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An Army of Virus Tracers Takes Shape in Massachusetts An Army of Virus Tracers Takes Shape in Massachusetts
(2 days later)
BOSTON — Alexandra Cross, a newly minted state public health worker, dialed a stranger’s telephone number on Monday, her heart racing.BOSTON — Alexandra Cross, a newly minted state public health worker, dialed a stranger’s telephone number on Monday, her heart racing.
It was Ms. Cross’s first day as part of Massachusetts’s fleet of contact tracers, responsible for tracking down people who have been exposed to the coronavirus, as soon as possible, and warning them. On her screen was the name of a woman from Lowell.It was Ms. Cross’s first day as part of Massachusetts’s fleet of contact tracers, responsible for tracking down people who have been exposed to the coronavirus, as soon as possible, and warning them. On her screen was the name of a woman from Lowell.
“One person who has recently been diagnosed has been in contact with you,” the script told her to say. “Do you have a few minutes to discuss what that exposure might mean for you?” Forty-five minutes later, Ms. Cross hung up the phone. They had giggled and commiserated. Her file was crammed with information.“One person who has recently been diagnosed has been in contact with you,” the script told her to say. “Do you have a few minutes to discuss what that exposure might mean for you?” Forty-five minutes later, Ms. Cross hung up the phone. They had giggled and commiserated. Her file was crammed with information.
She was taking her first steps up a Mount Everest of cases.She was taking her first steps up a Mount Everest of cases.
Massachusetts is the first state to invest in an ambitious contact-tracing program, budgeting $44 million to hire 1,000 people like Ms. Cross. The program represents a bet on the part of Gov. Charlie Baker that the state will be able to identify pockets of infection as they emerge, and prevent infected people from spreading the virus further.Massachusetts is the first state to invest in an ambitious contact-tracing program, budgeting $44 million to hire 1,000 people like Ms. Cross. The program represents a bet on the part of Gov. Charlie Baker that the state will be able to identify pockets of infection as they emerge, and prevent infected people from spreading the virus further.
This could help Massachusetts in the coming weeks and months, as it seeks to relax strict social-distancing measures and reopen its economy.This could help Massachusetts in the coming weeks and months, as it seeks to relax strict social-distancing measures and reopen its economy.
Contact tracing has helped Asian countries like South Korea and Singapore contain the spread of the virus, but their systems rely on digital surveillance, using patients’ digital footprints to alert potential contacts, an intrusion that many Americans would not accept.Contact tracing has helped Asian countries like South Korea and Singapore contain the spread of the virus, but their systems rely on digital surveillance, using patients’ digital footprints to alert potential contacts, an intrusion that many Americans would not accept.
Massachusetts is building its response around an old-school, labor-intensive method: people. Lots of them.Massachusetts is building its response around an old-school, labor-intensive method: people. Lots of them.
“It’s not cheap,” Governor Baker, a Republican, said. “But the way I look at it, the single biggest challenge we’re going to have is giving people confidence and comfort that we know where the virus is.”“It’s not cheap,” Governor Baker, a Republican, said. “But the way I look at it, the single biggest challenge we’re going to have is giving people confidence and comfort that we know where the virus is.”
The state is currently experiencing a surge of cases that is expected to last for the next week, after which it may start to consider easing social-distancing rules. Robust contact tracing, combined with ramped-up testing, could smooth that process, the governor said.The state is currently experiencing a surge of cases that is expected to last for the next week, after which it may start to consider easing social-distancing rules. Robust contact tracing, combined with ramped-up testing, could smooth that process, the governor said.
“It’s hard to see how we create a sense of safety if we don’t have a program like this in place,” he said.“It’s hard to see how we create a sense of safety if we don’t have a program like this in place,” he said.
The idea of training a corps of contact tracers is emerging in many places at the same time, as leaders think ahead to the point when social-distancing constraints will be lifted.The idea of training a corps of contact tracers is emerging in many places at the same time, as leaders think ahead to the point when social-distancing constraints will be lifted.
President Trump was expected to announce that the Centers for Disease Control and Prevention would hire hundreds of people to perform contact tracing as part of his push to allow the country to go back to work and school, a top government official said this week. San Francisco is assembling and training 150 volunteers to augment the contact-tracing efforts of its own public health department. Ireland is deploying 1,000 furloughed government workers to do contact tracing.President Trump was expected to announce that the Centers for Disease Control and Prevention would hire hundreds of people to perform contact tracing as part of his push to allow the country to go back to work and school, a top government official said this week. San Francisco is assembling and training 150 volunteers to augment the contact-tracing efforts of its own public health department. Ireland is deploying 1,000 furloughed government workers to do contact tracing.
