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A medical anthropologist who studies epidemics just told my mother that my job is useless with this kind of community spread. Which tells me that some folks may not understand what a public health RN contact tracer actually does - and maybe they should. A thread:
If you test positive and I call you, I will tell you that there are three parts to my job: 1) talk about the medical stuff, 2) figure out where you got this virus, and 3) figure out where the virus might have gone after you got it. Let's look at each of these.
Part 1: we review symptoms & pertinent medical history. I (try to) catch complications before they become crises - pneumonia, blood clots, diabetes issues, etc. I send folks to their PCP, urgent care, or the ED. I advise about home symptom monitoring, management, & care. Why?
Bc usually you get tested for a disease in the context of ongoing medical care, so a provider reviews the results & advises you. That's not happening right now. & many people, trusting the system(!), think that they didn't get care advice because they didn't need it. Nope.
Then we talk isolation/quarantine. What do these mean? How long do you need to do them? What about your kids/work/school? How do you plan to get food and medicine? What will you do if you need medical care? What will you do in an emergency? We'll troubleshoot together.
I don't move on to parts 2 & 3 until you tell me you have no more questions about part 1. I start part 2 with this question: where do you think you might have gotten this? Lots of folks know or suspect, some have no idea, so we dig deeper. But why bother?
Because this is where I hear your boss pressures employees to work sick & not get tested. This is where I hear about the family gathering after which a lot of people got sick but no one got tested because it was too expensive or the pediatrician said they didn't have to.
This is where I hear that "runny nose means it isn't COVID," or "she tested negative so I figured she was fine," or "the facility told me I should come pick him up because he just kept getting sicker, they never said it might be COVID."
When I hear these things, I can DO THINGS about them - educate, intervene with workplaces, call PCPs to address misinformation, instigate or escalate investigations.
Part 3: Where might this virus have gone after you got it? Did you go to work in a school/restaurant/long term care facility the day before you tested positive? Are you the only babysitter for your niece's daughter who's also in daycare? Let's try to catch & stop the spread.
There's a secret Part 4. It's the part where I call you back, several times over the course of your isolation, to make sure you're doing okay. To see if you need anything. To listen to you grieve the partner or parent you've just lost to the virus you're sick with now.
The RNs doing frontline COVID-facing work are fucking badasses. I honor them and I'm grateful for their work. A bonus part of my job is also (hopefully) to lighten their job - to keep a few folks out of their EDs and their ICUs.
We are all on this hellish team together. I'm grateful to be doing a very small part.
So, since I have your attention, I would like to direct your attention to another very important public health effort: https://twitter.com/iamn0tthe1/status/1345905830009450496
