Last May, the Chicago Department of Public Health (CDPH) announced a contact-tracing program as part of its response to COVID-19. The program’s approach was unique: use community-based organizations (CBOs) to recruit contact tracers and train them in public health principles. The CDPH believed that hiring people through CBOs would help build trust between Chicagoans and contact tracers while also increasing the number of people qualified to later work in public health fields. However, contact tracing took longer than expected to implement. Now, with the vaccine rollout underway and people still hesitant to pick up their phones or answer questions about their behavior, the function of this momentous, multimillion-dollar initiative appears less about epidemiology and more about fostering community trust.

As of January 13, Illinois had vaccinated 365,000 healthcare personnel and residents of long-term care facilities, as part of phase 1A, which seeks to immunize those most likely to contract COVID-19 and people who work in settings where the virus is prevalent. Illinois estimates approximately 850,000 individuals comprise this group, and the state has  provided 920,000 vaccines so far to help immunize them (the vaccines currently being distributed require two doses given three weeks apart).

Phase 1B, which expands vaccinations to persons older than sixty-five and non–healthcare frontline essential workers, such as grocery workers, teachers, and first responders, began on January 25. Unlike the CDC recommendations, phase 1B in Illinois drops the requirement from residents over seventy-five to sixty-five to address the disproportionate effect COVID-19 mortality has had on communities of color. 1.9 million adults in Illinois are sixty-five or older, and 1.3 million Illinoisans are frontline essential workers, meaning that the state will require millions of vaccine doses to effectively cover this group.

But widespread deployment of the vaccine may still be months away. CDPH Commissioner Dr. Allison Arwady estimated phase 2 deployment, which would extend vaccinations to anyone over sixteen who has not been previously vaccinated, will commence on May 31.

Meanwhile, contact tracers, and the CBOs that employ them, say what they’re doing remains important. Contact tracers receive lists of people who have been in contact with people who tested positive for COVID-19. It is their job to inform those people of their exposure, help them get tested, and provide them with resources they may need in order to quarantine for seven, ten, or fourteen days, depending on their symptoms or their test results. Even as cases remain at 6.6 percent positivity, the contact tracers employed by Chicago do more than just inform people they need to quarantine.

Alyse Kittner, program manager at the CDPH, said that although “there is a point when community spread begins to diminish the effectiveness of contact tracing….getting health and spread-prevention messages out to the public through contact tracers will remain critical.” She said Chicago’s contact-tracing effort is not just about educating people on how to quarantine and when to isolate, but to also provide resources to help connect people to food banks, rent assistance, and health care locations when needed.

As vaccines become more widely available, contact tracers may also assist with the phased rollout. Karin Norington-Reaves, CEO of Chicago Cook Workforce Partnership (CCWP), which was tasked with getting 600 contact tracers working within Chicago, said that they have been deeply involved with Chicago’s COVID-19 mitigation efforts. “We are working with CDPH on a number of issues such as the Protect Chicago Campaign and we will also have the contact tracers pivot to the vaccination campaign when that’s ready to go,” Norington-Reaves said.

Sean McGinnis is the chief program officer of Lawrence Hall, a CBO that joined the contact-tracing effort despite not being traditionally involved with public health outreach. “This is a little bit outside of our wheelhouse,” he said, but clarified that they’ve worked with CCWP in the past. He said his organization was interested in the “vision of having people from the communities that are from the community making these calls versus a more traditional public health official.” He was optimistic about the possibility that this initiative might increase the number of public health care workers available to the city.

“There will be other public health issues and having community based organizations groups that have boots on the ground that have a feel for the neighborhood into that conversation is a brilliant idea,” McGinnis said. He feels like the people he’s helped onboard as contact tracers are “enthusiastic about this incredibly important work,” adding that “I don’t think anybody that we’ve hired had an area of expertise in health, but they felt the need to step up and help.” To that end, all contact tracers take a slate of training courses, including Coursera through Johns Hopkins (which is free for the general public), as well as online training videos through Malcolm X College and the Sinai Urban Health Institute.

