It’s Saturday and Taya Westfield is hard at work at the Johnson County Public Health Department in Iowa City. Surrounded by a handful of co-workers, Westfield is taking calls, building rapport, and notifying citizens about potential exposure to Covid-19.
For Westfield, a senior public health student at the University of Iowa, it’s just another typical day as a contact tracer, a job she never planned on doing this late in her college career. Westfield learned about the opportunity by chance last spring, after taking a course with the county’s community health division manager. He reached out looking for tracers when the pandemic started up.
“I am very much someone that likes to be involved in my community and when I see issues come up, it’s in me to want to help out,” she said.
Amid online classes and nationwide shutdowns, Westfield is just one of many students across the nation joining the fight against Covid-19 and taking the leap as newfound contact tracers with the help of university-run programs and their local public health departments.
These students join a dwindling profession that’s both underfunded and understaffed. Data from the Johns Hopkins University Bloomberg School of Public Health suggest that the United States needs at least 100,000 contact tracers to fight Covid-19 and contain the spread, while some estimates are as high as 300,000. According to a joint Johns Hopkins Center for Health Security and NPR study, there were more than 50,000 tracers nationwide as of October.
Last May, JHU launched a free online contact tracing course through Coursera, which has garnered more than 1.1 million users including students from universities and public health departments across the nation. It’s not the only program being offered nationwide, but it’s by far one of the most popular among universities.
Consisting of five modules, the course is designed to take individuals without contact tracing experience and teach them the ins and outs of the job including what the virus is, how it’s transmitted, what communication skills are needed, and the ethics when it comes to dealing with data and privacy, said Emily Gurley, an associate scientist at the university.
“Some people are naturally very good at talking to others and getting the conversation going, but you can teach these skills,” she said.
A range of programs for different needs
Every school program differs. Some students are solely tracing a school community, while others are aiding local or state public health departments as paid tracers. Restrictions also differ regarding who can join the program. At Dominican University of California in San Rafael, which teamed up with the local Marin Health and Human Services, contact tracing is offered as a clinical for the nursing program students. Some schools are opening the opportunity to students of all majors and backgrounds.
Training programs also range across campuses. Most universities have implemented the JHU course as a requirement, which takes about six hours to complete. The course is often supplemented with technical training, which differs by university and state. At Syracuse University, students must submit a certificate of completion of the JHU course, but some schools require students to complete a test. At the University of California, Los Angeles, students undergo 12 live lecture hours and six skills labs.
Joana Fernández Nuñez, a graduate student at the University of California, Los Angeles who worked over the summer as a full-time contact tracer in New Mexico, is currently assisting in training contact tracers at the university.
It’s challenging hearing the stories of individuals affected by Covid-19 and it’s difficult not always having the resources available to help, Fernández Nuñez said, but good communication and empathy are key to the process.
“A lot of people have these skills, but sometimes we don’t realize we have them,” she said.
Most university contact tracers never enter an office. Kyra Toquinto, a nursing student at Dominican set up shop in her husband’s office. On a typical morning, Toquinto, who worked about three half days a week in the mornings, started the day with a meeting, followed by a full shift researching, calling, and offering resources to individuals with potential exposure to a contact.
Many tracers are given a list every morning of positive cases and spend the majority of their day conducting research and building a web of potential contacts. Other schools, like Syracuse University, have contact tracers on deck at testing centers, prepared to ask questions. Case managers do initial intake interview for positive patients and then assign student tracers to investigate secondary and tertiary contacts.
While many contact tracers are given a script, each call is unexpected and different, regardless of how much training is provided. One of the hardest parts of the job is communicating information to callers in layman’s terms and overcoming misinformation about the virus, said Philip Braswell, a recent graduate of the University of Alabama — Birmingham School of Medicine, who had been driving for Uber and Postmates before taking on the job. Another hurdle is overcoming the distrust in government, especially among immigrant populations, Toquinto said.
“You really had to build a trusting relationship to relate to them and help them feel safe to give you the information you need to make sure that they can quarantine effectively,” she said.
Lacking long-term potential
Contact tracing is no new phenomenon. The profession has been around for decades in public health departments around the nation to trace HIV and other viruses. But, demand for contact tracers has soared during the coronavirus pandemic: By October 2020, postings for contact tracer jobs were 25 times higher than they were just six months earlier. Right now, there are more than 170 contact tracer jobs posted on job site Glassdoor.com.
The pay for contact tracers varies by location but the average is $19.72 an hour, according to job site Indeed.com. That’s relatively higher than the $11 an hour that workers typically make working retail, according to ZipRecruiter or the $9.41 an hour national average for food-service workers, according to Indeed. Many students, however, are working as contact tracers as volunteers or for credit.
Despite strong growth, Covid-19 contact tracing programs will likely only last in the short-term, experts say. Demand for the role will shift as more individuals get vaccinated and students shouldn’t look to the job as a long-term career.
“It’s not going to continue at this level,” said Christiana Coyle, a contact tracing coordinator at the CDC Foundation and professor at New York University’s School of Global Public Health.
Many organizations employ just a handful of contact tracers long-term, bringing on additional workers like epidemiologists when there’s an “incredible need,” said Coyle, who formerly worked as a contact tracer for both the Centers for Disease Control and Prevention and New York City’s Department of Health and Mental Hygiene.
The growth of university contact tracing stems from a need to contain the spread on college campuses. Over the past year, schools have grappled with how to reopen while preventing an outbreak. Many have failed, reopening only to shift online within a week. Now, universities face another semester of uncertainty.
Syracuse University began filling out its contact tracing program over the summer, employing about 30 students in the fall semester. Like other universities, program coordinator Dr. Mike Haynie worked closely with local county health officials to build the program, which included developing a database to share information.
Today, the program has expanded to 50 students across disciplines with four full-time case managers who conduct intake interviews. Students conduct secondary and tertiary interviews from the comfort of their dorm rooms, over Zoom, by telephone or from the university health center.
Many students involved in the program have worked as contact tracers for the state or New York City, said Haynie, the university’s vice chancellor for strategic initiatives and innovation, while others had “no idea” what public health was or any interest in entering the field.
“That’s going to be one of the silver linings of Covid,” Haynie said. “It really has opened up the eyes of folks to how significant it is to have the opportunity to make an impact.”
For others, working as a contact tracer has only re-affirmed their decision to join public health, which for Toquinto meant a reaffirmation of her decision to one day work as a physician’s assistant. Upon graduation, Fernández Nuñez hopes to pursue a career that helps reduce health disparities, an issue that has come to the forefront amid the pandemic.
“It was a way for me to help,” Fernández Nuñez said, reflecting on her experience over the past year as a contact tracer. “It was a way for me to rise to the moment and contribute some of the skills that I had.”