What to Expect If a COVID-19 Contact Tracer Calls You
By Joni Sweet
If you get a call from a number you don't recognize, don't hit decline — it might be a contact tracer calling to let you know that someone you've been near has tested positive for the coronavirus.
Ignoring calls from contact tracers could put you at risk of unknowingly transmitting the virus to your loved ones.
It can even land you in legal hot water if you knowingly avoid contact tracers.
Earlier this month, officials in Rockland County, New York, sent subpoenas to eight people who refused to participate in contact tracing and threatened them with thousands of dollars in fines.
Hearing the phrase "You may have been exposed to the coronavirus" coming from the other end of the line can be scary, but it's important to stay on the phone. Here's what to expect if you get a call from a contact tracer.
Interviews With Contact Tracers
Contact tracing is a public health strategy that involves identifying everyone who may have been in contact with a person who has the coronavirus. Contact tracers collect information and provide guidance to help contain the transmission of disease.
It's been used during outbreaks of sexually transmitted infections (STIs), Ebola, measles, and now the coronavirus that causes COVID-19.
It starts when the local department of health gets a report of a confirmed case of the coronavirus in its community and gives that person a call. The contact tracer usually provides information on how to isolate and when to get treatment, then tries to figure out who else the person may have exposed.
"We ask who they've been in contact with in the 48 hours prior to symptom onset, or 2 days before the date of their positive test if they don't have symptoms," said Dr. Heidi Gullett, associate director of the Center for Community Health Integration at the Case Western Reserve University School of Medicine and medical director of the Cuyahoga County Board of Health in Ohio.
If the person with the coronavirus hasn't left their home much, it's a relatively straightforward process.
The interview can get a lot more involved if the person has been traveling, working outside the home, socializing, and seeing lots of other people. The person might need to review their calendar, create a timeline of everywhere they've been, and figure out how long they spent with different individuals.
"We're not concerned about every single contact with others, just the high-risk contacts, defined as being within 6 feet of someone else for 15 minutes or more," said Brian Labus, assistant professor of epidemiology and biostatistics at the University of Nevada, Las Vegas' School of Public Health and a member of Nevada Gov. Steve Sisolak's task force to advise on the scientific aspects of the COVID-19 pandemic.
The case interviews can take anywhere from 30 minutes to a few hours, depending on the complexity.
“You’ve Been Exposed”
After the case interview, contact tracers will get to work calling the folks who may have been exposed to the coronavirus by the person who tested positive.
"We give them recommendations about quarantining or isolating, getting tested, and what to do if they become sick. If they're not already sick, we still want them to self-quarantine so that they don't spread the disease to anyone else if they were to become sick," said Labus.
Generally, the contact tracer won't ask for additional contacts unless they happen to call someone who is sick or has a confirmed case of the virus. They will help ensure the contact has the resources they need to isolate themselves, if necessary. The contact tracer may continue to stay in touch with that person over the next 14 days.
"We follow the percentage of people that were contacts, then converted into being actual cases of the virus. It's an important marker to help us understand what kind of transmission happens in our community and how to control the virus," said Gullett.
Why You Should Participate (and What Happens If You Don’t)
A Lancet study from June 16, which looked at data from more than 40,000 people, found that COVID-19 transmission could be reduced by 64 percent through isolating those who have the coronavirus, quarantining their household, and contacting the people they may have exposed.
The combination strategy was significantly more effective than mass random testing or just isolating the sick person and members of their household.
However, contact tracing is only as effective as people's willingness to participate, and a small number of people who've contracted the coronavirus or were potentially exposed are reluctant to talk.
"Contact tracers have all been hung up on, cussed at, yelled at," said Gullet.
The hesitation to talk to contact tracers often stems from concerns over privacy — a serious issue in healthcare.
"These investigations are all conducted through health departments which have strict laws about what can and can't be shared. Protecting people's privacy is a core part of what we do, and we don't release the information you share to the public or tell other people about your medical history," said Labus.
The Federal Trade Commission has guidance on how you can protect your privacy and make sure you're speaking to a legitimate contact tracer. Remember: A contact tracer will never ask for your immigration status, Social Security number, or any sort of payment.
While legal action against people who refuse to talk to contact tracers (like the eight people who received subpoenas in Rockland County) is rare, it can happen. The bigger risk of avoiding these calls is the potential for you to miss out on important guidance about your own health, undermine your state's ability to reopen safely, and transmit the virus to others.
"If you're doing contact tracing and you're getting a bad filtering rate — meaning you're only getting in touch with a fraction of the people you try to contact — then the program isn't effective or useful. The coronavirus is extremely contagious, so missing a few cases can lead to an outbreak," said Dr. Bruce Y. Lee, professor of health policy and management at the City University of New York's Graduate School of Public Health & Health Policy.
