Dominique Bruneau Saavedra spends endless hours on the phone as a Covid-19 contact tracer, informing people in San Miguel County, Colorado, that they have been exposed to the virus and tracking down their recent contacts.
But the work doesn’t stop there.
Saavedra works on a team of 15, but is just one of three contact tracers who speaks Spanish in the county’s Department of Health and Environment, which serves a mostly rural community largely supported by winter tourism. Increasingly, she spends her time telling people about food assistance programs or answering questions about getting affordable internet access.
“A lot of our people work at restaurants, and that's where they get their food. And when you can’t go to work, how do you do it?” she said. “With the kids at school, when they have to do school online because they have to quarantine, then they don't have internet sometimes.”
Even as approved vaccines provide a light at the end of the tunnel, public health experts say it will take months before the United States approaches containment. As contact tracers struggle to keep up with surging coronavirus cases in the U.S., they are fielding more calls from people turning to social services for needs such as food and child care.
By guiding those who have been exposed toward those resources, contact tracers are providing them with an incentive to self-isolate and not expose others to the virus, said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security who is focused on the global response to Covid-19. It’s a critical service that helps mitigate the virus’s spread, she added.
“We have contact tracers and public health workers that are getting people groceries and getting all their medications, arranging child care or adult care for people in the home who may need that,” she said. “And in some cases, providing replacement income, even for people who have hourly positions and won't get paid for those weeks that they're off quarantining.”
In addition to juggling her day job at a local nonprofit, Saavedra works on contact tracing much of her region’s Spanish-speaking residents. Oftentimes, that includes explaining public health measures to the people she reaches and connecting them with community resources they might not otherwise know about.
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In Alaska, Kris Knudsen, a contact tracer with the University of Alaska Anchorage, said the job can be daunting, but it’s both impactful and necessary.
“We want to put ourselves out there for hours and hours and hours every day,” she said. “And then wake up at 3 in the morning, going, ‘Oh my God, what did I forget to say?’ Or, ‘Oh my God, I forgot to arrange food delivery to this family or diapers to that family.’”
More than five months after the $600-a-week Coronavirus Aid, Relief and Economic Security, or CARES, Act supplement to federal unemployment benefits expired, Americans without the ability to work remotely have been forced to return to their jobs in person and potentially expose themselves and those around them to Covid-19.
A Pew survey conducted in July — when the daily case increase was just a fraction of what it is currently — showed that of the 32 percent of Americans who say it’d be “very or somewhat difficult” to quarantine, about 40 percent say being unable to miss work is the main reason.
“If they don’t have money for food, then they can’t survive anyways,” Watson said. “So what is needed: employers to provide paid leave for people who need to quarantine, not just people who need to take sick leave.”
“A lot of people are dying and a lot of people are sick and miserable — and struggling to even make the bills at this point."
A record-breaking 50 million Americans may experience food insecurity due to the coronavirus pandemic this year, including about 17 million children, according to the nonprofit Feeding America. Contact tracers have become vital sources of information to help those exposed to the coronavirus avoid going hungry.
Kailee Leingang, a contact tracer with the University of North Dakota, said there should be federal guidance around contact tracing across the country.
“A lot of people are dying and a lot of people are sick and miserable — and struggling to even make the bills at this point. And it doesn't seem like there's enough help,” she said.
But as millions are suffering economic hardship and hospital beds are filling up across the country as cases surge, even the basics of contact tracing have become more difficult.
Community transmission is so widespread that contact tracing cannot contain the virus on its own, Watson said. But, she added, it can still reduce transmission on some level and save lives as a result.
After the winter surge, contact tracing will become even more important for tamping down the last embers of the virus as the general public waits for large-scale vaccinations, she said.
“Once we get down to lower levels of transmission — where much of the population that's affected can be identified and contact traced — then it can be used as more of a fine-grained tool to really greatly reduce transmission and get us back to greater sense of normalcy quicker,” she said.
But until community spread is reduced to a manageable level, contact tracers continue to work around the clock to flatten the curve as the U.S. confronts what is expected to be the deadliest days of the pandemic. The positions are paid and require specialized training.
Leingang wakes up at 5 a.m. to complete her nursing school work before turning to her caseload in North Dakota each day. She then works from sunrise to hours after sundown, sometimes reaching contacts too late. “I remember every single one of my cases’ names that have passed away,” she said.
“We're not necessarily a nurse or a doctor or somebody like a police officer on the front lines,” she said. “I don't think you truly understand the heartbreak and the emotional rollercoaster you go through as a contact tracer until you do it.”
But Leingang says she won’t give up: “Every case that I contact is saving at least five other people in the community from that happening to them.”