Volunteer tracer Ye: “Stay on the line” and listen.
Jessica Ye asked the Covid-19-positive woman on the other end whom else she has been in contact with.
“I could tell you,” responded the woman, who is in her 60s. “But they’re dead.”
Ye, a Yale medical student, was making the call to help New Haven government track the local path of the deadly coronavirus in hopes of saving lives and positioning the city to gradually reemerge from lockdown.
She and 89 fellow future nurses, doctors, physician’s assistants, and public-health professionals have signed up to volunteer their time to serve as tracers. They call people who have tested positive for Covid-19, then call people who may have caught it from them. The city’s health department trained the 90 students, and has now trained another 70 volunteers to swing into action as New Haven approaches the peak of infections and hospitalizations.
The calls often stretch for half an hour. In addition to gathering facts and disseminating information, the volunteers are lending a needed ear to people in distress. Like the woman in her 60s with whom Ye spoke the other day.
Do you know how you got Covid-19? Ye asked the woman.
“I’m pretty sure I know how,” the woman replied. “My mom was in New York. Her sister’s place has Covid.”
That was a few weeks ago. Then her mother returned to New Haven. The woman and her mother next flew South, for a family funeral. Some of the people they saw there have subsequently died.
One day before Ye phoned, the woman’s mother died as well.
Ye’s medical training kicked in — the part that teaches students that their role is not just to impart diagnoses and prescriptions, but to listen as well, and try to comfort. People need information. They also need to talk.
Ye has had practice in that. In person. In hospital settings. On calls like this one, she was now learning how to do that from a distance, over the phone, which can prove more challenging.
“Oh my gosh. I can’t imagine,” Ye recalled telling the woman. She figured she didn’t need to recall the names and phone numbers of the deceased relatives. They wouldn’t need to be contacted.
She did write down their names, to pass on to her team as it worked on tracing the coronavirus.
“I’m really sorry,” Ye told the woman one last time. “If you need help …”
Ramping Up
The city’s health department has sought to trace the spread of the virus since it first hit the city last month. At first, the department’s epidemiologist, Brian Weeks, and his staff made the calls in house. The department also set up a system with Veoci, the New Haven-based emergency-communications platform design firm that has been helping responders around the world track the pandemic.
Then the cases, and the bodies, started piling up. The department needed help. Professors and students at Yale’s schools of medicine and public health answered the call. Working with Professors Linda Niccolai and James Meek of the Yale Emerging Infections Program (EIP) , students Tyler Shelby, Justin Goodwin, and Chris Schenck have helped organize the platoons of volunteers, who have made around 400 calls so far, working seven days a week.
“The work doesn’t stop,” said Schenck (in photo), a second-year medical student from Gainesville, Florida. “We’re working to stay on top of the cases.”
First they call the individuals whom the state’s public health database has recorded as testing positive. They ask about symptoms, about preexisting conditions, about where the virus may have been caught, about workplaces and recent travel and the names of all people with whom patients have been in close contact.
The callers ask about help the patients may need, then direct them to places to find food or medical care or other needs. “I feel fine,” many patients tell them, after fever has subsided; the callers reinforce the need still to quarantine and prevent spreading the coronavirus.
The callers then enter the information into the database. Another team of callers tracks down the contacts to warn them about possible exposure and discuss their own steps.
City Health Director Maritza Bond (pictured) said the tracing has three goals: First, identifying positive cases; second, ensuring that those people self-isolate and quarantine; and third, seeking to stem the spread.
As she and other officials plan for an eventual gradual easing of public restrictions, this information will play a key role in decision-making, she said.
Right now the team has no backlog of cases. But the number of cases in town is expected to continue to rise. So Bond put out the call for more volunteers to join the tracing team, including retired clinicians who need to stay home but can still dial and consult with people infected or exposed. Click here for more information and to volunteer as a contact tracer.
“What Do I Do?”
For Jessica Ye (in photo), the work is reinforcing her conviction in entering the medical profession in the first place. Even, or especially, on days with the most emotionally draining calls.
She and the other students work with a script. They also have to improvise at times.
The same day as the call with the woman in her 60s whose family members had died, Ye called the home of an elderly man who had tested positive.
His wife answered. She told Ye he wasn’t home, because he was in the hospital.
“I’m so worried,” the woman said. “How do I get in contact? What do I do?”
He might not make it home, the woman said. She and her husband have been married for 40 years. She wasn’t used to being alone.
Ye told the woman, who is also Covid-19 positive, about the city’s emergency Covid-19 hotline. She told her about the 211 number for other emergency help.
Mostly, she listened.
“I hear you,” Ye said. “I understand. I’m so sorry. Just know our hearts are with you and the community is behind you.”
The woman said neighbors have dropped off food for her. They talked some more. Maritza Bond said the city has also been making follow-up calls to seniors in cases like these to make sure they’re OK.
“Sometimes,” Ye said, “it just requires staying on the line and being a good listener.”