"We shouldn't sit here and think that the only options are to ride it out or get a vaccine," he added. "There are other public health measures we can take, and contact tracing is one of them."
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Bernice Dapaah calls bamboo "a miracle plant," because it grows so fast and absorbs carbon. But it can also work wonders for children's education and women's employment – as she's discovered.
These are the world's most bicycle-friendly cities. Statista<p>"The reason we use bamboo to manufacture bicycles is because it's found abundantly in Ghana and this is not a material we're going to import," says Dapaah, one of the World Economic Forum's Young Global Leaders.</p><p>"It's a new innovation. There were no existing bamboo bike builders in our country, so we were the first people trying to see how best we could utilize the abundant bamboo in Ghana."</p>
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a335b5dffdd806bd6bb4debea90c2045"><iframe lazy-loadable="true" src="https://www.youtube.com/embed/dxsb9c4HMn0?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Supporting Students<p>Besides encouraging Ghanaians to swap vehicles for affordable bikes, Ghana Bamboo Bikes Initiative is helping students save time on walking to school so they have more time to learn.</p><p>Each time they sell a bike, they donate a bike to a schoolchild in a rural community, who might otherwise have to walk for hours to get to school.</p><p>Dapaah knows how transformative a shorter journey to school can be to academic performance. She grew up living with her <a href="https://www.youtube.com/watch?v=sb3joGYmx9A&feature=emb_logo" target="_blank">grandpa, a forester in a rural part of the country</a>.</p><p>"We had to walk three and a half hours every day before I could go to school. He later bought me a bike, so I finished senior high and wanted to go to university."</p><p>The experience inspired her to launch Ghana Bamboo Bikes Initiative with two other students at college.</p><p>"When we started this initiative, I looked back and said, when I was young, I had to walk miles before I could get to school, and sometimes if I was late, I was punished.</p><p>"Why don't we donate bikes for students to encourage them to study and so they can have enough time to be on books."</p><p>To date, they have sold more than 3,000 road, mountain and children's bikes – and Dapaah says they plan to donate <a href="https://www.entrepreneur.com/video/350343" target="_blank">10,000 bikes to schoolchildren over five years</a>.</p>
Empowering Women<p>The enterprise is also providing local jobs. It teaches young people to build bikes, particularly women and those in rural communities, where jobs can be scarce. More than 50% of people they have trained are women.</p><p>Dapaah says they want to boost the number of people they employ to 250 over the next five years and they are looking to partner with NGOs to build a childcare facility so mothers can continue to work.</p>
Reducing Emissions<p>By promoting a cycling culture in Ghana, Dapaah says they're also committed to reducing emissions in the transport sector and contributing to the UN's Sustainable Development Goals.</p><p>"I love the idea of reusing bamboo to promote sustainable cycling. People want to go green, low-carbon, lean-energy efficient," she says.</p>
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Melting and crumbling glaciers are largely responsible for rising sea levels, so learning more about how glaciers shrink is vital to those who hope to save coastal cities and preserve wildlife.
Groans, Creaks, Icebergs’ Calving Splashes<p>Oskar Glowacki already knew that melting glacial ice sounds like frying bacon. As ice bubbles burst, anyone nearby can hear crackling and popping, said Glowacki, a postdoctoral scholar at the Scripps Institution of Oceanography. Using hydrophones, he and other scientists now can make more nuanced measurements of how a changing climate sounds underwater, from the groans, creaks and splashes of a calving iceberg to the changes in whale songs as the ocean warms.</p><p>Glowacki recently used a pair of hydrophones to study the underwater world of glaciers, publishing his findings in <a href="https://www.the-cryosphere.net/14/1025/2020/" target="_blank">The Cryosphere</a>. He and co-author Grant B. Deane measured glacier retreat by <a href="https://yaleclimateconnections.org/2020/07/melting-glaciers-sound-like-frying-bacon/" target="_blank">recording the sounds of ice</a> – from small chunks to enormous slabs – falling off the glacier and splashing into the water.</p><p>During the summer of 2016, Glowacki's team placed two hydrophones near Hansbreen Glacier in Hornsund Fjord, Svalbard. For a month and a half, they recorded sounds, also using three time-lapse cameras to collect images – including the "drop height" (how far the ice fell into the water) – so they could compare photos to the recordings. The team created a formula to represent the relationship between the size of a piece of ice falling from a glacier and the sound it makes underwater, also accounting for the pieces of ice falling from varying heights. (Hear an example of the sound an iceberg makes while calving <a href="https://soundcloud.com/user-248456662/iceberg-calving-hansbreen-glacier" target="_blank">here</a>.)</p>
