Virus tracers play several roles

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SALT LAKE CITY (AP) – Health investigator Mackenzie Bray smiles and chuckles when chatting over the phone with a Utah retiree who recently tested positive for coronavirus.

She tries to keep the atmosphere bright because she must know where he was and who he has been for the past seven days. She peppered him gently with questions, including where he and his wife had stopped to buy flowers during a visit to a cemetery. She encourages him to read his bank statement to see if it reminds him of the store visits he made.

In the middle of the conversation, a possible break: his wife lets out that they had family for Mother’s Day, including a grandchild who could not stop chatting.

“Was there like a shared food platter or something?” Bray asks. “There was, OK, yeah … sharing food or drinks, even just being on the same table, it can spread that way.” “

Suddenly, with a shared punch bowl, the web got bigger and Bray had dozens of people to find.

She is part of an army of health professionals around the world playing one of the most important roles in the effort to guard against a resurgence of the coronavirus. The practice of so-called contact tracing requires a hybrid work of interrogator, therapist and nurse as they try to coax nervous people to be honest.

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The goal: to create a roadmap wherever people are infected and who they have been.

While other countries have devised national approaches, a patchwork of efforts has emerged in the United States where states must create their own agendas.

Bray normally does this type of work to track the contacts of people with sexually transmitted diseases. She is now one of 130 people from the Salt Lake County Health Service assigned to follow up on coronavirus cases in the Salt Lake City area. Investigators, including many nurses, juggle between 30 and 40 cases each and try to reach everyone, with the original person within 6 feet for 10 minutes or more. They stay in touch with certain people throughout the 14-day incubation period, and calls can take 30 minutes or more while they painstakingly go through a list of questions.

Some estimate that up to 300,000 contact tracers would be needed in the United States to adequately limit the spread. While some states like Utah have reported having enough contact tracers, others lack hundreds or even thousands of people.

Contact tracers are often found in a tangled network of half-truths and mismatched facts. Linguistic and cultural barriers arise that require painful interpreters and conversations that leave investigators wondering if the person understands what they are trying to do.

They occasionally find themselves in a complicated family dynamic where people are reluctant to tell the truth.

Health investigator Maria DiCaro discovered several days after the case of a father who slept in his car because he and his wife were separating. The man had stopped forwarding DiCaro’s calls, and this key information came from his child.

“I get people who lie all the time,” said DiCaro. “I’ve been trying to get as much information from the start, but that just isn’t always the case. And time is one of those things you can’t take back when you try to prevent and you know how to do these contact tracing surveys. “

Each call is an exercise in good cops, bad cops. She needs people to cooperate, but no one is legally required to answer questions. Usually kindness works better than strong words.

Some people lie because they are afraid or because they forget to go out. Construction workers, housekeepers and others without paid sick leave can hide the symptoms so they can return to work. Some undocumented immigrants delay testing because they fear it may lead to deportation.

“People sometimes think of contact tracking in black and white, but there’s a lot of gray in there,” said Bray, who often thinks of his parents and his 97-year-old grandmother when she tries to help stop the spread of the virus. . “Our worst fear is to push too hard and lose someone. It’s not just their health that is at stake, it’s the people around them. “

No matter the tension, Bray and DiCaro frequently point out why this is important: “Thank you for what you do. You help the community, “said DiCaro on a call.

She knows that at the other end of the line, the first call from a plotter can be shocking. Sometimes DiCaro and Bray have to report that someone has been exposed or tested positive.

“It’s okay to speak with your doctor, but you never expect the health service to call you and say,” You have been exposed to a serious illness, “” said Anissa Archuleta.

The 23-year-old received a call from DiCaro after she, her sister, and her mother took a rare break from squatting to help organize a birthday party by car for a young cousin. They put down a gift, then gave in and accepted an impromptu invitation to go inside to get some food.

What they didn’t know: The birthday man had coronavirus, and unconsciously exposed more than a dozen people at the meeting.

After this first call, DiCaro registered daily for two weeks. The fear slowly faded after their tests returned negative and they began to relate to DiCaro. She asked what their symptoms were and how they felt every day, and learned how Archuleta’s mother lost her voice due to fibromyalgia. Archuleta was transmitting messages that her mother whispered in her ear.

And after a while, Archuleta started asking DiCaro about her life and how she was holding up.

About a week after their calls, during the daily recording, Archuleta thanked DiCaro for taking care of them and checking in every day. Tears welled up in DiCaro’s eyes.

“Ah thank you,” she said, grabbing a Kleenex to wipe her eyes.

After hanging up, she leaned back in her chair and closed her eyes for a few seconds.

“When you do this like 10 to 12 hours a day … It’s nice to have these positive reactions from very grateful people who see the purpose of what we do,” said DiCaro. “It’s nice to be appreciated. “

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