This means restoring capacity that has been pared away for decades by cuts to public health budgets, said Allyson Pollock, the director of the Institute of Health and Society at Newcastle University in the northeast of England.This means restoring capacity that has been pared away for decades by cuts to public health budgets, said Allyson Pollock, the director of the Institute of Health and Society at Newcastle University in the northeast of England.
“All our fancy scientists think it’s boring, because it’s people, you need people on the ground,” she said. “It’s the hard bread and butter of communicable disease control, and we’ve decimated our services.”“All our fancy scientists think it’s boring, because it’s people, you need people on the ground,” she said. “It’s the hard bread and butter of communicable disease control, and we’ve decimated our services.”
The Massachusetts program is staged by the nonprofit Partners in Health, whose doctors have led responses to infectious disease — Ebola, Zika, drug-resistant tuberculosis, cholera and typhoid fever, among others — in the world’s poorest countries.The Massachusetts program is staged by the nonprofit Partners in Health, whose doctors have led responses to infectious disease — Ebola, Zika, drug-resistant tuberculosis, cholera and typhoid fever, among others — in the world’s poorest countries.
It is built around one-on-one telephone interviews of newly diagnosed patients and their contacts, so that subjects must answer the phone when it rings. Paul Farmer, a physician-anthropologist and one of the group’s founders, said there was no substitute for the bond of trust formed by a human contact tracer.It is built around one-on-one telephone interviews of newly diagnosed patients and their contacts, so that subjects must answer the phone when it rings. Paul Farmer, a physician-anthropologist and one of the group’s founders, said there was no substitute for the bond of trust formed by a human contact tracer.
“Somebody needs to say to people who are worried and not feeling well, ‘We got you,’” he said. “‘If this is Covid-19, we got you. And we’ll look out for your contacts, your spouse and your children.’ And I think that’s another thing you can do remotely or virtually, is reassure people that there is no reason to believe everything is lost.”“Somebody needs to say to people who are worried and not feeling well, ‘We got you,’” he said. “‘If this is Covid-19, we got you. And we’ll look out for your contacts, your spouse and your children.’ And I think that’s another thing you can do remotely or virtually, is reassure people that there is no reason to believe everything is lost.”
Dr. Farmer, 60, whose work on tuberculosis gave him a kind of rock-star status in the public health world, tried to calm the nerves of around 80 new recruits last week, describing his own experience investigating a tuberculosis outbreak as a medical student.Dr. Farmer, 60, whose work on tuberculosis gave him a kind of rock-star status in the public health world, tried to calm the nerves of around 80 new recruits last week, describing his own experience investigating a tuberculosis outbreak as a medical student.
His eyeglass frames had broken, something he cheerfully blamed on the pandemic, and he had to balance them on the bridge of his nose as he spoke.His eyeglass frames had broken, something he cheerfully blamed on the pandemic, and he had to balance them on the bridge of his nose as he spoke.
“Once you get in someone’s space — this is going to be different, to the extent that it is virtual — but sitting with folks in their homes, the subtext of these tracings was, ‘Hey, we want to help you and your family,’” he said.“Once you get in someone’s space — this is going to be different, to the extent that it is virtual — but sitting with folks in their homes, the subtext of these tracings was, ‘Hey, we want to help you and your family,’” he said.
The downside of human contact tracing is that it is expensive, can overlook contacts a subject may not recall, and, some argue, is too slow for a fast-moving virus.The downside of human contact tracing is that it is expensive, can overlook contacts a subject may not recall, and, some argue, is too slow for a fast-moving virus.
“Using automation to do it, cellphones and triangulations of data, that is the easiest and fastest way, and probably the most effective way to do this,” said Ranu S. Dhillon, a physician at Brigham and Women’s Hospital in Boston, who advised the government of Guinea on the Ebola outbreak.“Using automation to do it, cellphones and triangulations of data, that is the easiest and fastest way, and probably the most effective way to do this,” said Ranu S. Dhillon, a physician at Brigham and Women’s Hospital in Boston, who advised the government of Guinea on the Ebola outbreak.
“If you’re taking one or two days to manually figure out where someone went, you’re adding more time where people can transmit it to others,” he said.“If you’re taking one or two days to manually figure out where someone went, you’re adding more time where people can transmit it to others,” he said.
But human outreach is a standard public health practice, first used in many countries to seek out sexual partners of men and women known to be carriers of sexually transmitted diseases.But human outreach is a standard public health practice, first used in many countries to seek out sexual partners of men and women known to be carriers of sexually transmitted diseases.
