8/21/20

Throughout the COVID-19 pandemic, contact tracing has played a critical role in preventing the virus’ spread. Historically used for several other infectious diseases, contact tracing has been shown to be especially important at the early stages of an outbreak when there is scarce information about the disease and treatments are not yet available.¹  Given how little was known about COVID-19, particularly early in the pandemic, the Brigham’s rapid ability to create its own COVID-19 contact tracing program was critical to ensuring our patients and staff remain safe as possible.

According to the Centers for Disease Control and Prevention, contact tracing consists of three main steps:²

1. Letting people know they may have been exposed to COVID-19 and should monitor their health for signs and symptoms of COVID-19.
2. Helping people who may have been exposed to COVID-19 get tested.
3. Asking people to self-isolate if they have COVID-19 or self-quarantine if they are a close contact.

Brigham Health’s Occupational Health, Infection Control and Quality and Patient Safety teams came together early in the pandemic to create a process by which each of these contract tracing steps could be accomplished within our hospital and community so that possible COVID-19 exposures are identified and communicated, and patients and staff with possible exposures are supported as much as possible. The communication strategies we have undertaken have even been published in The Joint Commission Journal on Quality and Patient Safety. Additional details on our health care staff communication strategies can be found here, and patient communication strategies here.

Through our program, any patient or staff member who tests positive for COVID-19 within the Brigham Health system is thoroughly reviewed for possible exposures. Interviews are conducted with all staff with confirmed positive test results and any possible employee or patient exposures are identified.

Additionally, all patients who test positive at a Brigham Health site, either at the hospital or at an ambulatory clinic, have manual reviews performed of their medical record to identify any possible exposures to COVID-19 that may have occurred. Exposures are also analyzed using a medical record tracing function, allowing Infection Control to identify staff who interacted with the patient and subsequently may have been exposed.

Once any possible exposure risks are identified, staff are contacted by Occupational Health, and patients received a phone call from a physician. The physicians ensure all patients’ questions and concerns are addressed and that appropriate resources, such as social work and communication with the patient’s primary care provider, are offered. Staff and patients are also educated on the latest Centers for Disease Control and Prevention recommendations around symptom monitoring and isolation precautions and are given assistance and information on how to get testing.

We firmly believe that our efforts to implement contact tracing within our hospital helped to prevent countless additional infections from occurring. As the pandemic is ongoing, we are committed to ensuring this process continues and that transparency and the safety of our staff and patients remains our highest priority.

References:

¹Keeling, MJ., Hollingsworth, TD., Read, JM. Efficacy of Contact Tracing for the Containment of the 2019 Novel Coronavirus (COVID-19). J Epidemiol Community Health. 2020 Jun 22. PMID: 32576605

²Centers for Disease Control and Prevention. Notification of Exposure: A Contact Tracer’s Guide for COVID-19.

https://www.cdc.gov/coronavirus/2019-ncov/php/notification-of-exposure.html