Trust and Time: Key Factors in the Success of Contact Tracing in Lancaster

The author of this article, Alisa Jones, MPH, President & CEO of Lancaster Health Center, is pictured.

The COVID-19 pandemic has changed our everyday experiences and conversations – there’s no denying that. And within those experiences and conversations, the COVID-19 pandemic also changed our vocabulary and introduced concepts previously only used within the sphere of infectious disease and public health.

Social distancing.


Contact Tracing.

Although such concepts are new to many of us, contact tracing is a tried and true public health  tool to reduce the spread of diseases transmitted person-to-person.

Contact tracing at its core is the detective work to quickly identify a person with the disease, encourage that person to isolate until they are no longer infectious, and just as quickly find and reach out to their contacts to encourage isolation and self-monitoring. If a contact begins to experience symptoms, then testing is indicated.

In theory, it should be that simple. But much like the pandemic itself, contact tracing is much more complex.

To ensure contact tracing can work successfully, the key factors of trust and time must be in place. Trained contact tracing staff from a health center or health system will call when an individual tests positive with the disease and ask who they were in contact with 24-48 hours before symptoms appeared, including household and social contacts. The individual must be able to trust that their information is secure and will be used only to promote public health.

This is where the finesse of assuring privacy and confidentially comes into play as contact tracing staff initiate the conversation. If trust is not quickly developed with a contact tracing staff member, the individual is less likely to provide contact details. And already having an established relationship with the health system increases the likelihood of sharing critical information that halts the spread of the disease with the contact tracing staff member.

Lancaster Health Center (LHC) began contract tracing with our patients from the very beginning of the COVID-19 pandemic. Because we were the first health center in Lancaster to begin contact tracing, the concept was unfamiliar to many in our community, especially those on the receiving end of the contact tracing call. Nicole Eby de Rodriguez, an LHC Registered Nurse and Patient Care Coordinator, supported our contact tracing staff by making contact calls and COVID-19 follow-up calls to check on the health of our patients who were recovering from the disease from home, particularly our Spanish speaking patients. She recognized immediately that our grassroots care and warm approach activated familiarity and ease with families, which solidified trust and opened up the conversation. Often times, she would call the same families multiple times from an LHC phone number, and someone would answer the phone by saying, “Hi, Nicole!”

Time is the other critical factor. Any delay in obtaining testing, results, or contacts reduces the likelihood that contact tracing will help prevent new infections. The public health strategy is built on all other factors such as testing and results working optimally. Delays ebb and flow based on changing resource needs throughout the Country, which creates a backlog of challenges not only for our staff and patients, but for our community as a whole. Delays increase our community’s vulnerability.

In the midst of an unprecedented pandemic, it’s unlikely that any aspect will work optimally. However, we can still do all that we can to increase access to testing, communicate authentically and transparently with the community, and promote best practices such as wearing a face covering, social distancing, and contact tracing to help keep families, friends, and neighbors safe and protected. Our concerted and coordinated work as a community will help Lancaster come out of this pandemic more connected, informed, and stronger than ever.

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