The Navy Medicine Readiness and Training Command Bremerton’s Preventive Medicine department has been assigned the important task of contact tracing for each positive COVID-19 contact investigation since Day One of the ongoing pandemic outbreak.

Contact tracing is a painstaking process. The preventive medicine technicians or PMTs meticulously evaluate those who have tested positive for the coronavirus to determine if they have had close contact with another person. Close contact is described as being within 6 feet for more than 15 minutes without proper personal protective equipment, such as a cloth face covering.

“Contact tracing is not easy. It can be time consuming and at times frustrating,” said Chief Hospital Corpsman Dawn Dillow, Preventive Medicine department leading chief petty officer. “It can take anywhere from one hour to one day trying to figure out another person’s past movements. We’re contacting someone and asking them to remember back 14 days from the test date to identify anyone or any place they might have infected. As an important part of any case investigation, it really helps us determine if others have been exposed.”.

The need for timely and accurate contact investigation of all COVID-19 cases is deemed crucial in the ongoing effort to stop the spread of the disease. As soon as a test result comes back positive, the command’s Urgent Care Clinic and Preventive Medicine make contact with the infected individual.

The contact tracing process begins by clarifying administrative, demographic, and clinical status for each person, along with noting predisposing conditions, clinical testing, hospitalization status, and any treatment update(s).

Next comes going over the novel coronavirus exposure timeline – from the test date backward through the exposure period to earliest exposure date ­to identify any sources of infection. This requirement focuses on determining locations of potential exposure for the past 48 hours (the more complete, the better); addresses and phone number of those deemed high-risk; work and play settings; and dates and times of specific places visited, especially any health care facilities, schools, or day care centers.

“This is where the challenge comes in,” explained Dillow. “We’re relying and hoping that someone doesn’t have selective memory or hold anything back because they’re afraid they might get in trouble. We’re not tattle tails and out to get someone in trouble with their command, which is going to know their status anyway.”

Dillow acknowledged that it can be taxing to recollect every stop, every location, and every person someone encountered in a normal routine, including through shopping, dining, traveling, and any type of gathering.

“We go over suspected exposure settings, checking any that apply from the same household, co-workers and any health care environment,” said Dillow, adding that the PMTs query not just before but also after the onset of symptoms, during the contagious period.

Information is collected into COVID-19 contact investigation notes listing such details as the names of any contacts, the date exposed, and if the contact is known to be symptomatic with COVID-19 symptoms.

“Our preventive medicine technicians have been trained in this and are the best at what they do in their specialty. No one really knew that much about our Preventive Medicine department. Now? They’re showing they are the real deal. This [stopping COVID-19] is what they’ve all trained for. They know this is serious and important, and do not take their responsibility lightly. They have taken on the challenge of conducting the contact tracings along with all their other duties supporting ship, shore, and submarine commands. Their attitude has been tremendous in balancing everything,” commented Dillow.

Hospital Corpsman 3^rd Class Tiffany Hubbard has worked tirelessly as a PMT on contact tracing; she and her counterparts have been going almost nonstop since March.

“We’re one of the first notified of a [COVID-19] positive case. That notification kicks off a chain of events that we oversee and contribute,” explained Hubbard. “Upon notification from the lab or ordering provider, we notify the COVID-19 subject matter experts and chain of command. We then call the individual to find who might have been exposed so we can track and monitor them to keep our community safe.”

PMTs don’t accomplish their tracing task electronically or automatically. Its boots on deck to contact a specific individual, then rely on that person, or prompt if needed, to honestly remember their movements and interactions with others.

Although the PMTs deal primarily with active duty personnel, they have conducted contact tracing for a few civilians in federal civil service.

“Once contact tracing is completed, it is sent to Kitsap Public Health District as part of the case investigation. Our relationship is close. We essentially work with the county,” Dillow noted.