In addition to tracking the potential spread of COVID-19 from person to person, contact-tracing investigators at county Public Health Department also hand-deliver isolation orders to homes in Imperial County where COVID patients and their family members have been ordered under quarantine. | COURTESY PHOTO
IMPERIAL COUNTY — Rosalinda Garcia and Alhi Ingle are among a growing legion of gumshoes across the country who will make it possible to open up America.
Re-opening Imperial County may not be any time in the immediate future, but certainly the duo will play a critical role now in investigating how COVID-19 is moving through communities.
Registered nurses by training, Garcia and Ingle are two of around 20 to 25 Imperial County employees across various disciplines and departments, who are under the direction of county Public Health Department’s epidemiology staff, to trace the path of coronavirus from those infected, outward to those in their respective families and who they work and live among.
“As a nurse, we’re used to treating one patient at a time. Now, we’re treating the whole community,” said Garcia, a 19-year veteran of the county Public Health Department, who normally works in the occupational clinic doing physical exams and tuberculosis tests, among other duties.
“Our work is making a difference and helping the community keep safe in stopping the spread of the disease,” Garcia, a community health nurse II, said May 12.
“We’re here to slow the progression (of COVID), and allow a strategic approach” to investigating coronavirus in the community, said Ingle, who has been a public health nurse II assigned to work with children on psychotropic medication under the Department of Social Services for one year.
“Without herd immunity, it’s important to re-open society in a safe manner,” Ingle said, adding what she is doing in her current assignment ensures that.
It’s a process known as “contact tracing,” and Garcia and Ingle are “contact-trace investigators,” albeit temporary, enlisted to meet certain public health metrics suggested by the state to ease out from under mandated business closures and stay-at-home orders but also to form the backbone of an understanding of the entire county as a COVID patient.
Gov. Gavin Newsom is requiring 15 contact tracers per 100,000 residents, and Imperial County would need 27 contract tracers to move further into his “Roadmap to Recovery” plan, public health officials have said.
While Public Health Officer, Dr. Stephen Munday, said May 11 that Imperial County can be at that number in almost an instant, the county is still far away from other metrics needed to move further along the roadmap.
As of May 13, Imperial County has recorded 14 COVID-related deaths, 647 total positive cases, 324 of which are active and 42 considered new cases. The new case number is one in which the county is far from reaching the state’s bar of no more than 14 new cases a day per population for two weeks straight to begin to open up more types of businesses and ease some restrictions.
Meanwhile, during a May 11 press conference, Munday explained more about the contact-tracing process.
“So essentially what contact tracing is, is kind of what it sounds like. … It’s when we have a (positive COVID) case, then we want to know what other people are in contact with that person. … So what we do is somebody who has training in this area sits down with this person … it could be over the phone or whatever, but has a conversation with them with regard to where they’ve been and whom they’ve been around in the period of time before they got sick,” he said.
“What we normally do is we try to go back two days before their symptom onset, if we can, because that’s when we believe they start becoming contagious. So, in the case of a death, then we try to get information from the people, say in the family, or other people who know the case who could give us that information,” Munday said.
“Then what happens is our people who are trained in contact tracing go on to contact the other people that are identified and determine what, if any, exposure they really had. How close it was, and then of course, whether or not they’ve become ill,” he added.
Garcia and Ingle said there is also a degree of educating involved, meaning they share with family members of the afflicted how to further prevent the spread of the virus. Part of the job, on a rotational basis, is also delivering isolation and quarantine orders to households in person.
Another job in contact tracing is preparing a family or individual for being released from isolation/quarantine. Ingle was working her first day on that assignment May 12.
“I’m following up on positive cases, finding out how they feel, see how they can be released safely,” she said.
It’s not an easy job. It’s more than working the phones and asking prescribed questions. Munday has said previously the candidates are highly skilled and highly intelligent in their respective fields and undergo specialized training from the four-person epidemiology staff.
Garcia and Ingle said the position can be emotionally taxing, too.
“I delivered quarantine orders where the person had passed away. It was a sad situation,” Garcia said. “This is someone’s mother, grandmother, sister, daughter. It hit me, like, this person actually passed away from coronavirus.”
“When we give out isolation and quarantine orders, I get emotional. Every house or person I go to in the community … I get to know their story, and sometimes their family members are hospitalized,” Ingle said.
“My heart breaks in those situations. You just want to be in your house with your family. It’s heart breaking,” Ingle added.
Munday said that although county Public Health can ramp up to the required number of tracers, more help is needed locally.
“The state is gearing up a program. I was on the phone with the state Health Officer several times (May 10) and she confirmed that the plan is for this program to be up and running by the end of this week,” he said. “We are certainly on the top of the list to get additional help. … Besides what we’ve done internally, we will have additional external help as well. And we welcome that very much.”