A Contact Tracer'S Guide For Covid-19: CDC - Gov/coronavirus
A Contact Tracer'S Guide For Covid-19: CDC - Gov/coronavirus
A Contact Tracer'S Guide For Covid-19: CDC - Gov/coronavirus
cdc.gov/coronavirus
CS317452-A 6/5/2020 2PM
Contents
OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Intro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Verifying Identity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Reason for Call . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Confidentiality & Privacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
COLLECTING LOCATING AND DEMOGRAPHIC INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Intro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Locating and Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Emergency Contact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
HEALTH INFORMATION AND ASSESSING DISEASE COMPREHENSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Intro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Disease Comprehension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Symptoms of COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Underlying Health Conditions and Other Risk Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Testing for COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
REVIEWING QUARANTINE RECOMMENDATIONS AND RESOURCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Quarantine Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Assessing Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Assessing Living Situation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Assessing Other Supports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Release from Quarantine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Release from Quarantine: Special Circumstances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Disclosure Coaching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
HEALTH MONITORING AND RESPONDING TO CHANGES IN HEALTH STATUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Intro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Monitoring Agreements & Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Responding If Symptoms Develop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Medical Provider and Other Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Check-in, Questions and Agreements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Acknowledging the difficulty and keeping the door open for contact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
APPENDIX A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
COVID-19 Symptom Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
OVERVIEW
A successful notification of exposure allows for an exchange of information with the person (contact) exposed to
COVID-19 and offers an opportunity to answer questions and provide referrals for testing, medical evaluation and
other necessary support services. The goals of this interaction are to inform the person that they may have been
exposed to COVID-19, assess their medical condition and other risk factors, and gather information for continued
monitoring and support. Developing trust and a warm, empathetic rapport, while maintaining a professional
relationship, is key to providing effective support and collecting accurate information to inform the next steps in the
contact tracing investigation.
Language is important. It sets the stage to build rapport with contacts and opens the door to honest dialogue. It is
critical to establish open communication with people exposed to COVID-19 so that they feel comfortable expressing
what they need in order to safely self-quarantine and seek help if they develop symptoms. If supportive statements
and genuine concern are combined with active listening and open-ended questions, powerful information can be
gathered to interrupt the spread of the virus. Asking open-ended questions prompts a dialogue and elicits more
detailed information, and often the information is helpful in learning more about the person and their circumstances.
This document provides suggested communication approaches for Local Health Jurisdictions (LHJs) to consider
as they craft their own scripts for contact tracers. Local scripts may need to be modified to address local needs,
including but not limited to highlighting available resources, cultural nuances, exposure sites, and the capture of
epidemiological data. Interviewers should use what is helpful and the best fit for the interaction; all questions or
statements may not be required and additional probing questions may be necessary. Programs are encouraged to
share best practices in framing and phrases as they are identified.
INTRO
• May I speak with [respondent name]?
• Am I speaking with [respondent name]?
• Hello, this is [interviewer’s name stated and spelled out]. I am a/an [title] with the <xxxx health department>,
calling for {respondent name].
• [For minors] Who is their/your parent/guardian? How can I reach their/your parent/guardian?
• What language(s) do you feel most comfortable speaking?
• [If language barrier and interpreter available]: We can work with an interpreter (provide information on if that
person will be connected or if will need to call back).
• [If language barrier and team member who speaks the individual’s preferred language is not available]: A team
member who speaks (language) will call you back.
• I am following up with you to discuss an important health matter. This call is private and intended to assist you
with this matter. Is now a good time to talk privately? If not, what time works best for you?
• If you are not available now, let’s schedule a time to talk. We have some important health information for you
and want to be sure that you can get the referrals and resources you may need, and answer questions that you
may have.
VERIFYING IDENTITY
• It is important for me to ensure that I am speaking with the right person. What is your full name and date of
birth, please?
• Before we get started, I would like to make sure that the information we received is correct. Please spell your full
name. And what name do you go by/what do people call you? What would you like me to call you?
OTHER
• What questions can I answer for you before we start?
INTRO
• If it’s OK with you, I’d like to start with a few questions to make sure that the information that we have is correct
and also find out the best way to contact you.
