Students assist "disease detectives" as they connect the dots of COVID-19
March 17, 2020
Fayette County has seven COVID-19 cases. Think of each one as a spider web. In the center is the infected patient. Radiating outward are each of the people that patient has been in contact with. Each of those people has contacted other people, and so on, until you have an entire web of people.
Every single one of them needs to be told they had contact with an infected person. Every single one of them needs to be monitored to make sure they don’t show signs of illness. And in Fayette County, that job falls mainly to Mia Williams and Hollie Sands, two extremely overworked epidemiologists at the Lexington-Fayette County Health Department.
“We’re disease detectives,” said Mia Williams, who by total coincidence lives in Cynthiana, the state’s initial epicenter of COVID-19, with 6 confirmed cases in Harrison County so far. Most of her four years at the health department has been spent monitoring outbreaks of influenza, Hepatitis A and measles. Now it’s all COVID-19, all the time.
“I don’t think I could have foreseen something like COVID-19,” Williams said. “It’s a once in a lifetime thing.”
Contact tracing is the more technical term for what Williams and Sands do. After someone has a positive test, the epidemiologists find a spouse or family member to provide the names and numbers of people they’ve come in contact with, along with public places they’ve been.
For each of the seven patients, they have contact tracing for between 10 and 20 people. Williams and Sands tell them they’ve been exposed to COVID-19, get them to self-quarantine, then monitor their health and well-being, from providing thermometers to making sure they can see a doctor if needed.
They separate the contacts into low, medium and high risk, depending on how close they’ve been to that patient zero.
“One of our goals is to connect all the cases to see who is connected to whom,” Sands said. “That way we can connect the dots to prevent further spread of the disease.”
They’re in constant contact with the state health department, which notifies them of every positive test. For example, thanks to communication with the state and other county health departments, they figured out the most recent two positive cases in Fayette County were in close contact with previous cases, although they declined to say how.
Williams says they’ve gotten lucky with the first five patients because none of them appear to be hugely social, or had been in big crowds, like a trip to Disneyland or a concert in Rupp Arena. That detective work would have required finding every person who sat anywhere near them. No one from Fayette County was among the 16 Kentuckians who were on the Grand Princess cruise ship that had several infected passengers.
“You just feel like you can never stop,” said Sands. “People are now seeing public health in a different way.”
Sands and Williams are also backed up by a fleet of school nurses, who are trained to switch jobs fluidly, and can take on the contact tracing they’re too busy for.
Everyone at the health department is busy. In addition to all their regular patients in regular clinics, officials meet in the COVID-19 war room, with twice a day conference calls with the Centers for Disease Control. They have a COVID-19 hotline, where people call with all their COVID-19 questions.
The University of Kentucky College of Public Health has also jumped in. UK students Leah Harold and Brendan Mathews don’t have classes right now, so they’re driving over to Loudon Avenue to help out, putting together the database of current cases and their contacts.
“This is a perfect learning opportunity,” Harold said. They’re being overseen by Anna Kucharska-Newton and Kathleen Winter, both public health professors in the college.
“I feel like I need to be involved,” Kucharska-Newton said. “There is nothing to compare this to.”
Williams and Sands are certain COVID-19 will get worse before it gets better. If the spike gets to Italy’s proportions, the detective work will stop in favor of mitigation. That’s why they strongly support the state and federal guidelines that are keeping people home, and want others to do the same.
“People don’t believe that something as simple as washing hands and social distancing can stop such a big disease,” Williams said. “The thing about public health, if you don’t know about it, it worked. If we flatten the curve successfully, it will still be seen as an overreaction.”
By Linda Blackford for the Lexington Herald-Leader
Photo by Matt Goins for the Lexington Herald-Leader