Coronavirus Disease 2019 | COVID-19

What is contact tracing?

Contact tracing is a routine process public health professionals use to help slow and prevent the spread of infectious diseases, such as COVID-19. The purpose is to speak to people who have a disease (cases) and then find the people they may have exposed (contacts). Public health professionals then notify contacts, assess their risk and provide guidance on how to take care of themselves and members of their household.

Local health departments often conduct this work with the support of the Washington State Department of Health and its partners.

How does contact tracing work?

Spokane Regional Health District (SRHD) contact tracing staff take the following steps during the contact tracing process:

  • Identify, contact and interview individuals who have tested positive for COVID-19 (cases).
  • Interview individuals to find close contacts, or people that they were in close physical contact with (within six feet for 15 minutes or more) from the time they were contagious** until they separated themselves from others to avoid spreading illness (this is called isolation).
  • Contact and interview their close contacts to let them know they have been exposed to COVID-19 and assess their risk of getting sick.
  • Advise individuals diagnosed with COVID-19 and close contacts to take the following precautions:
    • Avoid physical contact with others as much as possible (this is known as isolation for those who are ill and quarantine for those who were exposed to a disease and may become sick)*
    • Follow guidelines for household cleaning and personal hygiene to prevent the disease from spreading (for example, hand washing and cleaning high-use surfaces like door knobs)
    • Ensure they are prepared with a supply of basic necessities such as groceries, prescription refills and cleaning supplies while they are under isolation or quarantine
    • Identify new or worsening symptoms, and safely seek care from a health care provider (by calling ahead) if needed
    • Follow guidance until isolation or quarantine has ended (14 days after the last day the individual was in close contact with a confirmed case)

*SRHD contact tracing staff and volunteers understand that avoiding close physical contact is not possible for everyone, especially parents and caregivers. That is why it’s important to take other precautions like wearing a mask when you can’t physically distance in the home and practicing good hygiene.

**The Centers for Disease Control and Prevention (CDC) defines a close contact as someone who was within 6 feet of an infected person for at least 15 minutes starting from 48 hours before illness onset (or, for asymptomatic cases, someone who was within 6 feet of an infected person 2 days prior to positive specimen collection) until the time the patient is isolated.

How does contract tracing prevent the spread of COVID-19?

Contact tracing finds people (close contacts) who might get sick because they were exposed to an ill person. Public health officials inform close contacts about being exposed and provide them with precautions to take to prevent further spread of disease. Precautions include staying home, limiting contact with others, washing hands often and cleaning and disinfecting surfaces often.

Close contacts may or may not become ill. If they become ill, these precautions will reduce the number of others exposed to COVID-19. If they do not become ill, they can likely return to normal activities after their quarantine ends (14 days after last close contact with a confirmed case while the case was infectious).

Are all close contacts interviewed?

Yes. CDC and Washington State Department of Health guidance recommends interviewing all close contacts. If close contacts are in a single household, SRHD may only contact one member of the household. In some circumstances, SRHD contact tracing staff prioritize close contacts based on what they learn about them from the case. Close contacts are considered high priority if they are

  • In high priority groups such as essential workers (e.g., health care, first responders, construction and grocery)
  • Living with people at high risk for complications from COVID-19 (e.g., nursing homes, jails, homeless shelters or other congregate settings)
  • Are linked to a known outbreak

Who does contact tracing in Spokane County?

Contact tracing in Spokane County is conducted by SRHD staff reassigned to the COVID-19 response, eight designated SRHD Disease Investigation Specialists, and 16 additional investigators contracted through the Public Health Institute’s Tracing Health Program. All of the contract tracers have received training on how to interview people who have tested positive for COVID-19 and their contacts.

In addition, the Spokane Alliance, which is led by WSU, works with volunteers to provide optional daily health monitoring for people who have tested positive for COVID-19. The SRHD Care Coordination team is available to provide resources to people who have been isolated or quarantined.

What can I expect if the health district contacts me as a case?