Unlocking Information About Antarctic Ice Shelf<p>Other researchers also are using hydrophones to learn more about crumbling glaciers. Bob Dziak, research oceanographer with the NOAA/Pacific Marine Environmental Laboratory <a href="https://www.pmel.noaa.gov/acoustics" target="_blank">acoustics research group</a>, captured a massive calving event of the Nansen Ice Shelf in Antarctica with a hydrophone. He published the results with colleagues in <a href="https://www.frontiersin.org/articles/10.3389/feart.2019.00183/full" target="_blank">Frontiers in Earth Science</a></p><p>On April 7, 2016, satellite images showed a massive calving event had occurred on the ice shelf. The paper described it as the "first large scale calving event in >30 years."</p><p>However, once Dziak and colleagues delved into the data from three hydrophones deployed 60 kilometers east of the ice shelf, they uncovered a series of "icequakes" from January to early March 2016. He and other researchers believe that much of the ice actually broke free in mid-January to February, but it remained in the same location until an April storm – which their paper described as the "largest low-pressure storm recorded in the previous seven months" – broke the ice free.</p><p>"We suspected that the icebergs broke apart but remained in place – kind of pinned in place – until a major storm with high winds passed through the area and, finally, it was that last push that pushed the icebergs out to sea," Dziak says.</p><p>He and his co-authors wrote that "fortuitous timing and proximity of the hydrophone deployment presented a rare opportunity to study cryogenic signals and ocean ambient sounds of a large-scale ice shelf calving and iceberg formation event."</p>
Listening to Songs of Humpback Whales<p><a href="https://www.mbari.org/" target="_blank">Monterey Bay Aquarium Research Institute</a> studies the ocean, including its acoustics. One of the institute's projects involves examining the soundscape of California's Monterey Bay, including sounds from animals, humans, weather, and geologic processes like earthquakes. The researchers once even recorded an under-sea landslide. They also focus on recording and analyzing the <a href="http://www.mbari.org/humpback-song/" target="_blank">songs of humpback whales</a>. Male humpback whales' songs can be over 15 minutes in length, and they can be repeated for long periods of time – even hours. Listening to these songs and analyzing them can provide unique insights into the lives of these complex animals.</p><p>"Any time we want to study marine mammals, sound gives us a window into their lives because they use sound for all of their essential life activities, really," says institute biological oceanographer John Ryan. "Communication, foraging, reproduction, navigation – depending on the species, of course."</p><p>Previously, scientists had thought singing occurred only during courtship and mating, but now they think whales may also use song while migrating and hunting. They know song has a crucial role in the whales' lives.</p><p>"There's a whole other dimension to humpback whale song," Ryan says. "It is a mode of cultural transmission in this species. They learn songs from each other. They share songs as a population, and when populations mix and mingle, they learn new ideas, they explore with their song, improvise, and it's a real essential part of their culture."</p>
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A number of conservationists claim cats are a zombie apocalypse for biodiversity that need to be removed from the outdoors by "any means necessary" – coded language for shooting, trapping and poisoning. Various media outlets have portrayed cats as murderous superpredators. Australia has even declared an official "war" against cats.
Faulty Scientific Reasoning<p>In our <a href="https://doi.org/10.1111/cobi.13527" target="_blank">most recent publication</a> in the journal Conservation Biology, we examine an error of reasoning that props up the moral panic over cats.</p><p>Scientists do not simply collect data and analyze the results. They also establish a logical argument to explain what they observe. Thus, the reasoning behind a factual claim is equally important to the observations used to make that claim. And it is this reasoning about cats where claims about their threat to global biodiversity founder. In our analysis, we found it happens because many scientists take specific, local studies and overgeneralize those findings to the world at large.</p><p>Even when specific studies are good overall, projecting the combined "results" onto the world at large can cause unscientific overgeneralizations, particularly when <a href="https://doi.org/10.1016/j.tree.2015.01.003" target="_blank">ecological context is ignored</a>. It is akin to pulling a quote out of context and then assuming you understand its meaning.</p>
Ways Forward<p>So how might citizens and scientists chart a way forward to a more nuanced understanding of cat ecology and conservation?</p><p>First, those examining this issue on all sides can acknowledge that both the well-being of cats and the survival of threatened species are legitimate concerns.</p><p>Second, cats, like any other predator, affect their ecological communities. Whether that impact is good or bad is a complex value judgment, not a scientific fact.</p><p>Third, there is a need for a more rigorous approach to the study of cats. Such an approach must be mindful of the importance of ecological context and avoid the pitfalls of faulty reasoning. It also means resisting <a href="https://doi.org/10.1111/cobi.13126" target="_blank">the siren call of a silver (lethal) bullet</a>.</p>
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