Before March 2020, the term contact tracing may have been foreign to many people. Now, however, it is a commonly used phrase, specifically as it relates to helping to prevent the spread of COVID-19. According to the World Health Organization, contact tracing
is simply “the process of identifying all people that a COVID-19 patient has come in contact with in the last two weeks.” Though contact tracing is not new and is used with other diseases, efforts throughout the world have been ramped up, including the addition of digital tools to improve efficiencies. The Centers for Disease Control and Prevention identify contact tracing as essential in helping prevent the spread of COVID-19
as well as in protecting individuals and their communities.
Local contact tracing efforts have been underway for months through the Kent County Health Department
(KCHD). Currently, the KCHD has 42 KCHD staff members working as contact tracers as well as two clerks providing administrative support. Additionally, there are 74 non-KCHD individuals working as contact tracers.
Challenges in combating COVID-19
One of the initial issues that was identified was “the disproportionate impact of COVID-19 among Hispanic/Latinx and African American populations,” says Teresa Branson, KCHD’s deputy administrative health officer. This impact was clearly seen through the data being gathered.
“We have a lot of data on the disparate impact of COVID-19 among minority communities, and the Health Department took very deliberate efforts to use that data to make informed decisions regarding outreach, testing, and contact tracing efforts,” says KCHD data scientist Mike Fortman.
This information helped the Health Department work to ensure they had a diverse set of resources and staff to support their efforts. One of which was language services assistance to help combat the language barriers that arose.
To address this, the Health Department “partnered with local and national agencies to support with language line and translation of contact tracing educational materials for notification and isolation/quarantine,” says Branson.
“Quite early on, we developed a query to look for references to over 30 different language references in the case notes and how often translation services were required,” says Fortman.
Throughout the past few months, numerous organizations have been able to either expand or develop a relationship with the Health Department to assist with its outreach efforts. To date, these organizations include Arbor Circle
, Grand Valley State University, and the Black Impact Collaborative
Reaching out to provide support
“We work very closely with the health department on any number of projects,” says Kristin Gietzen, president and chief executive officer of Arbor Circle. Traditionally focused on providing mental health, substance abuse, and other services to individuals throughout the community, when COVID-19 started, Gietzen knew her team was in a position to assist the city even more.
“We initially became involved kind of early in the process. It was probably in the height of our lockdown, when we didn’t really know a lot about COVID. We didn’t know a lot about what contact tracing was, but we knew it was an important part of trying to prevent the spread,” Gietzen says. She felt that this was a time for community partners to step up.
“We just reached out,” she says. “We [have] staff that work in the area of social work and counseling, [so] we thought we might have some skills to help the health department temporarily.”
After completing specialized training, several Arbor Circle staff members served as volunteer contact tracers and there is one staff member still serving in this capacity.
Actively addressing disparities
Starting with a position paper, the BIC reached out to organizations working on COVID-19 related issues, including the KCHD. One of the main needs identified was the existing healthcare-related disparities in minority communities being further exacerbated by the pandemic.
“When the Black Impact Collaborative was created, it was really just us coming together daily to talk about COVID, about what was happening, and make sure that needs were being met. We quickly learned that there was work to be done and the Institute of Ubuntu was the organization that convened all of the people who came to the table,” says Black Impact Collaborative (BIC) member Senita Lenear.Senita Lenear
“Based on [the] County’s population, we would expect COVID infections by race/ethnicity to be around 3% for Asian and 10% for African American [as well as] Hispanic/Latino” says Fortman. “Early in the outbreak, our case percentages were about 10% for people identifying as Asian, 20% [for] African American, and 40% [for] Hispanic/Latino [individuals].”