If you are identified as a case, your healthcare provider will notify SRHD. You will then be contacted by an interviewer within 24 hours. You will be asked about your illness, including your symptoms and when they started. The interviewer will also ask for a detailed history of your activities. It’s important to tell them your activities for each day, from two days before your symptoms started (or two days before your COVID-19 test if you have no symptoms) until you fully isolated from others. The interviewer will ask you about the people you were with during your daily activities at work and at home.

Interviewers use pre-approved questions for case investigations and contract tracing. They ask every person for their date of birth, address, gender at birth, race, and ethnicity, and other questions. Interviewers will never ask for or write down immigration status, Social Security number, financial information or marital status.

Information collected during interviews is used only by public health agencies. The information is protected in secure systems and individual information is not shared with anyone else. Interviewers operate under strict confidentiality rules.

The purpose of the interviewer’s questions is to find people who may have been exposed to the virus before and during your illness. These people are called close contacts.

The contact tracing team will contact your close contacts to prevent others from being exposed to COVID-19. In addition, the contact tracing team will provide you with guidance and resources, including helping to ensure that you have food and other necessary supplies and to connect you with case management services if necessary. This will help you manage your isolation and self-care throughout your illness and recovery.

What does it mean to be a close contact?

Close contacts are people who have been within 6 feet of a person infected with COVID-19 for at least 15 minutes. This is irrespective of whether the person with COVID-19 or the contact was wearing a mask or whether the contact was wearing respiratory personal protective equipment (PPE).

A person with COVID-19 can spread the virus up to two days before and up to 10 days after their symptoms started. In cases where fever or severe illness is present, an infected person may still be able to spread the virus even longer than 10 days. In those cases, individuals are advised to end isolation only after they’ve been fever free for 24 hours. People without symptoms can also spread the virus. Because of this, public health officials work with asymptomatic individuals to identify anyone they were in contact with from two days before their test date until 10 days after. If you were within 6 feet of an infected person for at least 15 minutes, you may be considered a close contact.

If I am contacted by the Health Department as a close contact, what can I expect?

The interviewer will ask questions to understand the details of your exposure to the case. They will identify the date you were last in close contact to the case (last exposure) to determine your quarantine period. Quarantine is the practice of separating someone who may have been exposed to a virus from other people to see if the person becomes sick. This helps prevent the spread of the virus before symptoms develop. A quarantine period is usually 14 days after the date you were last exposed to the person with COVID-19. This could be longer for household members due to the possibility of repeated exposures. This is the period during which you could develop symptoms of COVID-19 based on your exposure to the case. During quarantine, it is important to avoid being in close contact with others.

The contact tracing team will give you guidance and information to manage your quarantine. This includes how to maintain proper infection prevention and control measures and monitor for symptoms. The contact tracing team will also work with you to ensure that you have food and other necessary supplies for the duration of your quarantine, this includes connecting you with case management services if necessary.

If I am a case, will you identify me to close contacts when you interview them?

No, the health district will not identify you to close contacts without your permission, unless absolutely vital to protect the health and safety of others. Please keep in mind that it may be possible for close contacts to identify you based on the dates, times and locations where they were exposed.

If I am a close contact but have no symptoms, can I get tested for COVID-19?

Yes, people who are exposed to COVID-19 can be tested even if they have no symptoms. However, a negative test within 14 days after your exposure does not mean you do not need to quarantine because the virus may be present in your body, but not yet detectable through testing. The virus takes 2-14 days to develop depending on the person, so it may become detectable at any time during that period.

The only way to confirm that you did not become infected due to an exposure is to be tested 14 days after your last exposure. In a household, this will be at least 14 days after the period of time your household member is last considered infectious; generally 10 days after their symptom onset. If you receive a negative test result, then you will be safe to resume normal activities. Because COVID-19 is easily transmissible within households, it may be advisable to test all members of a household where a confirmed case lives—speak with your doctor to determine next steps.

If I am a close contact and do not become ill, does that mean I will not get COVID-19?

No. You may not get ill while quarantined for the exposure the health district contacted you about, but that does not mean that you are immune to COVID-19.