What It Takes To Be A Contact Tracer

MICHEL MARTIN, HOST:

Public health experts say that one of the keys to safely lifting stay-at-home orders around the country is contact tracing. So we wanted to spend some time now learning more about what it takes to implement a statewide contact tracing program and how people are being trained for this. To do that, we're joined now by John Welch. He is with the group Partners in Health, which is working to ramp up the contact tracing program in Massachusetts. John Welch, welcome. Thanks so much for joining us.

JOHN WELCH: Thank you so much for having me.

MARTIN: I'm shocked that you have time to talk to us, so thank you for that. How is the initial implementation going, this ramp-up period going?

WELCH: Yeah, thanks. It's going well. It is exactly as you described it, a ramp-up at this stage, a lot of quick hiring and, you know, in-depth training and making sure we have the right people who have the right skills but then most importantly people who have the patience and the empathy to listen. They're reaching out to people who are in crisis and some people who are in acute crisis sort of superimposed on a chronic crisis of maybe poverty or marginalization. And those individuals need extra time and not only need it - they deserve it. So these contact tracers are balancing the need for understanding how to do the work while also just being a gentle ear.

MARTIN: I can imagine that this would evoke a range of emotions. I mean, I - what are some other ways that people react to this?

WELCH: You know, first and foremost, we're very sensitive to a variety of populations who might not be interested in anyone who's sort of affiliated with state government reaching out to them. And we're very sensitive to that and want all those individuals to know that this is a public health activity, that their information is very safe with us and that our interest is in helping them and keeping their families and friends safe.

But then the folks who we do get in touch with are actually by and large relieved, you know. We live in a world now, in this country where to receive health care, you've got to go and find it. And this activity is care coming to find you. So while contact tracing is an important epidemiologic tool, it's also an act of caring. And I think by and large people are really relieved to receive that phone call.

MARTIN: Well, you know, some countries have relied heavily on apps and other technology to assist with contact tracing. Is Massachusetts doing this as well as the human-to-human approach? And do you have an opinion about whether that's a good solution for states that perhaps don't want to hire a whole team of contact tracers?

WELCH: Yeah, it's a great question. And I think, you know, health delivery has always been human-driven but technology-supported, you know. My other hat when I'm not working in global health and public health is as a nurse anesthetist, and that work is very technologically heavy. But there's no app for an empathetic ear. And, certainly, people are really sharing a lot of stories and a lot of feelings with us when we reach out to them, telling us about the challenges they face by being apart from their partner of 40 years or, you know, missing, visiting their mother or grandmother down the street. And I think it's difficult for an app to replace that human touch.

MARTIN: You've worked all over the world and in some very challenging situations. Is there anything about this particular experience that has surprised you, that has struck you?

WELCH: Well, I think, you know, one of the things that we see in all of this is that the public health infrastructure in the United States has really been defunded and in some ways decimated over the last few decades. And countries that rely heavily on public health - you know. I'm thinking about my colleagues and friends in West Africa and other colleagues and friends in places like Rwanda - they understand and could quickly mobilize the tools that you need for an epidemic response.

I see here that some of these seem like new or novel techniques in public health, certainly not for our public health colleagues but, you know, for the public. And I think that's just a symptom of how little we've really supported public health over these years. So I think that's - one of the things that we'll learn from this is just how maintaining a really robust public health infrastructure can help us prevent getting to this place some other day.

MARTIN: Well, you're being very diplomatic. But what I think I hear you saying is that people are far worse off and more isolated and their difficulty of accessing care is harder than you thought it would be in an affluent country. Is that really what you're saying?

WELCH: I think - you know, I think it's no surprise to us, though we can't take comfort in the fact that this epidemic is continuing to shine a light on health disparities and health equity in our country and around the world. This epidemic will affect marginalized populations in ways that we can't even count but in ways that are very preventable. And I think that this epidemic is just reiterating that whole challenge of health equity in our world.

MARTIN: That was John Welch. He is Partner In Health's director of partnerships and operations for the COVID response in Massachusetts. John Welch, thank you so much for joining us.

WELCH: Thanks for having me.

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