The first was that the outbreak was spread outside of the plant, Patterson said, the second was the district was also able to potentially link the outbreak to a separate workplace outbreak outside the county.
“There has been more than one case contact who works at Dole that is connected to the other outbreak,” Patterson said. “Although it’s impossible to say that it came from this outbreak outside of the county, at least two contacts who work at Dole are connected to the other outbreak.”
MORE: Clark County health officials say cases at Dole came from outside work
Patterson said the reason this information is important is because it allows the district to identify and isolate asymptomatic-potentially positive coronavirus cases quickly.
“We know that a lot of people are asymptomatic when they are infected. So through this tracing, we are able to track down patients who may be carrying the virus and are not aware of it and we can isolate those people,” Patterson said. “Through these investigations, we are able to find more hot spots and stomp those out one by one.”
Clark County is related to three ‘hot spots’ or outbreaks - one at Dole, one workplace outbreak outside of the county and another at Southbrook Care Center. About 30% of Clark County’s coronavirus cases can be contributed to the outbreaks.
“We do not have any other places being investigated for an outbreak. We have seen a single case here and there, but we don’t have two or three around a workplace,” Patterson said. “What we are seeing in homes, it’s been very frequent, is a case where the boyfriend or wife gets tested and then they both test positive. We expect that.”
Roughly 30% to 50% of people infected with the coronavirus are asymptomatic, Patterson said, which means the patient can show little to no symptoms of the virus yet can continue to spread it to others. Right now, only patients who are symptomatic can receive a test.
That is why contact tracing is so valuable in cases like the Dole outbreak, Patterson said, where employees were spending so much time with one another outside of the plant. This allowed the virus to move through multiple households.
If the district tracks down every contact of a Dole employee who tested positive for the coronavirus, most importantly those who are asymptomatic and do not know they could be carrying the virus, then they can, “stop it in its track,” Anna Jean Sauter, the supervisor of assessment and surveillance and an epidemiologist at the CCCHD, said,
Contact tracing is one of the only tools public health has to slow the spread of the coronavirus and that’s why contact tracing has become “sort of a buzzword,” during the pandemic, Sauter said.
“The sooner you identify contacts the better chance you have of containing the spread. If you are able to reach the sick people and get those contacts quarantined and away from others, you have a better chance at stopping the spread in its tracks,” Sauter said.
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Contact tracing is part of the process of supporting patients with suspected or confirmed infections, according to the Centers for Disease Control and Prevention’s website. In contact tracing, public health staff members work with a patient to help them recall everyone with whom they have had close contact during the timeframe they may have been infectious, the website said.
Patterson said contact tracing is, “not new to public health.”
“Contact tracing is something that we do on a daily basis,” Patterson said. “We do contact tracing for many other diseases for instances, whopping cough, we do contact tracing for that. We do contact tracing for HIV, syphilis, gonorrhea, chlamydia, a whole other range of diseases. When we see mumps, when we see measles, we do contact tracing for those.”
Patteson said when the district refers to contact tracing in the coronavirus pandemic-era, it means the district traces all of the people a patient with a positive coronavirus test would have had, “extensive contact, or contact within the six-foot social distancing range, for more than 10 minutes.”
“When we have the laboratory positive, we interview them. In some situations, if they are unable to be interviewed, we interview their spouse or a close relative. We also, in some cases, interview their employer to better understand who they regularly come into contact with,” Patterson said.
The district has two epidemiologists and a communicable disease nurse on staff “that basically a majority of their job on a daily basis,” is to conduct contact tracing, Patterson said.
However, with the coronavirus pandemic, the district has struggled to keep up.
“One or two or three people aren’t able to keep up. So we have a team of individuals that are scheduled from 7:30 in the morning until 6:30 at night, Monday through Friday, we have a team scheduled from 10 to 4 Saturday, 10 to 4 every Sunday to receive those positive cases, the reports from the hospitals and the laboratories and then turn around and do that contact investigation,” Patterson said.
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Sauter said when the pandemic first began the district reassigned their whole staff, roughly 15 to 20 employees, to contact tracing.
“But now that some of our clinic services are opening back up, and nurses and health planners are starting to move back into their normal roles, we have hired 11 additional people and we are considering bringing on some more,” Sauter said.
Sauter said bringing in the additional staff will help the district comb through cases more quickly, as the amount of time it takes for the investigation on every case can vary.
“Some are straight forward if a case does not have many contacts. If you are able to identify many people that you have come into contact with, say you went to a large gathering of people, that can make the investigation last a lot longer,” Sauter said. “So if you are staying home, and social distancing and wearing a mask, those contacts get cut down a lot. And it saves us a lot of time.”
Patterson said the investigation helps the district find out “not just where they sit at work and who sits around them but do they sit in the same office, who socially lives in their home, or who have they been around and who do they ride to and from work with?”
What contact tracing will not show, Patterson said, is interactions a patient may have had with someone in a public setting.
“They won’t show that the person was at Lowe’s and stood in line and went and brought something,” Patterson said. “We are never going to know that, we aren’t going to be able to trace all of those people.”
Sauter said this is why it’s so important for people to social distance.
“The whole idea behind (contact tracing) is that the virus doesn’t move on its own, people move the virus. So if we are able to stop the people, we can stop the virus,” Sauter said.
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