Craig Chico, CEO of the Back of the Yards Neighborhood Council, which has also brought in new contact tracers, shared this sentiment. “The training has been very, very detailed, and very thoughtful and very deliberate,” he said. “We’re hiring from the community, which means most of these folks have never done anything of this nature before, including me and our staff. But in our case, we’ve prioritized our community. So we’ve gotten a lot of people that are bilingual and from our community. Those are two big priorities for us.”

Angela Soriano is a contact tracer for Chicago through Metropolitan Family Services, a CBO with sites scattered across the city. She is passionate about educating the people she talks with about how to stay safe and what resources are available for them. When Chicago first shut down, she spent time making masks and scrub caps for her local hospital. Soriano’s daughter works at Metropolitan Family Services, and when they put up a job description, she jumped at the chance. “That was so much better than sitting at home being anxious, “because I was actually doing something,” she said. “When I heard about contact tracing, I was like, ‘Yes, I want to do this.’”

Soriano encountered COVID-19 personally when her husband, who works at a restaurant at O’Hare airport, was diagnosed. “He was our sole income and the airport never shut down bars and restaurants and I was so worried about him because he had three pre-existing conditions. I can’t believe he actually listened to me, but I made him approach his job and say ‘Listen, I’m at risk.’” Fortunately, he was put on leave and was able to collect unemployment. However, her husband did go back to work in June; at the end of October, he came home sick.

“If I hadn’t had this job while my husband was sick I don’t know what I would have done,” Soriano said. “I had so much support from my colleagues. That made me realize…I don’t know how I would have done it alone.” Even with two adult children to help out at home, she said, “It was exhausting. You really need somebody in [your] corner to talk to about this.

Soriano was previously a massage therapist, but said that being a contact tracer “has been my favorite job ever.” When contact tracers are no longer needed, she would like to find something in public health or work for a nonprofit. “It’s just been so rewarding to talk to these people when they need somebody to talk to. I’m not a therapist or anything but I could listen to them and give them some guidance and link them to resources. Sometimes you’ll have someone who’s perhaps elderly and they’re just lonely as well. It’s a lonely time. It’s nice and it’s rewarding to be able to help people when they need it.”

Her tips for Chicago? Pick up your phone and use the resources available. “It’s not a punishment to be called and told you have to quarantine. We really try to be supportive. And we’re trying to help you. We have links…. We can help get access to food or a letter for their employer or help find testing, help find somewhere to go for medical care.” The Chicago Department of Public Health offers free teletherapy and can be reached at (312) 747-1020 from 8:30am to 4:30pm Monday through Friday. There is also a Crisis Text Link offered through the Illinois Department of Public Health that can be reached by texting “HOME” to 741741.

Colleen Holifield is also a contact tracer with Metropolitan Family Services. Her fiance contracted COVID-19 around the same time as Soriano’s husband. “When COVID-19 first started being discussed, I was terrified,” she said. “I wanted to know more about it so I kind of got fixated on knowing what it was and how I can keep my family safe and protect others around me.” She said that seeing people not taking it seriously made her worried for her own parents. “I just wanted to be a part of the mission to enlighten people and empower them to make better decisions to protect their family and to protect their own grandparents. I know there are people that were terrified like myself and I want to be that voice of reason and help them calm down and understand what they can do to contribute and to mitigate the spread.”

In late October, Holifield said her fiance developed high fevers. She searched around for same-day testing sites and when he tested positive, she said she went into panic mode.  “I grabbed all my cleaning supplies. I disinfected the entire house. I isolated him in our master bedroom for about two weeks. My daughter and I FaceTimed and he told her and she cried because she watches the news. Although my daughter was here, I felt so alone. It was stressful.” Shortly after her fiance recovered, she ended up on a call with a pregnant woman. “Her husband ended up having it and she was crying. And I explained to her, and I just gave her a disclaimer, ‘please, please, please, keep in mind I’m not a doctor or a nurse, but let me tell you how I got through this and you’re going to be okay.’ I lived through this and I’m living through this. We’re human, too, we’re not exempt from COVID-19 hitting us personally.”

