Just three months ago, I worked as a librarian at the San Francisco Public Library's Main Branch, where I answered questions on a reference desk. Now, I spend my days calling strangers to ask: Have you had any novel coronavirus symptoms in the last three days? Are you able to stay at home? Can we monitor your symptoms? And, by the way, have you been tested?
SARS-CoV-2, the virus that causes COVID-19, is so easily spread that if you are in close contact with someone who has it, it's my job as a contact tracer to help make sure you stay home.
As part of the contact tracing team for the City of San Francisco, I do this work from home on my computer. Some days my list of calls to make are few, some days the list approaches a dozen. Often a contact's first language is Spanish because, here in San Francisco, the pandemic has affected the Hispanic and Latino/a populations hardest: they make up 15% of the population, but 47% of cases.
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Under the current health order in San Francisco, those who have been exposed to the virus should quarantine for 14 days after their last contact with a positive case, and isolate, if they become symptomatic or test positive themselves.
The city's tracing team is a partnership between University of California San Francisco (UCSF), the San Francisco Department of Public Health, and Dimagi a software company. We are a group of more than 150 — including contact investigators who gather the names of contacts from positive cases — working to help slow the spread of COVID-19.
Connecting people, saving lives
I am proud to be part of a team helping our community by connecting people with information that can save lives. Most of us are not health professionals; many, like me, are city workers reassigned during the emergency pandemic. There is a clinician on each team and we're working four hour shifts most days from 8 a.m. to 8 p.m.
It's not the easiest job. Some contacts simply don't want to talk; some are audibly sick; some are distraught over hospitalized family members; and some are reluctant to share personal information, possibly distrustful of a government that has discriminated against their community or worried about their immigration status.
I wonder: Am I being culturally sensitive; am I gathering all the right information; can I convince the person I'm talking to to stay home? There is a gravity to this request. Staying home is difficult for people who have to leave their house to work, for those who don't have a home or are in a congregate living situation where it would be virtually impossible to isolate.
In the workflow developed by UCSF, we have a guide and procedure to connect contacts to resources for help with food, cleaning supplies, testing or housing, and I hope they are able to take advantage of them.
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Studies have shown that even people who don't have symptoms can be carriers of the virus and they could be contagious while asymptomatic. In light of this research, as shelter-in-place is lifted and we slowly begin remaking our social lives, it will be more important for contact tracers across the country to act fast to trace positive cases and their contacts to stop the virus from spreading through our community like wildfire.
I am grateful and relieved when people say they are staying home, that they want to keep the community healthy. I listen when people want to share how anxious this disease has made them, how hard it is not knowing whether a stuffy nose and fever is the disease. Sometimes I say, yeah, I'm anxious too. It's scary being this close to the pandemic.
One day, I talked to a man who was at home in a residential hotel in the city's tenderloin neighborhood, an area notorious for homelessness and drug abuse. The virus has hit this area of the city the hardest. He told me he was going to do all he could to quarantine even though it was difficult in his environment.
Then I mentioned I used to work in his neighborhood at the Main Library and he said he used to go there every day for the computers. Had we talked once in person? I bet we have, I said.
And we both imagined a day when we would be back in the library. Our conversation is confidential, I told him, but if you're comfortable, come to the third floor and say hi when this is all over. And hopefully it will be if we all do our part.
Shawna Sherman works as a coronavirus contact tracer in San Francisco.