Throughout their discussions with the Health Department, the BIC presented several possible solutions to address the identified areas of concern. One of the BIC’s recommendations was “increasing COVID testing in the 49507 zip code as it was the highest zip code that had positive COVID cases yet there was not a location for people [there] to get tested,” says Lenear. “Another [recommendation] was to partner with the Black Impact Collaborative to do a testing day in 49507.” A community testing day, which provided residents with free COVID-19 tests, was held in June at LINC UP
“There were a few other [suggestions], but the recommendation to establish a partnership with the Black Impact Collaborative for contract tracing was a recommendation because we recognized that the way black people were fairing, at least what we were able to discern, [was] tied to some of the cultural disconnects that exist for black people in healthcare,” says Lenear.
“What we wanted to try to do is to remove the barrier so that at least there would be a group of Black people that would be a part of the contact tracing that was happening in Kent County,” she says. Due to this partnership and funding from various sources, including the CARES Act, BIC has been able to hire 12 contact tracers as well as a team liaison. “Our goal was just to be a resource for the County. I think that we’re fulfilling that by the partnership that exists,” Lenear says.
Maintaining momentum post-COVID-19
Based on the data gathered, the Health Department has seen a shift in the initially reported figures. “Our overall rates are now approximately 4% [for] Asian, 15% [for] African American, and 30% [for] Hispanic/Latino,” Fortman says. “Our actual rates by month for the last couple months are even lower than that. We have more specific information over time,” he says.
Though COVID-19 is a current concern, Lenear and others know the issues at hand are larger and there is more work to be done. “It starts obviously with COVID, but we know that there are other areas where we should spend some time understanding what’s happening so the outcome will be healthier Black people,” she says.
“I think that the outcomes that we see with Black people in healthcare is a circumstance that requires more research and the Black Impact Collaborative could potentially be doing some of that research in the coming months as we’re talking with another partner,” Lenear says. “We do want to get to the bottom of why disparities exist because we all know that they do but what we have not done well is to make [an] impact on those disparities, so we have interest in that.”
For Lenear, addressing these issues is something all organizations should have a vested interest in. “Recognizing [the disparities] exist is the first step within any organization and then making sure that [their] goals are tied to addressing [them],” she says. “Employers may not be healthcare providers but they frequently provide healthcare insurance for their employees so they too have a vested interest in making sure that these disparities are reduced.”
“I know employers are spending a lot of time already trying to evaluate how they are interacting in communities of color. I think that healthcare shouldn’t be an area that’s left off the table, even if the industry [they’re] in isn’t tied to healthcare,” Lenear adds.
Answering the call
As the Health Department and other organizations continue to address the issues at hand, it is also important for individuals to be aware of their role in the process. For those who feel they would be well-suited for a position as a contact tracer, the Health Department is currently hiring. For more information, reach out to Maxim Healthcare
and let them know you are interested in working with the Health Department in this capacity.
Looking from the other end of the phone, though it is natural to be apprehensive about receiving a call from a contact tracer, being prepared can help.
Gietzen encourages people to educate themselves. “I would recommend people to go to places of fact. If you’re looking for information about the spread of COVID, data, about what we know at any particular time, use the health department information,” she says. “Use the state of Michigan Department of Health and Human Services information
, [and] information from reputable sources, like Johns Hopkins
or the Centers for Disease Control and Prevention
“Don’t use information that’s just posted on Facebook, reposted, or retweeted without verifying that it’s coming from a reputable source. There’s a lot of bad information out there,” Gietzen says.
“It’s a scary phone call,” she says. Despite that, it’s important to know that “the person who’s calling you is there to help and they have resources.”
“Engaging with [the people] who are trying to contact you is very important. This is not the time to ignore the phone call but [to] really engage to make sure that they have the information so that we can try to stop this virus in its tracks,” says Lenear.
Photos courtesy City of Grand Rapids, Black Impact Collaborative, and The Kent County Health Department.
About Leandra Nisbet: Leandra Nisbet, Owner of Stingray Advisory Group LLC and Co-Owner of Brightwork Marine LLC, has over 15 years of experience in leadership, sales & marketing, and graphic design. She helps businesses grow and assists with: strategic planning, marketing concept development/implementation, risk management, and financial organization. She is actively involved in the community, sitting on several Boards and committees, and has been recognized as one of the 40 Under 40 Business Leaders in Grand Rapids.
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