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COVID-19 stories from the field: Notes from a case and contact investigator

By Sara Eve Sarliker

Originally published by the Washington State Department of Health

“Wait… I do have a question. How do I get through this?”

In two months as a COVID-19 case and contact investigator, this was the first time anyone asked me that.

As an investigator, I interview people who test positive for COVID-19, and those with whom they have close contact. Information I gather helps identify where and how people are exposed to the virus — in an effort to help slow and prevent the spread of COVID-19. I also provide information about how to stop the spread of COVID-19 and answer questions people may have.

While recovering from COVID-19, this friendly, outgoing person was not sure how they would stay home and make it through the 10-day isolation period. Their question caught me off guard. There’s certainly no canned response or easy answer I could use. I took a deep breath.

“Well, you’re probably more than halfway through it,” I said.

I based my response on the guidance that once symptoms resolve, a person can end isolation around 10 days after symptoms began. More than five days out from onset of symptoms, the person was feeling better. I thought about the kind of advice I’d want to hear at a time like this.

“It is hard. You might call up some old friends you haven’t talked with in a while, maybe connect on social media…” I trailed off, hoping I conveyed the compassion I felt for their situation. In some ways, engaging with people who are isolated or quarantined — people who can’t do what they usually do — is the most difficult part of COVID-19 case and contact investigations.

That’s what it’s like as an investigator. You meet a person for the first time on the phone, someone in distress, anxious, or uncertain, and you’ve got about 30 seconds to build a rapport.

Another case went a little differently. The caller said they felt guilty for potentially exposing their work colleagues and customers to COVID-19, even though they didn’t have symptoms at the time. They were also worried about keeping others safe when they returned to work.

“It sounds like your employer and you were following the guidelines,” I assured them. “This is an extremely contagious virus. Any one of us could be in the same situation.”

As someone who is prone to guilt, I really empathized. I think I’d feel the same way if I exposed someone to COVID-19, even though I’ve been trained to know that continuing to follow the guidance is the best anyone can do.

A week later, I received a follow-up text from this person letting me know that a subsequent COVID-19 test was negative: “Thank you so much for your kindness during our call last week. I really felt better after speaking with you.”

Another case involved a person who struggled to physically care for and support a family member with COVID-19. My heart went out to them. I wanted to drive right over (OK, maybe a five-hour drive across the state isn’t right over) and deliver the groceries and cleaning supplies they needed to stay home in quarantine. I stayed on the phone for an hour answering their questions.

At the end of a long case/contact investigation shift, I often pray to myself:

“May we all continue to be in the best possible whole health. May we recover, maintain and renew our relationships while maintaining safe distances, and prevent illnesses in family, friends, and strangers alike.”

I hope we all see the other side of this pandemic with stories to tell of our resilience.

Sara Eve Sarliker is part of the Heart Disease, Stroke, and Diabetes Prevention Program team at the Washington State Department of Health.