Homer’s Lora Wilke is coming out of retirement. And she’s happy about it.
Wilke, a retired registered nurse, has completed a training program for contact tracing put together by the University of Alaska Anchorage.
“I first heard about the program on Alaska News Nightly on public radio,” Wilke said. “I became very interested in it because it’s something I can do to help out in a pandemic.”
This week, Wilke will become one of the first from the program to begin doing calls on her own. That’s no surprise given her background not only as a nurse, but also as a radio and print journalist.
“I remain very interested in nursing and public health and I feel like I have a contribution to make,” Wilke said. “I have the experience and ability to talk to people and I want to make a difference.”
Wilke said contact tracing is a key tool in preventing the spread of the new coronavirus. Contact tracing, according to Wilke, involves contacting somebody who has tested positive for COVID-19 and doing a lengthy interview.
One of the purposes of the interview is to determine the recent contacts of the person who has contracted the disease. Those contacts are then contacted and told to get tested, if possible, or quarantine for 14 days and see if they develop symptoms.
“We have to prevent people from getting the coronavirus,” Wilke said. “Once you get it, you’re in never-never land. You don’t know if you’ll have mild symptoms, be on a ventilator or pass away.
“It’s a new disease and we don’t know much about it. We do know we can prevent the spread by quarantining at home if you are exposed.”
Building on the fly
Gloria Burnett, the director for UAA’s Alaska Center for Rural Health and Workforce, said the university received a call from the state on May 5. The state said that, based on projections, it would need to add 500 contract tracers.
“They were hitting capacity at that point,” Burnett said. “You can imagine where they are now.”
On May 5, the state announced one new case to bring the total of positive cases in Alaska to 371. Saturday, the state announced 115 new cases to bring the total number of resident and nonresident cases to 2,868.
According to a public health alert issued by the Alaska Department of Health and Social Services on Thursday: “The considerable increase in COVID-19 cases throughout Alaska has delayed the ability for public health to connect individually with all new cases and their close contacts in a timely manner.”
The alert goes on to say that when case counts are high, it may take three to four days for public health staff to contact patients.
The Clarion emailed questions Friday morning regarding contact tracing to Tari O’Connor, deputy director with the state’s Division of Public Health and also the point person for the UAA training program with the state. There had been no reply to the questions as of deadline late Saturday afternoon.
Burnett said a team of five at the university, with support from human resources and information technology, developed the course from May 13 to June 8. Training was launched June 15, with the first group completing the course by June 30.
“I’m using the analogy that we’re building our ship as we’re recruiting our crew, as we’re charting our course, and there’s all sorts of storms we’re hitting along the way,” Burnett said. “It’s taking longer than we thought to get to our destination.”
Bottleneck slows progress
Burnett said the university has had success getting people in the program. The state has contracted with UAA to hire some who have completed the training.
The state will also use school district employees, National Guard members and municipality employees to fill the need. All of them are getting training from the UAA program.
As of Thursday, 285 have completed the training. As of Tuesday, 328 were working their way through the training. The training takes about 20 hours for supervisors and 16 hours for nonsupervisors.
Once completing the training, potential contact tracers still need to spend time shadowing current public health nurses doing contact tracing.
“The issue is public health nurses are so overwhelmed, especially due to the recent increase, it’s hard to carve out time for training because they are at capacity and beyond,” Burnett said. “We’re just wanting to help them.”
No time for regiment
Burnett said the UAA program is looking to accelerate the process by taking advantage of the trainees with the best prior experience, like Wilke.
Wilke is classified as Tier 3 because she is a current or retired licensed health care provider, meaning professionals like physicians, registered nurses, physician’s assistants and nurse practitioners.
After shadowing, Wilke will make her own calls this week. She then will go from being the shadower to the shadowee in short order.
Burnett wrote in an email Friday that the goal is to have Tier 3 employees running their own teams and tracking their own cases starting the week of Aug. 3.
“Where we are right now is every man on deck,” Burnett said. “We have to respond to cases. We’d love to slow down and do a more regimented thing, but at this point it’s every man on deck and we’re working to get calls made.”
Burnett said the UAA trainees are ready to step up to the challenge.
“Talking to the first four working independently, they see firsthand the burden of the public health nurses who are working,” Burnett said. “They feel like they need to do more than just job shadowing.”
How organizations can help
Burnett said she is getting calls from places like universities and school districts. Those entities are seeking to get some of their people trained to do contact tracing within the organization.
According to Burnett, that’s not the way the UAA program works. Those making it through the program do contact tracing for the state Division of Public Health.
As an example, Burnett said a nurse from the Juneau school district making it through the UAA training would be doing contact tracing for the state’s Division of Public Health. So the nurse may get assigned a case in a city far from Juneau.
Burnett said there are ways organizations can help out.
“Individual organizations can do things like keep track who’s in every building, signing in and keeping track of who’s in every room,” Burnett said.
How individuals can help
In addition to Tier 3, UAA has Tier 2 and Tier 1 classifications for trainees. Tier 2 is a group that includes professions like licensed clinical social workers, counselors, nutritionists, dietitians and physical therapists. Tier 1 is those without experience.
In the UAA surge workforce, as of Thursday 43 completing the training were Tier 3, 65 were Tier 2 and 120 were Tier 1. Burnett said, at this point, the program doesn’t need any more Tier 1 people to enroll in the program.
Burnett said there is still plenty the general public can do to support contact tracers.
“It keeps getting more and more overwhelming as we get increasing cases,” she said. “If you really want to support contact tracers, wear masks, socially distance, don’t go out unless you have to and follow individual mandates in your regions.”
Burnett said keeping social circles small is vital.
“I was talking to one of the nurses,” she said. “Earlier, one case meant they had to contact four or five people. Now, there can be 50 to 100 contacts for one case.
“Imagine the workloads and how that multiplies. That’s what’s so overwhelming.”
‘Can’t wait to get going’
Wilke said the calls she has sat in on have been positive.
“On the calls I’ve been involved in, people are cooperating and anxious to help us,” she said. “They seem to realize the importance of us needing their contacts and helping us reach out to people in order to get a handle on this thing through prevention.
“We’ve also got cooperation from contacts agreeing to quarantine at home for two weeks until they are in the clear.”
Wilke said a contact is considered being within 6 feet of somebody for 15 minutes or more. The contact tracer will want to know how many contacts the person had in the two days before developing symptoms. That may not be as simple as it sounds.
“If you get your test and you get a positive result, you might have to think back a week,” Wilke said.
If the person with the positive test does not know how COVID-19 was contracted, Wilke also said the contact tracer will eventually try to work back 14 days to see where the disease might have been acquired.
“What really helps is people keeping their bubbles small and keeping tabs on where they’ve been and who they have been in contact with,” Wilke said.
Of course, Wilke said the best thing is to never have to do an interview with a contact tracer.
“Prevention is just so important,” she said. “Wearing masks, social distancing, hand-washing and sanitizing.”
Despite the increasing cases and stress on contact tracers, Wilke is not regretting coming out of retirement.
“I’m fascinated by this,” she said. “I can’t wait to get going.”