MORGANTOWN, W.Va. – Since the start of the COVID-19 pandemic, West Virginia public health entities have been spearheading efforts in contact tracing to meet the state’s specific needs.
In attempts to be responsive to a continuously changing epidemic landscape, training and implementing contact tracers throughout the state has become an integral part in the fight against the spread of the virus. Through West Virginia University’s School of Public Health and the West Virginia Department of Health and Human Resources (DHHR), a course was formed to do exactly that.
“Early on, since COVID-19 is a very infectious disease that was spreading through our population, it was very important for us to quickly build up our capacity for contact tracing to limit the spread,” said Dr. Chris Martin, course co-director and physician in WVU’s school of Public Health.
Recognizing a need for contact tracers early on, Martin, along with co-directors Dr. Lisa Costello and 1st Lt. Jaymie Brooks Dumproff, epidemiologist for the West Virginia National Guard who is on loan to the School of Public Health, created an online class titled Contact Tracing and Pandemic Response at WVU to instruct and certify individuals on how to contact trace. Beta tests were originally administered to DHHR staff members and National Guardsmen, and they then became open to the public. Volunteers then began signing up en masse.
“We had hundreds of people register for this course,” said Joanna DiStefano, course administrator and WVU program manager for the Global Engagement Office. “Close to 250 people have completed it so far.”
Beginning in May, the “asynchronous online learning” course was designed to evolve with new information, while remaining sensitive to the current disease situation in the state. Students spent about 15 hours over 10 different online modules that went through the basics of epidemiology, public health surveillance, how to report cases, along with other fundamentals of contact tracing.
Students also underwent various training and interviewing techniques during the course schedule. Part of a contact tracer’s job is to ask sensitive questions pertaining to the contact’s (someone who came into contact with a COVID-positive person, or a case) whereabouts and if they came into contact with other individuals. This required motivational interviewing instruction was provided by Martin’s resident, Rasika Thomdukalam. Volunteers also got certified nationally as contact tracers in the Association of State and Territorial Health Officials as part of the course.
Once certified, the information was then sent to state public health officials to begin utilizing contact tracers across the state. When Fayette County had outbreaks in May, county health officials turned to the course for help.
“[The Fayette County health officer] worked with our course to identify individuals in their community who would take the class,” said Costello. “They’ve engaged in contact tracing efforts more directly in their community.”
Along with providing information and assistance to state and local health officials, the course directors shared the class with public health entities beyond West Virginia’s borders.
“We were getting contacted by the state of Maryland’s public health department, the county public health agency in Fort Worth, Texas, indeed, other countries, as well, like British Columbia, Canada,” said Martin.
With other public health bodies reaching out to further their knowledge on contact tracing, a dynamic was exposed on the knowledge gap between what healthcare workers were focusing on before and what part they needed to act on now with a different center of attention.
“Even if you work in public health, your main job may not have been contact tracing,” said Costello. “In the pandemic, however, that’s a role you would need to play.”
Some of the issues being faced with contact tracing have come from testing and its limitations in fighting the spread.
“Testing is taking three to five days in some cases to get results, which poses a problem for contact tracing,” said Dr. Martin. “ If you get a positive result five days after testing, that’s a bit more challenging.”
Although contact tracing is an almost century-old method used to monitor the spread of disease, the extent to which it is being done now is new. Some people have raised questions about the storage of patient data and the legality surrounding it.
With previous disturbances surrounding data usage, Jonathan Marshall, director for Consumer Law and Education at WVU, said he believes public health observation should involve more engagement with the population.
“Surveillance in the pandemic can be used to prevent further spread, but where does the privacy concern give way to the need of the public to combat this virus?” said Marshall. “My view is I really want the public to know what’s happening already with their data.”
Marshall also refers to an article published in Johns Hopkins University Press that urges public health officials to consider the legal and ethical ramifications of digital contact tracing. Some concerns addressed include who should be allowed access to contact tracing information and whether consent to access that data is necessary in these procedures.
Currently, state agencies are working to administer new software to allow contact tracing to be remote. This would make the spread of information between contacts and health officials easier, as well as provide testing and treatment locations.
Despite this, it is still the residents of West Virginia who are volunteering their efforts as contact tracers on the frontlines of this pandemic, doing the work needed to stop the spread of the virus.
“I know the pandemic has been exceptionally chaotic for a lot of us, but knowing that there are so many people in small towns throughout West Virginia who care about their communities and want to see people safe, and healthy and willing to step up to do this for them has been very inspiring,” said DiStefano.
More information on how to sign up for the contact tracing course can be found here.