DEMOGRAPHICS
• I know that I already confirmed your name. Are there any other names that you go by or your medical
information may be under (e.g., maiden name)?
• What is your gender?
• What is your race?
• What is your ethnicity? Are you of Hispanic origin?
• Do you have a tribal affiliation? If so, which tribe?
• [For women] Are you currently pregnant? (If yes) how far along are you (months, weeks)?
• What is your [any other locally specific socio-demographic information]?
WORK
• What do you do for work (name, location(s), hours)?
• Tell me about your work. What do you do there?
• Where do you work (name, location(s), hours)?
• Where else do you work (name, location, hours)?
• What other things do you do to earn money besides the job you just described?
• When was the last time you were at work?
• How does your workplace protect people from COVID-19? (e.g., providing masks for employees, establishing
social distancing space with markers for employees/customers, “screening” for temperature and symptoms
upon entry, putting up clear plastic dividers between employees or employees and customers, providing hand
sanitizer, posting signs about COVID-19 and how to prevent it, increasing cleaning and disinfection.)
• Some workplaces have different requirements for people who are exposured to COVID-19. For example:
◦ health care workers, first responders and other critical infrastructure workers
◦ employees in long-term nursing facilities, assited living facilities, group homes, mental health hospitals,
correctional facilities, homeless shelters
◦ and employees who work in large work areas, like factories and food processing plants
◦ Does your role at your work or work setting fall into any of those categories? If so, we can discuss in more
detail about what this means after we talk about your health and what support you may need.
EMERGENCY CONTACT
• In case of an emergency, if I could not reach you, who would I call? What is their number? What is that person’s
relation to you?
INTRO
• I would like to take a few minutes to talk with you about the virus, check in on your health and discuss how to
keep you as healthy as possible and support you during this time. How does that sound?
DISEASE COMPREHENSION
• First, what do you know about COVID-19?
• What have you heard about COVID-19? (e.g., online, in the news, from friends, family or coworkers.)
SYMPTOMS OF COVID-19
• COVID-19 can cause a variety of symptoms. Some COVID-19 symptoms can seem like a common cold and others
are more severe and sometimes people have no symptoms. Please let me know if you have had any of the
following symptoms and when they started. [Note to Contact Tracer: See Appendix A for a table of COVID-19
symptoms, with space to indicate onset and duration. This Information can help to identify contacts who will
need to be referred for medical evaluation due to current symptom presentation, and also allow for discussion of
which symptoms the contact should be “on the lookout” for during quarantine.]
• What symptoms were you having? [Note to Contact Tracer: See Appendix A for a table of COVID-19 symptoms,
with space to indicate onset and duration.] When did those symptoms start?
• [If patient states any of the emergency warning signs (e.g., trouble breathing, persistent pain or pressure
in the chest, new confusion, inability to wake or stay awake, or bluish lips or face) refer them for emergency
medical attention immediately!]
◦ From what you are describing, it sounds as though you should be seen by a health care provider to further
evaluate your symptoms as soon as possible. You need to call 911 or go to the emergency room. Wear a
cloth face covering when an ambulance comes to get you and during your visit to the medical provider.
Let them know that you received a call from the health department to notify you of possible exposure
to COVID-19.
• [If yes to symptoms] If you have any of these symptoms, have you gone to see the doctor/ER/health care
provider (yes/no).
◦ [If yes, contact already seen by health care provider]
▪ What happened at the visit to your health care provider? Did you talk about COVID-19?
▪ Did your doctor/nurse/health care provider test or diagnose you with COVID-19? What type of test
did you receive? What were your test results?
▪ How are you feeling now?
▪ We want to make sure that we can best support you, so we will have a health department liaison
follow-up with you to discuss your health care visit and symptoms in more detail.
◦ [If contact not yet seen by health care provider]
▪ Given the symptoms you have described, it seems that you should be seen by a health care provider.
▪ Who is your primary medical care provider? What is their office location and phone number? Would
you like to reach out to them today or would you like us to have <insert local public health services>
follow-up with you to help with a referral for testing and a medical assessment? What is the best
number for them to reach you at today?
