After learning that a member of the school community had tested positive for COVID-19 in mid-October, Lyme school officials’ first call was to the New York Department of Health and Human Services. Hampshire.
After that, the school nurse and two parent doctors got to work interviewing the affected family to determine who they might have interacted with while they were contagious, then calling those people to determine if they responded to definition of close contact. If so, health providers have asked affected students and school staff to self-quarantine for 14 days after their last possible exposure.
Contact tracing to be done locally is becoming more common as New Hampshire’s COVID-19 case count rises, creating a backlog among the state’s official public health contact tracers.
“We are primarily the people doing this contact tracing,” Lyme school principal Jeff Valence said in a phone interview Wednesday. “The state gets it back afterwards.”
As COVID-19 cases increase across the region and the country, contact tracers have become busier identifying those who may have been exposed to the virus through interactions with people who have tested positive. It is important to trace close contacts quickly so that they can begin quarantine, thereby preventing further spread in case they carry the virus.
In North Dakota, beleaguered public health officials began in October asking people who tested positive to tell people they thought they had been in close contact with about their positive test and the need to get away. quarantine. An Alaskan health official said The New York Times that they have switched to a “simple” form of contact tracing.
Public health officials haven’t gone that far in New Hampshire, but they’re asking school nurses, long-term care providers and hospital staff to start contact tracing when they know who the infected are with. were able to have close contact, New Hampshire Department of Health and Human Services Commissioner Lori Shibinette at a press conference in October.
“Absolutely, we will ask them. Please, if you know this person has had close contact, go ahead and ask them to self-quarantine until we complete our investigation of the case and come to that,” he said. she declared.
As rapid antigen testing has taken hold in New Hampshire, people can get their results immediately and share the news with school officials and others as little as 24 hours before state officials don’t get it, Shibinette said. Additionally, she said the number of contacts in each case has increased from the spring, from three in March and April to five or six now.
Contact tracing has become more complex as schools and businesses have reopened and the coronavirus has infected students and young adults. Work was simpler at the start of the pandemic, when people stayed closer to home and had less interaction with others.
“It’s a big step forward for us,” Shibinette said Oct. 15. a club, or something like that.
Schools are not the only ones being asked to participate in contact tracing. As of Saturday, diners in restaurants in New Hampshire are now required to provide their names and phone numbers to improve the process if it is later determined that someone was at a restaurant during their infectious period, the report reported. ‘Associated Press. The requirement was requested by the New Hampshire Restaurant Association and approved by Gov. Chris Sununu’s reopening task force on Thursday.
The number of cases in the twin states has returned in recent weeks to levels not seen since the spring, with New Hampshire this week hitting a new high for the average number of new daily cases, which stood at 113.3 on Wednesday. Statewide, the level of transmission was considered “substantial” on Friday. In the Upper Valley, Grafton County went from a “minimal” to “moderate” level of transmission last week. Sullivan County remains in the “minimal” category.
To cope with the increased workload, New Hampshire brought in more contact tracers, including at least 30 members of the National Guard, Shibinette said. This week, the department had a total of 120 contact tracers, in addition to the Manchester and Nashua health departments, which carry out their own contact tracing, DHHS spokesman Jake Leon said in a statement. E-mail. The state had about 90 tracers in the spring and has flexed to having as many as 150 at a time, he said.
All cases and close contacts are notified within a day of the department identifying a case, Leon said. He didn’t say who makes that contact, but when cases involve schools, at least the first contact often comes from a school employee.
Vermont has 37 active contact tracers, Vermont Department of Health spokesman Ben Truman said. Contact tracers in Green Mountain State typically conduct interviews with infected individuals within 24 hours of learning of the case.
As cases increased, Truman said it took longer for contact tracers to complete their work, which he attributed mainly to the difficulty of getting people to pick up the phone.
While for the most part contact tracing is going smoothly for New Hampshire schools, it’s not without its challenges, said Paula MacKinnon, president of the New Hampshire School Nurses’ Association.
“It’s very stressful for schools to take on this role now,” she said. “Sometimes there are difficult parents to deal with who we have to try to get on the side of public health. It takes a long time.”
While school nurses were celebrated at the start of the school year for their role in reopening schools, some of that shine has dissipated now that they must follow all the various COVID-19 safety guidelines, according to MacKinnon.
It’s “not easy for a parent to hear that a child needs to be home (or) tested,” she said.
Michael Hinsley, municipal health worker for Hanover and Lyme, who has been helping cities and schools in those cities in their response to COVID-19, praised school staff for stepping up contact tracing, which he described it as “a critical work in a finite time frame.”
“Our local communities have been exceptionally well served and protected through the efforts of school nurses,” he said.
As in Lyme, school officials in SAU 70 also made the decision to notify those who may have been exposed after positive cases were identified at Ray School, Richmond Middle School and the Hanover High School last month.
“Although we have provided the Department of Health and Human Services with a list of students who may have had ‘direct contact’ with the positive case, there are currently more than 900 people statewide in the queue. ‘waiting for contact tracing,’ Richmond Middle School Principal Tim Boyle said in an Oct. 10 email to families after a case was identified there.
Because of the backlog, Boyle said the school will “send another confidential email shortly to families and teachers who are part of the cohort.”
Similarly, SAU 70 officials have also begun contact tracing and worked with Dartmouth-Hitchcock Medical Center to arrange testing following a positive case at Hanover High School.
“This will save individuals from having to wait for DHHS contact tracers to call,” Superintendent Jay Badams said in an Oct. 16 letter to families. “With the help of DHMC, we will be contacting all of these students and staff directly shortly. Some of you may have already been contacted, but we want to make sure our community has the most up-to-date information in a timely manner.
SAU 70, like the school in Lyme, has the advantage of having doctors in the community. The SAU has a physician advisory group that advises school officials on their response to COVID-19. He also has a school district physician, DHMC pediatrician Dr. Steve Chapman.
In an email, Chapman stressed the importance of schools working in a coordinated manner with DHHS in their response to a COVID-19 case.
“This involves identifying close contacts, notifying families and staff, and then testing and quarantining those identified,” Chapman said. “What schools can do is keep accurate seating plans, use the cohort where possible, and continue to practice risk reduction strategies that work such as mask-wearing, hand sanitizing, physical distancing and of course staying home if you are sick.
He also noted that the cases in schools are coming from elsewhere, as the virus does not appear to be transmitted in schools.
“We had over 100 close contact tests, all of which came back negative,” Chapman said of SAU 70. “Children, teachers and administrators are doing a great job keeping schools safe.”
Through the work of the school nurse and Lyme parent doctors, the school has identified 56 close contacts whom it has asked to quarantine, Valence said. Coordinated testing with DHMC revealed no additional cases. Due to these quarantines and the effect on staff, students in grades 5-8 at the K-8 school transitioned to distance learning from October 20 through last Friday.
While Valencia said it would be nice if the state had enough resources to do the contact tracing itself in a timely manner, “we were very lucky to have a lot of people with great expertise.”
Even schools outside the immediate vicinity of the state’s only academic medical center are working on contact tracing. When Newport school officials learned of a case in a high school student on Tuesday, the high school nurse and principal conducted contact tracing to identify people who may have been in contact. close with the person who tested positive, Superintendent Brendan Minnihan said in an email. to families.
The school staff notified these contacts. The high school moved to distance learning on Wednesday to allow time for cleaning and contact tracing, but was able to reopen for in-person instruction Thursday.
Valencia acknowledged that not all schools have doctors in the community to help when a case of COVID-19 arises, but he said “schools are inherently very innovative and we have to be able to respond to so many different things”.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
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