Why COVID-19 Contact Tracers In Mass. Will Send You Milk

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Luisa Schaeffer scrolls through her COVID isolation case list for the day: one woman is out of milk, another needs help finding a doctor and making an appointment. A man asks about help paying his rent. (Jesse Costa/WBUR)
Luisa Schaeffer scrolls through her COVID isolation case list for the day: one woman is out of milk, another needs help finding a doctor and making an appointment. A man asks about help paying his rent. (Jesse Costa/WBUR)

En español, traducido por El Planeta Media.
It’s a familiar moment. The kids want their cereal and the coffee’s brewing, but you’re out of milk. No problem, you think — the corner store is just a couple of minutes away. But if you have COVID-19 or have been exposed to the virus, you’re supposed to stay put. Even that quick errand could continue the chain of transmission.

Luisa Schaeffer’s first call of the day is to a woman poised at the door to her apartment in Brockton, debating whether to take that quick walk. Schaeffer’s job is to help the woman make the best choice for the public’s health.

The woman has COVID-19. Schaeffer is her assigned care resource coordinator, tasked with supporting the woman while she remains in isolation. Sometimes, that’s as basic — and important — as delivering a jug of milk.

“That’s my priority, I have to put milk in her refrigerator immediately,” Schaeffer says. “Most of the time it’s the simple things, the simple things can spread the virus.”

The woman who needs milk is one of eight cases referred to Schaeffer one recent day through the Massachusetts Community Tracing Collaborative (CTC). Contact tracers make daily calls to people in isolation because they are positive, or in quarantine because they’ve been exposed to the coronavirus and must wait 14 days to see if it develops. The CTC estimates that between 10%-15% of cases request assistance. Their requests are referred to Schaeffer and other care resource coordinators.

Schaeffer’s next call is to a woman who doesn’t have a primary care doctor. Schaeffer will help her find one who is taking patients and make an appointment. She’ll help the woman apply for health insurance through MassHealth. That call is in Spanish.

For her next call, Schaeffer switches to her native language, Cape Verdean Creole. The man on the other end of the line has been sick and out of work, as has his mother. He applied for food stamps and was denied. Schaeffer texts the regional head of the state office that manages that program. Schaeffer, who is on loan to the CTC from her job at the Brockton Neighborhood Health Center, has deep roots in the community. The director says he’ll look into the case.

“He’s a very nice man,” Schaeffer says. “His staff works very quick to provide the food [stamps] the next day.”

The CTC says most requests are for food, medicine, masks and cleaning supplies. COVID-19 patients who are out of work for weeks or who don’t have salaried jobs may need help with rental assistance or unemployment. An older woman employed in the laundry room at a nursing home was told she wouldn’t be paid while out sick. Schaeffer got in touch with the CTC’s attorney, who reminds the company that paid sick leave is required during the pandemic.

“So, now, everything’s in place. She started getting paid,” Schaeffer reports.

There are glitches. People who are undocumented fear losing their job and return to work. When the local food bank runs out, Schaeffer asks a local grocer for help. When clients don’t know what to make with the free food available, Schaeffer finds a nutritionist and sets up a conference call cooking lesson.

“I love the three-way calls,” she says, beaming.

Schaeffer and other care resource coordinators have responded to about 10,000 requests for help so far through the CTC. Demand is likely greater in Brockton, with higher infection rates than most of the state and a 28.7% lower median household income.

“So many people are on this razor thin edge and it’s often a single diagnosis like COVID that can tip them over into the place where a role like a resource coordinator becomes essential in them getting back to a sense of health, a sense of wellness, a sense of security,” says John Welch, director of operations and partnerships for Partners in Health’s Massachusetts COVID Response.

Partners in Health, the non-profit managing the state’s contact tracing program, has carved out care resource coordination as a separate role in this project. It’s not new. Local health departments routinely include what might be called support or wrap-around services when they do contact tracing.

“You can’t have one without the other,” says Sigalle Reiss, the public health director in Norwood and president of the Massachusetts Health Officers Association.

But Welch, who is advising other states, says the importance of having someone assist with food and rent while residents isolate isn’t getting enough attention.

“I don’t see that as a universal approach with other contact tracing programs across the U.S.,” he says.

Some of the new contact tracing programs that schools, employers or states are rushing into place during the pandemic just cover the basics.

“They’re focused on: get your positive case, find the contacts, read the script, period, the end,” says Adriane Casalotti, chief of government affairs at the National Association of City and County Health Officials. “And that’s really not how people’s lives work.”

Casalotti acknowledges that this support role and services for people isolating or in quarantine adds to the cost of contact tracing. She urges more federal funding to help with this expense, as well as a federal extension of paid sick time and more money for food banks so that people exposed to the coronavirus can make sure they don’t give it to anyone else.

“Individuals' lives can be messy and complicated so helping them to be able to drop everything and keep us all safe,” says Casaloitti. “We can help them through the challenges they might have to make that the easy choice.”

This segment aired on July 2, 2020.


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Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.



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