▪ How will you get to your health care provider? Do you have a mask to wear during transport and
while in the office? [NOTE: Discussing and problem-solving challenges, providing local resources
is essential.]
OTHER
• What worries or concerns do you have that you would like to discuss? Who would you want to tell about your
possible exposure to COVID-19?
• What questions do you have for me at this time about COVID-19?
QUARANTINE RECOMMENDATIONS
• Now, I’d like to talk with you about home quarantine, review the recommendations, and identify what you
may need to support you and keep you and your family and other household members healthy. How does
that sound?
• Since we don’t know yet if you will develop COVID-19, you will need to self-quarantine for 14-days from the day
when you were exposed to the virus. Self-quarantine means that you will have stay at home for <XXX> days or
until [date]. You should not go to work or out into the community to run errands or attend events. Ideally, you
should stay in a separate part of the house from others who live with you, preferably in a bedroom by yourself,
and use your own bathroom that no one else uses during this time. Specific instructions for quarantine are
available on the CDC website.
• Being on quarantine means that you will not be able to go to work or the grocery store or other places
around town.
• During the next <insert number of days for self-quarantine based upon last exposure>, you will need to limit
your interactions with people in your household, staying 6 feet (2 meters) away from them.
• When interacting with others in your household, you should wear a cloth face covering over your nose and
mouth to help protect others in case you’re infected but don’t have symptoms. Your caregiver may also wear a
cloth face covering when caring for you. Children under age 2, or anyone who has trouble breathing, should not
wear a mask.
ASSESSING CONCERNS
• What would self-quarantine look like for you?
• What concerns do you have about the situation that I just described? [NOTE: Validating concerns, exploring
solutions and offering support/resources (as appropriate) is essential.]
• Does this sound like something that would be hard or easy for you? Why? What could you do or what support
would you need to address the hardest parts?
• What would be helpful for you to better understand or remember the instructions about home isolation?
DISCLOSURE COACHING
• Given that there will need to be a plan for social distancing and also supports set in place to assist you while you
are on home quarantine, it will be important to think about how to talk about this with those in your household.
• Who in the household are you planning on telling about your exposure to COVID-19? What do you expect
that discussion to look like? [Offer coaching if appropriate] Would you like support in telling them about your
exposure? Would you like to arrange for a 3-way call, so that I can be available to answer questions that may
come up?
OTHER
• What other concerns (e.g., someone may be sick, someone may have a pre-existing health condition) do you
have regarding the home quarantine instructions, the members of your household or being separated from
them during self-quarantine? Let’s discuss some steps to take that may address your concern(s).
• Who in your household has been sick recently? (If yes, what type of symptoms, when started for how long)
◦ Have they gone to the doctor or to get tested for COVID-19? (If yes, when and where, results?)
• What questions or concerns do you have about self-quarantine that we have not covered?
INTRO
• I’d like to talk with you about setting up a plan for you to monitor your health each day so that we can get you
help if you need it. Shall we continue?
• We would like to work with you to set up daily check-ins, so that we can make sure that you are okay. This way if
you start to develop symptoms, we can work together to get you the medical care that you need.
• Let’s talk about setting up daily check-ins in order to monitor your health by taking your temperature every
day and keeping track of how you feel. There are a few things that we can provide to help you monitor
your symptoms.
OTHER
• This was a lot of information, what questions did this raise for you about COVID-19?
CONCLUSION
Aims: Check-in on agreements; Answer remaining questions; Set stage for follow-up
ACKNOWLEDGING THE DIFFICULTY AND KEEPING THE DOOR OPEN FOR CONTACT.
• I just want to check in to be sure that you know how to reach me if you have other questions or concerns after we
get off the phone. My name is spelled, <insert name>, and my phone number is <insert phone number>.
• Either my colleague or I may reach out to you to check in to see if you are ok or whether you’ve connected with
the other services we talked about today. They will also protect your privacy. We may have other questions that
arise. Just wanted to confirm the best number to reach you is <repeat ‘best contact number’ provided
by patient>.
• I can’t thank you enough for talking to me and helping us stop the spread of COVID-19 in [location]. I know this is
a very difficult time for you and your family and we truly want everything to go well for you.
• Before we hang up, I just want to check on what additional questions you may have for me?