Hi Ed,
It was clear early on that community transmission was occurring and so we stopped doing contact tracing weeks ago (although it seems like months) for employees
on our campus. There was no threshold, but a judgement about where our staff could be better used. We chose to focus on interviewing and counseling those who were confirmed cases and/or reported work-related exposures, answering inquiries and concerns
and helping to develop standardized approaches. The transition was gradual and differed among our university’s 4 employee health services. Contact tracing is still being done if needed for congregate living facilities, for example, in correctional facilities
and by our student health services for students living in dormitories. On our campus, Covid-19 testing was centralized in a combined General Medicine/ID service.
We asked our state health department for guidance about when to stop contact tracing and they sent us the following on March 26:
Re 1-2, 4 below. This is the message we give to LHDs—ideally, if resources allow, contact tracing should be done; as resources become strapped, it might make sense for locals to shift more efforts on mitigation
efforts.
This is similar to the CDC advice. Our state and local health depts were/are overwhelmed, so could not provide assistance.
Good luck and stay well,
Larry
Lawrence D. Budnick, MD, MPH
Professor of Medicine
Director, Occupational Medicine Service
Rutgers University New Jersey Medical School
65 Bergen Street, Suite GA-167, Newark, NJ 07107
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From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Galaid Edward I
Sent: Monday, April 06, 2020 3:04 PM
To: Occ-Env-Med-L@listserv.unc.edu; mcoh-eh@mylist.net
Subject: [MCOH-EH] Contact Tracing for HCPs exposed to a case of COVID-19
Have you determined a threshold of community transmission that would have you stop doing contact tracing? Are you still doing it?
Just a reminder…from the March 7 CDC update…
“While contact tracing and risk assessment, with appropriate implementation of HCP work restrictions, of potentially exposed HCP remains the recommended strategy for
identifying and reducing the risk of transmission of COVID-19 to HCP, patients, and others, it is not practical or achievable in all situations.
Community transmission of COVID-19 in the United States has been reported in multiple areas. This development means some recommended actions (e.g., contact tracing and
risk assessment of all potentially exposed HCP) are impractical for implementation by healthcare facilities.
In the setting of community transmission, all HCP are at some risk for exposure to COVID-19, whether in the workplace or in the community. Devoting resources to contact
tracing and retrospective risk assessment could divert resources from other important infection prevention and control activities.
Facilities should shift emphasis to more routine practices, which include asking HCP to report recognized exposures, regularly monitor themselves for fever and symptoms
of respiratory infection and not report to work when ill. Facilities should develop a plan for how they will screen for symptoms and evaluate ill HCP. This could include having HCP report absence of fever and symptoms prior to starting work each day.”
Ed Galaid
Edward I. Galaid, MD, MPH, FACOEM
ABIM, ABPM (OM)
Medical Director, Roper St. Francis Physician Partners Occupational Medicine
Charleston, SC
Member, ACOEM Task Group, Guidance for the Medical Evaluation of Law Enforcement Officers
Special Expert, NFPA Fire Service Occupational Safety & Health (FIX-AAA) Committee
(O) 843-402-5053
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