So You Want to be a Contact Tracer in New Jersey?

The Jersey Shore before the storm by Laura Stinchcomb

Finally! Last week the CDC recommended to congress that 30,00- 100,000 contact tracers be in place in the United States before a possible next spike in novel coronavirus, Sars-Cov-2 (the virus that causes COVID-19) this September. Local New Jersey publications have been interviewing health departments throughout the State about their intent to hire contact tracers. However, anecdotally, I had seen little evidence of mass hiring in New Jersey.

Because of my healthcare knowledge, hospice volunteer training, ability to interview and make cold calls, I figure that I would make good contact tracer for COVID-19 and I am willing do this as a volunteer because I feel so strongly about containing this novel virus. This past May, I signed up and completed Coursera’s free contact tracing certificate program sponsored by Johns Hopkins. I also registered with the State of New Jersey’s database for people wanting paid/volunteer contact tracing jobs, received a 19-digit confirmation number and a subsequent email suggesting that I take another free e-course on contact tracing sponsored by ASTHOS (Association of State and Territorial Health Officials)- Which I did!

At least four of my well qualified friends told me that they also registered with the Department of Government NJ Contact Tracer hiring database and they also had received long verification codes but no additional word on hiring. Was the state too overwhelmed with responses from the legions of unemployed or were health departments trying to make due with the current staff and already contracted town employees to help fill the gap between need and declining state/town revenues?

The official COVID-19 Information Hub for the State of New Jersey says that it IS hiring aCommunity Contact Tracing Corps… at least 1,000 and as many as 5,000 contact tracers may be needed in New Jersey”  Efforts are to be spear headed by … “Rutgers University, led by their School of Public Health and including the School of Health Professions, School of Nursing, School of Social Work, and Graduate School of Applied and Professional Psychology, we will launch the corps and create several hundred jobs. We will also be expanding the effort to include other colleges and universities throughout the state.”

Just this weekend, I spoke to a Dean of an urban New Jersey community college who is looking into continuing education programs to supplement New Jersey’s Contact Tracing training but everything seems to be on hold-or stuck. Last week, I called my town’s health department to find out where they were with regard to getting contact tracers on board (I told her that I would work Pro Bono). They too are in a kind of limbo and are waiting for ComCare digital platform -which will integrate the surrounding state with a digital platform- to get rolled out and further instruction from New Jersey.  My town’s health department supports 8 townships consisting of approximately 110,000 citizens and would love to have tracers who are familiar with local support services. I gave them my name just in case the Big Government database doesn’t really trickle over to them.

Contact tracing is a decades old method to contact those who are infectious with a communicable disease, identify their contacts – those who may also be potentially infected- and ensure that they are all compliant with medical treatment -or in the case of COVID-19- in isolation or quarantine.  I personally feel that for contact tracers to really be effective, there are far more issues than getting funding, training, a software platform, contact tracers and service coordinators in place.

Compliance for Quarantine or Isolation require services that we just don’t have in place yet or have been greatly displaced. Each state and town will have to have its own method and support structures for people who must isolate or quarantine themselves. In many places, I believe social services may fall short. Neither the Coursera course or the ASTHOS course are really able to describe what “real” support will look like because that will have to fall within each jurisdiction. In fact, in the ASTHOS one(a particularly difficult e course to navigate) the suggestion that the contact tracer might be also possibly send hand sanitizer and a thermometer AND refer them to social services,while certainly helpful, made me laugh. In the mock interviews in the Johns Hopkins course, the objections of the “cases” (those infected with COVID-19) to isolation are magically solved by some kind of sleight of hand where, as far as I can tell, magical services that don’t really exist are produced.

To get people to a place where they can miss work, take care of elderly parents or children, make meals for a family, clean and disinfect a house, isolate in a separate space with a private bathroom from the rest of the roommates all while possibly being really sick – will take resources which I have yet to hear of in my NJ town. I have resources and I could not even get a grocery delivery to my home at the peak of the pandemic.

We are experiencing such an unprecedented disruption to our economy combined with the need to socially distance. Many of the social services that people rely on are non-governmental and volunteer-based and have had to re think how they operate.  In a blink of an eye, my volunteer jobs in a hospice and long-term care facility and delivery job for our library’s Books on Wheels program evaporated. Moreover, the Presbyterian Church in Westfield had to suspend its volunteer-run Agape Community Food kitchen in the beginning of New Jersey’s stay at home orders in March due to the health risks. The church provided almost 200 hot meals once the of a week to hungry people in Elizabeth. AFTER THREE MONTHS, the church and Agape Volunteers have cobbled together a new “hyper local” supplemental food to delivery 30 needy families in Westfield, NJ once a week. Families displaced by the pandemic.