It was gritty, solitary work. A contact tracer who worked in New Zealand in the 1970s described spending her evenings in bars and boardinghouses, tracking down subjects based on sketchy descriptions, like, “she goes to the hotel at Friday nights and she drinks Southern Comforts,” and “Kathleen — with a generous superstructure.”It was gritty, solitary work. A contact tracer who worked in New Zealand in the 1970s described spending her evenings in bars and boardinghouses, tracking down subjects based on sketchy descriptions, like, “she goes to the hotel at Friday nights and she drinks Southern Comforts,” and “Kathleen — with a generous superstructure.”
The work required such abnormal hours and such secrecy, the contract tracer told the historian Antje Kampf that it was difficult to have a social life or marriage. “I sometimes wonder if I was chosen for the job because I was a loner, or if it was the other way around,” she said.The work required such abnormal hours and such secrecy, the contract tracer told the historian Antje Kampf that it was difficult to have a social life or marriage. “I sometimes wonder if I was chosen for the job because I was a loner, or if it was the other way around,” she said.
In recent years, jolted by SARS and then by MERS, Asian countries have poured resources into contact tracing, combining sophisticated digital tools with large networks of public health outreach workers.In recent years, jolted by SARS and then by MERS, Asian countries have poured resources into contact tracing, combining sophisticated digital tools with large networks of public health outreach workers.
Jim Yong Kim, a co-founder of Partners in Health, who recently stepped down as president of the World Bank, said he was struck by the contrast between American and South Korean leaders, who, because of robust contact tracing, felt able to go on the offensive against the virus.Jim Yong Kim, a co-founder of Partners in Health, who recently stepped down as president of the World Bank, said he was struck by the contrast between American and South Korean leaders, who, because of robust contact tracing, felt able to go on the offensive against the virus.
“We’re sitting back, hunkering down, waiting to see what the virus is going to do to us,” he said. The language of South Korean colleagues, he said, “was completely different from the language I was hearing in the U.S. They were talking about the virus as if it were a person. Telling me how tricky it was. It was the experience of chasing it down.”“We’re sitting back, hunkering down, waiting to see what the virus is going to do to us,” he said. The language of South Korean colleagues, he said, “was completely different from the language I was hearing in the U.S. They were talking about the virus as if it were a person. Telling me how tricky it was. It was the experience of chasing it down.”
Updated June 12, 2020Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
In a late-night phone call at the end of March, Dr. Kim pitched his idea to Governor Baker, pointing to data from Wuhan, China, that showed that social distancing alone could not bring the virus’s spread rate low enough to lift the current restrictions.In a late-night phone call at the end of March, Dr. Kim pitched his idea to Governor Baker, pointing to data from Wuhan, China, that showed that social distancing alone could not bring the virus’s spread rate low enough to lift the current restrictions.
“When people say you can’t do that, it’s too labor-intensive, it makes no sense to me,” he said. “Ask all the people sheltering in place, the 70 percent of people who have lost income — I would ask those people, how much is it worth to us to really get on top of it? $100 billion? $500 billion?”“When people say you can’t do that, it’s too labor-intensive, it makes no sense to me,” he said. “Ask all the people sheltering in place, the 70 percent of people who have lost income — I would ask those people, how much is it worth to us to really get on top of it? $100 billion? $500 billion?”
Governor Baker, who listened to the pitch in his car that night, said he appreciated that Dr. Kim could point to concrete experiences of battling outbreaks in African countries and in Haiti.Governor Baker, who listened to the pitch in his car that night, said he appreciated that Dr. Kim could point to concrete experiences of battling outbreaks in African countries and in Haiti.
“I have people reaching out to me all day with theoretical things that we could do, God love ’em,” he said. He said he had also heard from “everyone who had a phone-pinging program,” and that digital tracing may be integrated into the state’s program later, but that human outreach was critical to reaching people without an easy way to isolate themselves.“I have people reaching out to me all day with theoretical things that we could do, God love ’em,” he said. He said he had also heard from “everyone who had a phone-pinging program,” and that digital tracing may be integrated into the state’s program later, but that human outreach was critical to reaching people without an easy way to isolate themselves.
“You’ve got to be able to connect to people in some way that’s meaningful that’s beyond a ping on the phone,” he said.“You’ve got to be able to connect to people in some way that’s meaningful that’s beyond a ping on the phone,” he said.
Already, Massachusetts’ local departments of health had been carrying out contact tracing, assisted by 1,700 volunteers from the state’s academic public health community.Already, Massachusetts’ local departments of health had been carrying out contact tracing, assisted by 1,700 volunteers from the state’s academic public health community.
