State limits COVID-19 contact tracing as infected Iowans wait days for a call

A doctor takes a swab sample. (Stock photo by Mladen Sladojevic/Getty Images)

When Dan Corron of Ankeny learned he had tested positive for COVID-19 on Halloween after being exposed at work, he wanted to do the right thing and make sure anyone he might have exposed was notified.

He thought he would get a call from a public health staff person conducting “contact tracing.” He knew he had traveled for work and met with others, masked at all times, after his likely exposure, but before he knew he had tested positive.

“I just wanted to get contact tracing to protect others,” Corron said. “I just wanted to do my part of making sure I wasn’t part of a long chain of events and possibly having death on my hands, you know.”

But when no call came within a day or two, Corron phoned the Polk County public health department and was told the local agency was only tracing school-related cases. By this time, he’d started to feel symptoms of fever, fatigue and body aches. He was told he’d likely hear from the Iowa Department of Public Health.

When no call came, he tried to call the state agency and was directed to the 211 COVID-19 hotline.

“They said they weren’t responsible for doing any of that,” Corron said, and they were unable to direct him to the correct agency. He asked to speak to the director of the Department of Public Health and was told he should contact the governor’s office instead.

So on Nov. 4, Corron said, he called the governor’s office. He said he reached the director of constituent services, who also was unable to give him any information about contact tracing.

A day or two later, roughly a week after testing positive, he finally received a call from a contact tracer, he said. The caller asked how many people lived in the household and their ages, he said, but nothing about anyone outside the home he may have potentially exposed.

By that time, Corron said, it was likely too late for any contact tracing to do any good.

Other Iowans, who responded online to a question from Iowa Capital Dispatch, reported a variety of different experiences with contact tracing, depending on where they live. Some heard within a few days from contact tracers in their county after testing positive. Others received calls after five days or more, or not at all.

Contact tracing’s goal is to limit disease spread

Public health officials say it’s common practice in infectious disease control to contact people who have tested positive in an effort to learn where the infected person had been and with whom. It’s important so people who may have been exposed can be advised to isolate themselves from others to avoid spreading the virus.

When Gov. Kim Reynolds unveiled the Test Iowa COVID-19 testing program in April, she suggested contact tracing would follow every positive test:

Gov. Kim Reynolds speaks during a news conference Nov. 19, 2020, at Iowa PBS in Johnson. (Screen shot from Iowa PBS livestream)

“It’s as easy as three simple steps,” Reynolds said. “Step one, you go to to complete a brief assessment that captures information about symptoms or underlying conditions that you may have, as well as where you live and what your occupation is … Step two, get tested if you currently have symptoms, have interacted with someone who has already tested positive, or have recently visited a place where COVID is more widespread. Step three, if you test positive, we’ll do the contact tracing to determine who you’ve been in contact with.”

On Thursday, however, State Epidemiologist Caitlin Pedati said the state, because of the high number of cases, “has increasingly focused on high-risk situations, which includes households.”

State limits contact tracing to households for 63 counties

After the news conference, a spokesman for the Iowa Department of Public Health said the agency was only conducting household-level contact tracing.

“IDPH is temporarily adjusting its contact tracing guidelines to contact trace only household contacts of positive cases,” IDPH spokesman Matt Highland said in an email. “Household contacts are the highest risk of transmission of the virus. This change is due to the increased case volume occurring right now.”

The state is conducting contact tracing for 63 of Iowa’s 99 counties. The department has about 138 team members involved in contact tracing, a number that fluctuates as staff is recruited and trained, Highland said.

The state issued an emergency request for proposals last week to contract for additional contact tracers, and staff from other agencies also have been recruited to assist, he said.

The public health communications officer for Polk County, Nola Aigner Davis, said the county has focused on school contact tracing — which includes staff, students and teachers —  since classes resumed this fall. A key question for schools is whether anyone who was infected or may have been exposed was wearing a mask, because school guidelines don’t require quarantine if both parties were wearing face coverings.

The county tries to make contact as soon as it gets a positive test. Speed “is incredibly important,” Aigner Davis said.

Public health official: Iowans should do their own contact tracing

She said if people test positive, they should do their own contact tracing.

“If you have family members and friends that you love and that you care about … you need to be your own contact tracer,” she said. Talk to anyone you have spent time with in the 48 hours before testing positive and encourage them to quarantine, she said.

Aigner Davis also pleaded with Iowans to cooperate with any contact tracing efforts. “I don’t think people understand who important it is to be truthful,” she said. “We are not the shame police.”

Public health officials are asking questions because they need to make sure everyone who may have been exposed is notified and knows to quarantine. “It’s not like you name is going to appear on a billboard or something like that,” she said.