DOH traces the steps of COVID-19


Identifying a positive case of COVID-19 is just the start for the Hawaii State Department of Health. A group of scientists, nurses and volunteers are tracing and reaching people who were possibly exposed, but as the number of sick climbs, their job keeps getting harder.

The lead epidemiologist in charge of tracing the steps of the virus, Dr. Joe Elm, said Hawaii is still able to follow the movement of the virus but their investigative work expands with every known positive case.

Elm said, “It can’t go on forever, we are running, we’re trying to keep up.”

Public health nurses and health staff who work from home are helping follow the cases and the people who may have come in contact with people positive for coronavirus. The staff has tracked-down thousands of people for the more than 300 cases known, so far.

Elm said, “So we’re talking, 1,800, 2,000 contacts, immediate contacts that we have to interview and sometimes we have to go contacts to contacts, so it’s really growing enormously as the case count goes up.”

For example, if the person traveled by plane, DOH will need to track down passengers who sat nearby, then their mode of transportation, they will contact the taxi or Uber driver. There is also lodging, they have to determine if hotel workers were exposed or family members and the list goes on.

Health staff typically use medical record for contact information, but there is also social media.

Elm said, “We use everything in our means, sometimes we google, sometimes we look at Facebook to try to match a person with a place or occupation. The idea is to see if the person is in fact the person we are looking for.”

He said this type of investigative work is needed in order to isolate those close contacts even before there are signs of illness.

Elm said, “You have to identify the person that’s sick and its contact and then you sequester in place by isolation or quarantine and hope it doesn’t spread out there.”

However, there are questions about the amount of time it takes to contact people who may have been exposed. The positive case announced Thursday on Molokai, DOH director, Dr. Bruce Anderson said, the individual had about 100 close contacts and they are pulling resources together to notify each of them.

“Our resources are limited, volunteers have come out to help with contact tracing,” Anderson said. “In this case, in particular, we are getting a lot of supportive assistance from others in trying to identify the contact to make sure they are in quarantine.”

The DOH recruited medical students and retired medical workers to help reach the people who may have been exposed, but Anderson said at some point they will not be able to contact every individual as the list grows.

Elm said COVID-19 hot-spots around the country can no longer sustain this level of investigative work, and if numbers grow exponentially in the state, the DOH will have to rely on messaging, such as washing hands, wearing masks and keep social distancing.

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