The 1,000 new jobs, announced at a news conference on April 3, set off a deluge of applications, now numbering around 15,000. Ms. Cross, 27, who is training to be a nutritionist, said she was so emotional about taking part that she wept during her recorded interview.The 1,000 new jobs, announced at a news conference on April 3, set off a deluge of applications, now numbering around 15,000. Ms. Cross, 27, who is training to be a nutritionist, said she was so emotional about taking part that she wept during her recorded interview.
“I feel like I have all this energy that I want to funnel into prevention,” she said.“I feel like I have all this energy that I want to funnel into prevention,” she said.
Harvey Schwartz, 72, a retired civil rights lawyer from Ipswich, said he sent in his application within 15 minutes of Governor Baker’s announcement, offering to work without pay.Harvey Schwartz, 72, a retired civil rights lawyer from Ipswich, said he sent in his application within 15 minutes of Governor Baker’s announcement, offering to work without pay.
“I’ve been spending two and a half hours every morning reading the news, and getting more and more depressed,” he said. “This is the antidote to that.”“I’ve been spending two and a half hours every morning reading the news, and getting more and more depressed,” he said. “This is the antidote to that.”
“Cohort One” of the state’s program — a group of around 80 hires, among them graduate students, Peace Corps volunteers, medical assistants and retired nurses — logged on for the first time last Thursday, to learn the nuts and bolts of the system.“Cohort One” of the state’s program — a group of around 80 hires, among them graduate students, Peace Corps volunteers, medical assistants and retired nurses — logged on for the first time last Thursday, to learn the nuts and bolts of the system.
Each time a citizen tests positive, the results will be immediately shared with a case investigator through a secure database. Within two hours, the case investigator will aim to reach the patient by phone and compile a list of every person he or she had been in close contact with in the 48 hours before the onset of symptoms.Each time a citizen tests positive, the results will be immediately shared with a case investigator through a secure database. Within two hours, the case investigator will aim to reach the patient by phone and compile a list of every person he or she had been in close contact with in the 48 hours before the onset of symptoms.
The names of the contacts — the expectation is 10 people per new case — will then be passed to contact tracers, who will attempt to reach each one by telephone within 48 hours, calling back three times in succession to signal the call’s importance. For now, tracers are not leaving messages or callback numbers.The names of the contacts — the expectation is 10 people per new case — will then be passed to contact tracers, who will attempt to reach each one by telephone within 48 hours, calling back three times in succession to signal the call’s importance. For now, tracers are not leaving messages or callback numbers.
The contact tracers, speaking from their prepared script, will inform the contact of approximately when they were exposed, and then take an inventory of symptoms, talk the contact through quarantine requirements, and help arrange assistance with food or housing if the contact cannot easily quarantine.The contact tracers, speaking from their prepared script, will inform the contact of approximately when they were exposed, and then take an inventory of symptoms, talk the contact through quarantine requirements, and help arrange assistance with food or housing if the contact cannot easily quarantine.
The new contact tracers began placing their first calls over the weekend.The new contact tracers began placing their first calls over the weekend.
“It was a real microscopic look into the lives of people who have this disease,” said Mr. Schwartz, the former civil rights lawyer, who reached around 10 people in his first eight-hour shift. To his relief, they all seemed eager to speak to him.“It was a real microscopic look into the lives of people who have this disease,” said Mr. Schwartz, the former civil rights lawyer, who reached around 10 people in his first eight-hour shift. To his relief, they all seemed eager to speak to him.
“Some people were lonely,” he said. “Some people were glad the state was involved. A few people named the governor by name.”“Some people were lonely,” he said. “Some people were glad the state was involved. A few people named the governor by name.”
David Novak, 53, a social worker, found that his conversations were stretching to 30 or 40 minutes apiece, as the people he contacted told him about their difficulties maintaining distance from their family members.David Novak, 53, a social worker, found that his conversations were stretching to 30 or 40 minutes apiece, as the people he contacted told him about their difficulties maintaining distance from their family members.
One woman told him how strange it is, after a long marriage, to sleep away from her husband.One woman told him how strange it is, after a long marriage, to sleep away from her husband.
“This is where the human element of public health comes in,” Mr. Novak said. “You can use technology to make the humans more efficient, but if you take the humans out of it, how do you ask questions?”“This is where the human element of public health comes in,” Mr. Novak said. “You can use technology to make the humans more efficient, but if you take the humans out of it, how do you ask questions?”
“You’re going to have to talk to them,” he said.“You’re going to have to talk to them,” he said.