In response to the recent spike in positive coronavirus tests in Bexar County, the health department has quadrupled the number of contact tracers tasked with finding out who people with the virus might have been in contact with.

The San Antonio Metropolitan Health District will be deploying an additional 75 case tracers Friday, bringing the total number of contact tracers to 100, San Antonio Metropolitan Health District officials said. The increase comes as Bexar County has reported more than 2,200 new coronavirus cases in the last 10 days, including 436 on Tuesday alone.

Contact tracers get in touch by phone – or, if they are unable to get through, make a home visit – with people who test positive in order to find out who they have recently been in contact with and any places they may have visited, Metro Health Director Dawn Emerick said.

The investigation takes about an hour per person to do, Emerick said.

“The information we get from contact tracing investigations are a critical component to understanding the spread of the virus,” Emerick said. “If we don’t know the number of people exposed, it literally ties our hands from doing our job.”

When tracers do an investigation, it includes documenting the infected person’s history of exposure with others outside the home – along with any businesses the person may have visited – so the health department can then contact those people via phone and encourage anyone exposed to get tested.

Additional case investigators have been reassigned from within Metro Health to ensure that each reported case of coronavirus is investigated within 24 to 48 hours of receiving a positive test result.

Boosting the number of contact tracers is part of the City’s health transition plan to closely monitor community infection rates and hospital capacity as the city reopens, expanding testing and contact tracing capabilities, and continuing to educate the public about containing the virus’s spread. 

For contact tracing to be effective, however, the tracers need to get in touch with residents who have received positive coronavirus test results, and that’s sometimes a challenge, officials say, when people don’t return phone calls from Metro Health.

“There is a sizable portion of cases and contacts that our public health professionals have not been able to verify simply because we are not getting callbacks,” Nirenberg said Tuesday. “We need to make sure we do the proper contact tracing investigation” within 48 hours of a positive test.

To expand contact tracing, Metro Health is following a plan developed by the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security that increases the number of contract tracers based on the daily case count until 175 contact tracers are deployed locally. 

According to the plan, Metro Health will train 15 contact tracers when 70 new positive COVID-19 cases occur in daily succession, and if the case count is 90 per day over several days, an additional 15 contact tracers will be hired and trained until capacity is reached, Emerick said. Training the tracers takes three days.

The health department has assigned staff from its epidemiology, tuberculosis, immunizations, sexually transmitted disease, and community health areas for contact tracing investigations, but Emerick said volunteers from area colleges and universities also have been trained and deployed to further the effort. 

The health department also is utilizing technology to aid in its contact tracing efforts and is in the middle of a 30-day trial of a contact tracing app developed by Emocha, a mobile health technology company. Emocha’s app allows people who have tested positive for coronavirus to report their symptoms, such as body temperature, daily to Metro Health and document any interactions with people outside the home. 

The app does not track a person’s location when they leave the home.

Thirty-one City of San Antonio employees who have tested positive for the coronavirus are participating in the trial, which Emerick said is “another option for us to build internal capacity” to track how the coronavirus affects local residents who have contracted it.  

Roseanna Garza

Roseanna Garza reports on health and bioscience for the San Antonio Report.