Clearly lots will have to be put into place, and I hope New Jersey really does have the next two and a half months to prepare for a possible next spike of infections. I also hope that the other states who are now experiencing their first waves can look to New York and New Jersey for help. Meanwhile, I will be promoting contact tracing to my friends so we can get up to speed.

Pandemic Deja Vu

Curbside Pick up for coffee beans at our local Boxwood.

I have been experiencing bouts of déjà vu frequently during the last ten weeks since New Jersey has had ‘Stay at Home’ orders that took effect March 21st. My daughter suggested that it is because I am only seeing the same few rooms in our house day after day. She is stuck in a Hoboken one-bedroom railroad apartment working from home with her partner and says that they are experiencing the same thing.

I planned for this though and in February, I cleared out huge piles of “stuff” so we wouldn’t feel so claustrophobic in our overstuffed small house. I am immunocompromised, and when in January, an immunologist suggested that I would have a lot to worry about during a possible emergence of Coronavirus in the Tri-State area, I started to plan. The doctor said it with a laugh that made me feel like a hypochondriacal, worry wort- because “it probably would not make it here”. I hoped he was right but I ordered all of the major newspapers to keep on top of world events just in case.

 By the end of February, I had stopped going to group activities and cancelled my gym membership. As part of my prep for a possible pandemic, I cleared the basement and stocked up with toilet paper, cleaning products, MREs and shelf stable items and fridge stable meat. I also cleared a space so that 18-year-old son to have a “workshop” in the event that the three of us would need to hole up at home. I fitted up the in a third bedroom quickly as an office. I bought office chairs, keyboards and clunky rowing machine for the family room. I did all of this just in time because within weeks many these items would be difficult- if not impossible to obtain. As I bought these supplies in Costco and Bj’s, at the cash registers, others on line would double take as my totals were rung up. I noticed that this was the first thing that separated us from many other families who would not be able to purchase three months of food when they were trying to live pay check to paycheck. Did they have enough money to buy the large size Tylenol because the base ingredients would soon be unavailable in the supply chain? Would they be able to keep safe? What made our family more special than these hard working people? I continued to plan with gratitude and guilt over our bounty.

I realize that my Pandemic is not everyone’s Pandemic. I have been acutely aware that my family’s experience is not the experience of many- even those who live down the street- in our affluent suburb of Westfield. On many levels, the stay at home orders have been a blessing for us and has allowed me to have some control over an uncontrollable situation. Many others are also feeling the same guilt over knowing that they are the haves in a world of unexpected early deaths, unemployment and hunger. I am just thankful that I don’t have to worry that my son will be a vector for the virus now that he is not going to his germy high school -where he complained that they could not wash their hands because there was “no soap and someone peed in the soap dispenser”. I have stopped imagining all the times my husband touches his face on New Jersey Transit and in his hip- but very open office.

The curve in New Jersey has been flattened – even deflated for now. I feel safer knowing that if I had to make a hospital trip, I might not have to be in the ambulance that has to wait in line for hours just to get me through the front door of the emergency room. My family has also gotten better at this. We know how to wear masks, wash our hand and socially distance. We have a better sense of how to gauge risk and we know a little more about the virus.

In a sense, the combination of recession, social protests and stay at home orders remind me of another time in my life-the 70s. In the 70s , trips to the supermarket were limited to fewer available shopping days, hours and stock. The proliferation of processed foods was just really getting started, so often food was still made from scratch. Also, did you know that there was panic buying for toilet paper in 1973?

The toilet paper aisle one month into stay at home. It wasn’t til I saw Charmin on the shelf that I felt we were turning a corner.
By mid April, so many people were baking…supply was low.
Making extracts to use up all of the Vodka that I bought hoping to make precious hand sanitizer-only to learn that vodka does not have enough of an alcohol content.

My natural apple cider vinegar developed 5 extra mothers and I ran out of red wine vinegar. Why risk a trip to the store when I could make my own.
In the beginning, everyone was making bread while stuck in the house. There was a run on yeast, so I made lots of gluten free sour dough…and all other sourdough based breads including Injera.
We all craved fresh produce so much that we started a victory garden.

Spinach salad from garden and homemade vinegar.