Teva Brender
Brender is a second-year medical student at Oregon Health & Science University. He lives in Portland.
When the full extent of the COVID-19 pandemic started to become apparent in mid-March, Oregon Health & Science University, where I am currently a second-year medical student, quickly suspended all clinical rotations. Practically overnight the School of Medicine scrambled to move its entire curriculum online and salvage what was left of the spring term.
Like many, I found myself bored, stir-crazy and eager to help. So when the school offered an elective training students as contact tracers, I jumped at the opportunity. I went through four weeks of instruction and then put my new skills to work as a contact tracer for the Clackamas County Public Health Division.
These past few months have been a crash course in epidemiology, infectious disease, outdated IT infrastructure and government bureaucracy, leaving me both inspired by the amazing and thankless work that public health workers do to keep our communities safe and terrified of what is going to happen as we re-open the country and establish a new, post-COVID “normal.” Outbreaks are no longer mostly confined to nursing homes and long-term care facilities – now they are affecting retail businesses, grocery stores and restaurants. And whereas when I first started I could usually trace every case back to a particular outbreak, increasingly the people I call are unable to identify where they got infected – evidence of growing community spread.
When someone tests positive for the coronavirus it is our job to call them and ask them a battery of questions about their symptoms, risk factors and with whom they have been in close contact going back to the 48 hours before they felt ill. If the person has already been social distancing, their contacts are usually limited to their household, making this part of the interview pretty quick.
However, I usually find myself holding my breath at this point in the conversation. If the patient has been going to work, or mentions that one of their contacts has been sick, the situation becomes like a Hydra sprouting new heads. Cases and contacts multiply, and things can quickly spiral out of control. We have to track down each person and go through the same battery of questions as with the original patient.
But the most difficult part of an interview is having to give instructions for people to isolate themselves. Those who are confirmed to have COVID-19 are told that they must stay at home, often in a separate room if they live with other people, for 10 days and until they no longer have any symptoms before they can be considered recovered. Meanwhile, all those who came in contact with them are asked to quarantine themselves for 14 days after their last exposure. And because many people’s living arrangements are not amenable to isolating within the home, their own quarantine can only begin after their loved one has recovered. It’s heartbreaking to tell people who may be losing their business or job to stay home even when they aren’t symptomatic.
I am just as tired of the lockdown as everyone else. My sister-in-law just gave birth and I don’t know when I’ll be able to meet my new niece. I am anxious that due to the scheduling changes I may not be able to get all the courses that I need to graduate on time. And with summer fast approaching, I miss sitting in the sun and grabbing a bite to eat with friends. But the more people can limit their contacts, the easier it will be to keep COVID-19 infections from soaring. Contact tracing, the bread and butter of any infectious disease public health response, has never been deployed on this scale before; and though contact tracing isn’t usually particularly difficult, you need to be trained and approved by the state, and the work itself is time-consuming.
The stay-home orders helped flatten the curve temporarily, but cases are starting to rise again. So as we continue to open up, let’s be careful. Let’s keep ourselves, and the most vulnerable among us, safe. I am inspired every day by my new colleagues’ Herculean efforts, but our long-underfunded public health infrastructure is being stretched further than ever before. Let’s not see how far it can bend before it breaks.
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