’t mean they couldn’t in one or two more days.”

Ronchi said information about the person who tested positive is never shared with close contacts to protect people's privacy.

More recent cases have involved younger people who don’t know everyone they had close contact with or how to contact them, Freier said. That's been a big challenge for the department.

“We are responsible for following up on every confirmed case or incident within our county and all their contacts. So it can get to be quite extensive, say, when someone has gone out to a party or had a lot of close contact with many people," she said.

The way to avoid getting the illness and having to quarantine is to always maintain social distances, Ronchi said.

Ronchi said as many as 20 people have been tied to a single positive test result in Douglas County. That's why contact tracing is so critical, officials said.

“The most important part of contact tracing is to stop or contain the spread to keep it from growing exponentially,” Freier said.