John Owens Jr. has been doing contact tracing for 20 years. Usually, his work focuses on sexually transmitted infections -- each year, there are thousands of cases of gonorrhea and chlamydia, hundreds of syphilis cases and dozens of HIV diagnoses in Monroe County.
In the last few months, however, his focus -- and his job description -- have changed. Owens, 46, is now the county’s COVID-19 contact tracing lead.
He heads a team of people who get in touch with anyone who tests positive for the novel coronavirus in Monroe County.
Other people in the county’s tracing workforce are tasked with identifying and isolating those who have come into contact with a person who tested positive.
As the burden of COVID-19 on upstate hospital systems plateaus, contact tracing is becoming an increasingly important part of plans for regional reopenings.
“Contact tracing is going to become our top priority as we begin to reopen the economy,” said county health department spokesperson Steve Barz.
“As the state continues its work to flatten the curve, large-scale contact tracing is critical to safely and responsibly reopening communities while preserving the public health,” the governor’s office said.
“Contact tracing is a proven public health tool which can profoundly help ‘box in’ the virus.”
Several counties in upstate New York will lean on that state program for support, including Erie County, where 283 people have died of COVID-19 -- more than twice as many as in Monroe County, where the disease has killed 127.
In others, local officials described early efforts to build the contact tracing workforce.
“We’re not looking for reinforcements at the moment,” said Kate Ott, the deputy public health director in Ontario County. The contact tracing workforce there has already more than quadrupled since the epidemic began, Ott said.
In Monroe County, the number of people doing contact tracing has roughly doubled in the last six weeks, Owens said.
The team’s work is directly connected to saving lives, he said.
Everyone in the community should be staying isolated as much as possible, but that sometimes only happens when the pandemic hits home, said Owens.
“Every person that we place in mandatory quarantine that did not know that they had been exposed to coronavirus, and then we keep them from going to work or hanging out at their friend’s house, that can literally save hundreds of lives,” he said.
But COVID-19 is changing how it’s done. In STD tracing, Owens said, interviews can happen in person, because there’s no risk of airborne transmission.
That’s not the case for COVID-19. Coronavirus contact tracing in Monroe County happens remotely, usually through phone calls or text. Once the health department reaches a person, the tracer describes the terms of the isolation or quarantine.
Isolation is for people who have COVID-19. Quarantine is for people who likely came into contact with a person carrying the coronavirus but are not showing symptoms. People under mandatory quarantine can either be released after 14 days if they do not develop symptoms, or be shifted to isolation if they do.
If people in isolation and quarantine have a smartphone, the health department asks them to use an app to report their temperature and symptoms each day. If they can’t use the app, contact tracers call them.
It’s a good system, Owens said, but it’s not foolproof.
“There’s really no way to know for sure that everyone’s being honest,” he said. “People could tell us that their symptoms aren’t as bad. People could tell us that they are in isolation or quarantine and then end up going to work.”
At the beginning of the outbreak locally, contact tracers “were literally driving by people’s houses that we had in isolation and waving to them,” Owens said.
Now, with the number of active COVID-19 cases climbing toward 700, the county said it can no longer physically check to make sure each person is where they’re supposed to be.
Still, Owens said, he can tell that the vast majority of people are taking the disease seriously and are being honest with his team. If they weren’t, he said, the virus would be spreading much faster, and the county’s health care system would be overwhelmed.
And while apps and smartphones have enabled the team to contact more people more quickly, the county health department still resorts to some decidedly low-tech tactics when remote technology doesn’t work.
In a few cases, Owens said, workers geared up in personal protective equipment and left notes on doorsteps to reach people who didn’t respond to other attempts at communication.
“We’re not going to give up on those people,” Owens said. “We really need to reach everyone we can.”
The county is also supporting people who lack what they need to quarantine safely in their own homes, Owens said. The local health department can help with food and medical needs. For people who don’t have a home suitable for isolation, the county has lodging available at a hotel in Brighton.
Owens said the work has been ceaseless, but fulfilling.
“I’ve been here a long time,” he said, flashing a hint of a smile. “I have all kinds of reasons to be jaded or burned out, but I’m not. I’m fired up to come to work.”