It’s not the kind of call you might think it would be. It’s not “Hello, this is the Health Department and guess what?”
Instead, contact tracing for coronavirus in Evanston is, according to the person in charge, efficient, effective, and has “definitely played a role in helping to reduce the number of cases in our community.”
Ashlee McIlwee is the lead contact tracer for the City. Before the pandemic hit, Evanston had one contact tracing employee, to track illnesses like measles, whooping cough, and food poisoning. Now the City has twelve — the original staffer, four more (including McIlwee) who were temporarily transferred for coronavirus tracing, a part-timer who was hired, plus six volunteers.
McIlwee says Evanston began tracing as soon as the first COVID case was discovered here, in early March. At the peak of the pandemic, she says tracers were dealing with about twenty cases per day. Now, she says, it’s only two or three. At the outset, McIlwee explains, “we were very swamped. Every day was extremely busy.” Now, she says, “we can take a little more of a breath.”
The whole idea behind contact tracing is to let someone know that they have potentially been exposed to coronavirus. That individual can then begin to quarantine, and/or get tested, so they don’t spread the disease to someone else. Multiply one person giving it to another, who gives it to another, and so on … and you have Florida, California, and Arizona.
Once the Health Department is notified of a positive case, the tracers get to work. The patient is contacted, and asked to provide the names of people they’ve been in “close contact” with for two weeks before symptoms began. “Close contact,” McIwee explains, is “within six feet for 15 minutes or more.” That generally rules out check-out clerks at the grocery store, and other similar workers you probably could not identify.
Most of the “close contacts,” McIlwee says, are family members or friends of the patient, usually, she says, about three or four people. And often, those contacts are already aware they may have been exposed, before the Health Department even calls.
Still, those contacts are told about when the exposure occurred (date only, not the name of the person with COVID), about testing and about a 14-day quarantine. Numbers and statistical data about contacts are provided to the state, to help track COVID, but the contact’s name and other identifying information are kept private by the city.
While the situation in Evanston is improving — just three positive cases today — McIlwee says “we’re always keeping our eyes and ears open.” As of today, Evanston had 825 positive cases, and 71 deaths.
One new cause for concern is travelers coming back from out-of-state hot spots. “We have received an increase in cases of people who recently traveled,” she says. And that will no doubt increase as students return to Northwestern University. McIlwee says the City and the University are currently discussing how and who will handle tracing for students.
While the City of Chicago has a mandatory 14-day quarantine for those arriving from states with a high number of COVID cases, Evanston does not have such a rule. While such a rule would be close to impossible to enforce, McIlwee says the potential benefit of having such an order (which would have to come from higher-ups at City Hall), is it “shows the importance of being extra careful.”
Evanston has a certified municipal health department. That may not mean much to the average resident, but to contact tracers, it’s a big deal. “It allows us to monitor cases at the local level,” McIlwee says, “instead of being monitored by the county.” That can help speed up response, and help slow the spread of the virus.
There are plenty of reasons why Illinois, and Evanston, are among the few places in the nation where coronavirus has diminished, compared to the peaks of the past few months. Personal behavior, such as masks and social distancing, have been critical.
But having a tracing program which is “robust,” as McIlwee calls it, is also critical. The positivity rate, a key indicator of how hard a community is being hit, has been under 3% in recent days in Evanston. Under 5% is generally considered acceptable. The most recent daily rate in Miami-Dade County, Florida, was 30.5%.
The hope and goal, of course, is for Evanston to never get near such a rate. But McIlwee says one thing coronavirus tracing has taught her is “to take it day by day. It’s hard to predict the future. You need to prepare for a worst case scenario,” but work towards the best.
Photo credit: Jonathan Mauer / CC BY-SA