May 28, 2020: Public Health Update

From: Tom McLarney, MD

Subject: Public Health Update

Date: May 28, 2020

To the Wesleyan community,

Congratulations to all students for completing this academic year, and especially the Class of 2020, whom we celebrated during a virtual Commencement this past weekend. Knowing this class the way I do, I know you will be making our world a better place.

With the 2019-20 academic year officially a wrap, we now turn our full attention to planning for the next year. One thing that will be increasingly important as we prepare for an eventual return to residential education is contact tracing, and I’d like to offer a brief introduction.

Contact tracing, another term that’s entered into the public lexicon since the pandemic began, has actually been a public health tool for some time. It has been used to track infectious diseases such as tuberculosis and sexually transmitted diseases, and was crucial in getting the Ebola outbreak of several years ago under control. Contact tracing allows us to identify individuals who may have been exposed to a disease, and take appropriate action to prevent further spread.

Here’s how it works: When a person tests positive for Covid-19, a contact tracer will interview this person (known as the “case”) and identify all their possible contacts from within the 48 hours prior to symptom onset until the time that the patient isolated themselves. This includes intimate contacts; anyone who spent more than 15 minutes with the patient at a distance of less than 6 feet; and prolonged contacts, even if the distance was greater than 6 feet. Those contacts are then placed in quarantine for 14 days. The goal is to isolate the contacts before they become infectious, which can happen up to two days before the onset of symptoms.

This all sounds simple enough, but several factors actually make it quite complicated. We know that often the patient’s memory is inaccurate or incomplete; the patient may not know the identity of everyone with whom he or she has had contact; and some people are distrustful of public health officials or worry about confidentiality.

Another term you may have heard during this pandemic is the R naught (R0). This is the variable to determine how many susceptible people can be infected by one sick person. The R-0 for Covid-19 is 2-3 people. While this may not seem like a lot, it is important to know growth is exponential, so one case can quickly balloon to many. Through effective contact tracing, when we remove any contact (quarantine) before they become contagious, we can help contain the disease.

Contact tracing is off to a slow start in Connecticut. More training and staff are needed to carry it out as needed. If you are a Connecticut resident and are interested in learning more about becoming a contact tracing volunteer, please visit the CT Responds website. I myself have taken a course on contact tracing, and will be guiding the University’s efforts in coordination with the Middletown Health Department.

I’d also like to report on a new medical finding. Last week, the Centers for Disease Control and Prevention (CDC) changed its website to state that the coronavirus primarily spreads directly from person to person, and is not easily transmitted from a contaminated surface. This also applies to exposure to infected animals. This is reassuring, but my recommendation is still to operate out of an abundance of caution: continue to wipe down surfaces, allow the mail to sit untouched for a day, wash hands after touching high touch-point surfaces, and refrain from kissing the dog.

Finally, thank you to the parent who shared with me that her child, who had Covid-19 but has fully recovered, has since donated plasma twice. The antibody-rich plasma has been one of the best treatment modalities we have seen thus far for Covid-19. I would encourage anyone who has recovered from Covid-19 to consider this very selfless act. The donation is very similar to a standard blood donation, and they even give you back your red blood cells! Contact your local Red Cross for more information.

Tom McLarney, MD