NORTHAMPTON — At the end of Amelia Windorski’s senior year at Smith College last spring, they were in their dorm room training for a job that, the year before, they never could have imagined would exist.
Windorski is a COVID-19 contact tracer for Partners in Health, a nonprofit that is running the state’s Community Tracing Collaborative (CTC). Many cities and towns have hired contract tracers already, and for those that haven’t or need more assistance, the CTC picks up those cases.
Case investigators and contact tracers interview individuals who test positive for COVID-19 to track the people with whom they had been in close contact, notify their contacts of possible exposure, educate them about the illness and tell them to stay home. Around the Valley, these investigators and tracers are taking these steps every time someone test positive for the virus.
But, as Windorski explains, “It’s not just, ‘You have COVID, OK, don’t leave you house, bye.’ It’s really building relationships with them.”
After the initial conversations, tracers regularly talk with those who test positive and are ill, as well as check in with those who may have been exposed and who also need to quarantine.
Though the job is stressful at times, “I’ll laugh with people on the phone. We develop inside jokes and stuff,” Windorski said. “If someone trusts you, they are much more willing to come to you if they are having difficulties. They are much more willing to listen to public health guidelines.”
As a new disease, “We’re constantly learning about COVID,” said Connie Schwaiger, who has been handling contact tracing as the public health nurse for the Foothills Health District, an area that includes Goshen, Williamsburg, Whately and Westhampton.
But contact tracing is nothing new — it has been used for years for other infectious diseases, Schwaiger noted. “We’re falling back on what we know about contact tracers,” she said.
In addition to stopping the virus from spreading, the tracers help support people and connect them to any necessary resources.
“Do they need milk dropped off? Or bread or groceries? Are there any needs within the home?” These are some of the questions tracers might ask, Schwaiger said. “There’s a whole myriad of things that can happen because of isolation.”
Windorski noted “common resource needs” that they see, such as “people who are really living paycheck to paycheck, and then they get a COVID diagnosis, and they have to stay home, but they don’t qualify for paid time off or paid leave.” In some cases, Windorski has been able to connect people with resources and case managers to help beyond their period of quarantine or isolation.
“Sometimes we see folks who are struggling with the emotional toll of isolation,” Windorski added. An individual’s family and friends may be far away or also in isolation.
Calling strangers with ‘bad news’ “When I started this job, I had gotten very comfortable calling a complete stranger with generally bad news,” said Vivian Franklin, a public health nurse who works for the Northampton Health Department.
She started doing contact tracing in the spring and said part of the job is offering mental health support over the phone. “I don’t take it lightly when I have to tell someone they need to quarantine.”
Neither does Jenny Meyer, also a public health nurse for the city. Sometimes when she tells people who are asymptomatic but possibly exposed that they need to quarantine, “There’s just a lot of, ‘Wait, what?’” she said, adding that empathy is key.
“There was a time during all of this I had developed, for the first time in my life, really bad anxiety,” Meyer said. She felt shortness of breath and chest tightness and for a few days thought, “‘Holy crud, do I have COVID?’” she recalled. She thought about what would happen if she did have COVID-19 — how she wouldn’t be able to touch her daughter and how she would have to coordinate child care.
“I can get what we’re asking people to do is really hard,” Meyer said, noting that, for some, it can be “potentially financially ruinous.”
Meyer and Franklin have gotten used to answering a lot of questions. At this point in the pandemic, they are answering a number of questions from businesses, such as what to do if an employee is possibly sick. A common question Franklin gets: “What do I do if I was in contact with a contact?” she said. “It can be really challenging to determine what the risk level is, if there is a risk and what is a prudent next step.”
The tracers give advice. “The vast majority of what we do is helping people understand risk and their interactions with risk and how they want — and how we need them to, in some cases — to mitigate risk of exposing others,” Meyer said.
With widespread COVID-19 precautions such as social distancing and face coverings, “now there’s kind of a stigma and shame in catching COVID and possibly giving it to someone else,” Franklin said. Some people have “feelings of horrible guilt finding out they may have actually exposed someone who got really sick.” Even if you follow all the rules, she said, “you can still get COVID if you do every single thing right.”
It’s about risk reduction, Meyer said, not risk elimination.
Being nonjudgmental In talking with cases, Franklin emphasized the importance of building trust and being nonjudgmental, even when someone may have made different choices than you.
“Maybe they traveled because all their loved ones are far away, and they’re isolated,” Franklin said. “Well, that makes a lot of sense.”
It can be hard to not become personally involved sometimes. “Without going into specifics, there were cases that I was working with or around the case for many weeks,” Franklin said. “I was truly emotionally invested, more so than is probably advisable.” She got to know people and their families well, “to the point we would be talking about, ‘What TV shows are you watching to get through isolation?’”
In the spring and summer, Meyer led a public health nursing collaborative that the city of Northampton started as a way to help other municipalities, including smaller, more rural towns. Through that program, a pool of public health nurses did contact tracing around the area, and Meyer saw firsthand how draining the work could be. She had the tracers start working with a therapist “to deal with traumas we were going through as a group,” she said.
Windorski is addressing some of those same needs at Partners in Health. They spend half their time at work as a peer supporter, a position focused on supporting other contact tracers with weekly support groups and drop-in hours. Their colleagues experience stresses similar to those one may encounter in a human services job, Windorski said. Tracers are “working with folks who are dealing with pretty difficult life situations. It can be challenging to see folks who are struggling.”
At the same time, Windorski gets invested in cases and had some that resolved over the summer that they still think about. “It’s so funny to have these very intimate and personal calls with people and work with them for weeks at a time,” Windorski said, “and I would never know if I passed them on the street. It’s a bittersweet thing, but it’s a special thing to be doing during this difficult time in the world.”
At Smith College, Windorski studied psychology and was on the pre-med track. Their experience with contact tracing has made them think about potentially pursuing a career in public health or social work.
In the meantime, “I plan on being here until we turn the lights out on this operation,” Windorski said. “I want to see this through. I’ve become really passionate about contact tracing.”
Greta Jochem can be reached at gjochem@gazettenet.com.