Here’s how Sedgwick County epidemiologist ‘disease detectives’ investigate coronavirus
The new coronavirus pandemic has led the Sedgwick County Health Department to more than double its number of epidemiologists, the health care workers who investigate and analyze data on infectious diseases.
“We are the ones that if you come down with chicken pox or whooping cough, we’re going to be calling you to figure out who you’ve been around that could have given it to you and also who you’ve been around that you could have spread it to,” said Kaylee Hervey, the epidemiology program manager for the Sedgwick County Health Department.
“Our goal is always to prevent the spread of disease and protect the health of the public. With coronavirus, we’re essentially doing what we always do. We’re just doing it at a much larger scale.”
A typical month would see about 100 reportable disease investigations. Comparatively, 161 cases of COVID-19 have been reported in the three weeks since March 19, when the first COVID-19 case in the county was identified.
Of the 161 people to test positive for the coronavirus in Sedgwick County, 25 cases were travel-related, 61 were people who had close contact with another confirmed case, 32 are believed to be community spread with an unknown source and 43 remain under investigation.
A case takes about 12 hours of work for the “disease detectives,” but it includes followups spread over several days, Hervey said. Speaking with a new confirmed coronavirus patient takes about 30 minutes, and each close contact takes about 15 minutes. The caseload is spread out where half of the team investigate cases and the other half follow up with contacts.
The epidemiology team usually has around six staff members, but is now up to 13 because of the pandemic. Starting next week, there will be 15 people in the health department focusing just on the epidemiology side of the pandemic.
A case starts once a patient has a disease and it is reported to the health department, usually by a doctor, school nurse or state health official.
“The first thing we always do is reach out to the provider to determine if we need any information on the case from them, and then we contact (the patient),” Hervey said.
The epidemiologist asks a list of questions, including about symptoms, if they have underlying medical conditions, potential exposures and travel history “to get the most clear picture we can about the person and where they got the disease.”
Then they ask who the patient has been around — including whether they been to work, around family members or attended large gatherings. Epidemiologists reach out to the close contacts, discuss the risks and potentially place them into quarantine.
“Typically what public health does is something called a voluntary quarantine,” Hervey said. “The voluntary quarantine is just us saying per state regulations, you are required to be at home. But there’s not a lot of, like no legal force behind it.
“If somebody is not complying with quarantine, we can issue a legal order of quarantine to require them to remain in their home.”
Such an order is seldom used, Hervey said, and is more commonly used to help a worker not be fired for failing to show up to their job during quarantine. She declined to say whether any orders have been issued in Sedgwick County due to coronavirus, adding that the action will be used if a situation arises where it is necessary, either to protect someone’s livelihood or public health.
So far, people have been cooperative with the health department’s investigations into coronavirus cases.
“People are on heightened alert about it,” Hervey said. “People are working with us. They want to protect the health of themselves, their families, their friends just as much as we do.”
Close contacts include anyone who was within 6 feet of the patient for more than 10 minutes in the two days before they got sick. Oftentimes the patient has already told their friends and family, but the health department will still call all the close contacts.
A majority of the close contacts have been friends and family who spend a lot of time together, “which is why the stay-at-home order and the social distancing is so critical” to limit the spread of the disease, Hervey said.
As for the 6-foot and 10-minute rule, someone who happens to go through a restaurant drive-through in the days before getting sick would not have had a close contact with the cashier. The cashier would not be considered at-risk by the health department because of the short time of contact.
If you take your dog out for a walk and approach another person, there is no need to cross the street or go into the grass “if you’re just passing each other,” Hervey said. However, if you stop to talk to your neighbor, you should remain at least 6 feet away.
She said that advice is based on what is currently known about the virus and guidance from the Centers for Disease Control and Prevention and the state health department.
Epidemiologists have identified coronavirus clusters in Sedgwick County, including in churches.
Clusters are identified when multiple patients name the same location as a place they had been prior to feeling ill. The health department then provides the organization with information to give its members, including that they may be at risk, could develop symptoms and should stay home.
Epidemiologists will check in periodically with patients and close contacts while they are in isolation and quarantine.
Isolation is for a patient who is sick, and that person must remain in isolation for either 72 hours after symptoms stop or seven days after symptoms start, whichever is longer. At that point, the patient is considered to have recovered from COVID-19. The purpose is to prevent the spread of the illness.
Quarantine is for people who are exposed to someone who is sick. They are quarantined for 14 days since their last exposure. The purpose is to limit the spread in case the person becomes sick.
The county does have a text message system used for checkups, but people will only receive a text if they have already spoken with someone at the health department. Scam coronavirus texts purporting to be from the health department have been reported by people who have not spoken with an epidemiologist.
“The ultimate goal is to flatten the curve” so that hospitals are not overwhelmed by the numbers of patients, Herve said. The curve “seems to be” flattening in Kansas, she said, acknowledging that data is incomplete and the effectiveness of various measures likely won’t be known until after the pandemic is over.
Scarce testing supplies means there is limited data to be analyzed. More testing would mean epidemiologists could get a better picture of how the virus is spreading in Sedgwick County. Hervey said the goal of large-scale testing is to identify cases and create a clear picture of the prevalence of the virus in the county.
“We look at the data we have to try to find any trends, try to identify as best we can any potential prevalences, but we’re acknowledging we’re taking a somewhat biased sample,” Hervey said. “We are mostly testing symptomatic people because that’s the criteria we have right now.
“In a perfect world, we would be able to expand that and test anybody who wanted to be tested.”
This story was originally published April 10, 2020 at 9:49 AM.