Holifield plans to remain in the public health field after contact tracers are no longer needed. “When we first started, they asked what are we into, what are we looking forward to,” she said. “In my organization they have a position that’s a court advocate that deals with domestic violence situations. I’m preparing myself to get ready for that sometime in the next few months.” But right now, her advice for Chicago is: “When you think of COVID-19 don’t panic, just follow the guidelines that are given. It’s not to control you. But if you really want to protect your friends, your family, your children, this is about the human race, wear your mask. Maintain your distance. Just try to follow those guidelines. It’s really important.”

Armani Nightengale, a contact tracer with the Calumet Area Industrial Commission, has a background in health as a graduate student in rehabilitation counseling, which she sees as a great help. “So much of what we’re doing is really just reaching out to people and providing them with contact,” she said. “They can’t really go anywhere, they can’t see anybody outside of immediate family, and sometimes not even their immediate family. So you know, we’re doing these calls, and for some people it’s really the only contact that they have sometimes.”

She succinctly clarifies how she sees the work she does: “We’re not just giving information, we’re also giving a little hope.” She also brings up a point that isn’t well publicized. “Reach out to us. We would love to talk to people. If you have questions, just reach out. That number is a two-way street, it’s not just us calling you guys. We are more than willing to talk, see how you’re doing, answering whatever questions you have. We can call you, but you can also call us.”

Tricia Andrade was looking for a job and working on applications for medical school when she heard about contact tracing through Goodwill. “I have had family members who were infected with COVID-19; everybody is well now and people recovered, but that was tough,” she said.  “I also live in a household where one of my roommates is an essential worker, so I have been worried about that as well.” Speaking of her training, even as someone who is interested in medicine, she thought it was helpful: “It was very thorough and went into lots of details. I think just having that information definitely gave me the tools to share that with other people if people needed to have a better understanding of [COVID-19].”

However, contact tracing has not been without difficulties. “Right now,” she said, “our contact tracing can be a little bit hard because people are worried about answering unknown calls, which is completely understandable and valid. I would encourage people to reach out to us and respond when they do see our calls, so that we can try to connect them to resources they might need.”

Yessenia Carreon is a contact tracer with the Calumet Area Industrial Commission who has worn many hats and been involved in public service for years. She’s worked as a secretary for the South Chicago Chamber of Commerce board, worked for 10th Ward alderman John Pope for almost a decade, created a podcast called “Café con Canela,” and she ran for the 10th Ward committeeperson seat at the beginning of 2020. Of her experiences and how it relates to becoming a contact tracer, she laughs: “I’m used to the calling and getting hung up on.”

But contact tracing for Carreon was a little intimidating at first. “I am not going to lie, when I first got offered the position, I didn’t know anything about COVID-19. I mean, I was quarantining because that’s what we were told to do. I’ve always thought, ‘Well, I never get sick so I’ll be fine.’” Still, she wanted to quarantine to protect her kids and her parents. After taking the courses, her outlook changed. “It was an eye-opener and I feel more confident talking to my family and friends when they start thinking about going places. I take that role now where before I didn’t.” It helps that contact tracing and training is being done remotely. “We only had one in person, it was like an orientation to mainly pick up our laptops and equipment and everything.

Speaking of future plans in public health, Carreon says, “It never really interested me before, but now I’ve learned to appreciate it. I was worried I wasn’t going to be able to do it. I was worried that it was just going to be like a telemarketer which I didn’t want to do. But it reminded me of what I used to do in the alderman’s office, like talking to people and actual communication.” Her Spanish fluency has also been helpful in communicating with the people she reaches out to every day. “As soon as they know that I speak Spanish, they feel comfortable. And that really helps.” She wants Chicago to know she and her colleagues aren’t trying to invade anyone’s privacy. They just want to make sure everyone is okay. “We’re not doctors or anything, we can’t give you any medical advice, but we can sit on the phone and let you vent.”

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Elora Apantaku is a medical doctor and writer. She last wrote about remote learning for CPS schools and plans for reopening. 

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