ATLANTA — State officials have touted Georgia’s contact tracing efforts as the key to stopping COVID-19 spread, but it is only effective if people agree to self-quarantine.
After health districts notify people they’ve been in contact with a person who tested positive, they must also try convincing them to quarantine, a task that has become increasingly arduous as the state reopens.
District health contact tracers say they must navigate misinformation about the program and privacy concerns to get people who may be infected with coronavirus to stay in their homes.
Since the program began, the state has conducted case interviews with more than 6,000 coronavirus-positive patients, and has worked with those cases to identify nearly 15,300 contacts.
The state has also upped its army — rallying a contact tracing team of 1,000 people working to keep up with the virus as it spreads throughout the Peach State; as of Friday the total number of cases passed 45,000 and deaths were near 2,000.
Dr. Kathleen Toomey, commissioner of the Georgia Department of Public Health, said the biggest hurdle for contact tracing is "gaining the trust" of the public by making sure Georgians share private information with contact tracers and heed the advice of health officials.
Toomey said the process isn't meant to be "intrusive" or infringe on "civil liberties" and has made several pleas to the media to help correct any misconceptions.
"Contact tracing will not be successful if people we contact don't answer the phone or refuse to be part of this process," she said.
But as the governor continues to reopen businesses — bars and nightclubs given the most recent green light to start back up on Monday — it's unclear how people will react if asked to stay inside for two more weeks.
“It's getting increasingly difficult, as we are just all tired of it — especially if you feel good,” Sherry Gregory, infectious disease director for the North Georgia Health District (which includes Whitfield and Murray counties), said. “It is a challenge to try to convince somebody who doesn't feel sick that they need to stay away from everybody.”
Local health district teams make seemingly endless phone calls, review automated symptom checks and sometimes have employers scour security footage to get an accurate survey of who infected people have encountered.
Generally, the rule of thumb for identifying contacts is anyone who has come into contact with someone who has tested positive for coronavirus within 6 feet for 15 minutes or longer, starting 48 hours before symptoms.
Or a cough in the face, Gregory said.
The North Georgia Health District has a 35-member team tracking down contacts; the state provides some trackers but staffing varies district to district.
Ken Lowery, epidemiologist for the South Health District, said the 10-county district, that includes Lowndes and Tift counties, has about six contact tracers working seven days a week.
“It's really hard to explain — or to even fathom — how many cases we do a day,” he said.
Districts are often at the mercy of when test results return from private labs, he said, adding results often arrive in waves.
“Our whole purpose in this is to mitigate the amount of illness in our community so we can get to the point where we're reopening,” he said. “I know it's difficult to be named a contact and have to remain home in quarantine for 14 days. But in the grand scheme of things, we're really doing a lot of good with this.”
The burden of COVID-19 education has fallen on contact tracers picking up phones and making calls to strangers. Even now, going on four months into the pandemic, they often have to explain the severity of the situation and are faced with ever-changing information on symptoms and fluctuating state guidelines.
But the goal remains the same: preventing further spread, one person at a time.
“It's really important — from a case investigator point of view — that once we find out who these people are, to make sure we find out what day that they were last in contact with the positive person,” Lowery said. “No one wants to stay home longer than they have to.”
If people don’t want to comply with isolation or symptom checks, he said, the team will switch contact tracers, hoping a change in person or tone might change their minds. It usually does the trick.
Toomey said no matter how large the state’s contact tracing efforts, no staffing number will be enough.
“It is cooperation of the community,” she said, “that will make this effective.”
Riley Bunch covers the Georgia Statehouse for CNHI’s newspapers and websites.