Nevada health officials detail contact tracing, case investigation efforts

By Kelcie Grega

Tuesday, June 30, 2020 | 12:10 p.m.

State health officials say they plan to launch a targeted response effort this week to support communities most affected by the coronavirus pandemic. The plan will include education, outreach, mask enforcement and increased contact tracing and case investigation.

“One of the biggest challenges for COVID is that the cases reported today were exposed anywhere from one to two weeks ago,” said Julia Peek, Deputy Administrator of Community Health Services. “So any policy change we make today won’t be reflected for another week.”

Officials say they have been ramping up contact tracing and case investigation efforts since reports of the first positive case, and have since bolstered capacity using both full-time employees and volunteers.

With contact tracing, public health staff and volunteers can work with infected patients to identify everyone they’ve been in contact with. In countries such as China, South Korea and Germany, the strategy has proven effective for handling the outbreak.

“It creates a more concentrated pool for us to test from,”said Caleb Cage, the Nevada COVID-19 response director.

When an individual gets tested for COVID-19 and the results come back positive, that information is sent to the local or state health department, Peek said.

“We start an investigation with that case and try to understand how they were exposed and other factors related to that, including contact during the period of time they were infectious, to make sure they get critical care if necessary and have them quarantine at home for the 14 days they are infectious,” she said.

Case investigation is a more involved process, that includes looking at the medical record of the infected person before calling them.

“We’ve developed several Nevada-specific questions that help us get a (better) understanding of what’s happening,” she said.

Officials are also looking at trends in the data to see if there are infections linked to specific things like occupation or events to dictate further instruction or prevention moving forward.

The National Association of County and City Health Officials reported that there needs to be a minimum of 30 contact tracers per 100,000 people  to effectively track the virus within a population. Nevada has yet to meet that minimum, with a capacity of just above 500 contact tracers.

It’s important to note, however, that the number of contact tracers needed in Nevada isn’t necessarily based on population size alone, but rather the size of the community outbreak and the number of contacts per case, Peek said.

“We developed our contact tracing plan with that model in mind,” Peek said. “We’re implementing several tools that have not been available in the past, which includes … a tool that allows us to reach out through our joint call center and also allows us the opportunity to follow back with the contact by text if they choose to do so instead of a phone call, which greatly streamlines our processes.”