As COVID-19 cases reach record highs in the United States, Texas A&M University is preparing to welcome students back to campus as safely as possible for the fall semester. To effectively pull this off, the university has come up with a way to quickly “box in” positive cases on campus and those with whom they had contact.
Texas A&M and the Brazos County Health District have formalized an interagency agreement to form the Brazos Valley COVID Investigation Operations Center. Through this agreement, Texas A&M University Health Science Center (Texas A&M Health) will select, train and manage up to 60 employees, including contact tracers, case investigators and epidemiologists who will work at the Texas A&M Health Bryan campus. This workforce will support the investigation of positive COVID-19 cases, conduct contact tracing to help notify others that they may have been exposed to the virus, provide access to resources for those affected and promote best practices for managing the impacts of the virus.
“We need to be able to respond quickly to increases in cases,” said Angela Clendenin, PhD, MA, assistant professor at the Texas A&M University School of Public Health. “The most effective way to box in infectious disease cases is timely intervention with cases and identifying contacts, getting in touch with contacts and getting everybody who has been potentially exposed to the disease isolated from the rest of the population. The only way we can do that quickly and efficiently is to handle the operations locally.”
Clendenin is the project manager for the new Operations Center, which will help inform Texas A&M leadership in making timely decisions as the COVID-19 situation evolves. The Operations Center will also enable contact tracers to provide contacts with needed resources and support here in the Brazos Valley.
“One of the things we learned early on in our experience working with the Brazos County Health District is that when we are conducting an interview and recommending the person quarantine for 14 days, they need resources and support,” Clendenin said. “To be able to connect contacts with local resources is incredibly important for us, particularly when you’re talking about students coming from all over the country who are not familiar with our resources here.”
While the Operations Center will ensure Texas A&M cases are handled quickly, the personnel will maintain a presence with the health district to assist with overflow cases in the greater community and stay abreast of the larger picture of COVID-19 across the Brazos Valley.
“There is an exponential need for people to do this work,” Clendenin said. “On a day when we have 60 new cases, that can lead to more than 200 contacts to trace. And right now, there are some models that indicate we might not reach a plateau of cases until early November. Let’s hope with this work, and everyone’s commitment to smart behaviors to beat this virus, we see improvement much sooner.”
Texas A&M Health has provided space for the center to operate at the Health Science Center’s Clinical Building 1 on Highway 47 in Bryan. The space includes an area to train new employees, an electronic communication infrastructure, secure computing and private spaces to conduct confidential interviews. Employees are funded through the Texas Workforce Commission and Texas A&M Health has set aside funding for operations.
“From what we’re seeing, this academic-community partnership could be a one-of-a-kind model we’ve not found anywhere else in the United States,” said Greg Hartman, chief operating officer and senior vice president of Texas A&M Health. “We believe this operation will serve as a model for other communities in bringing together a comprehensive team across academics, public health, local government and the community to contain this and future infectious disease outbreaks. I am incredibly impressed by how quickly this came together with the support and collaboration of organizations across our community.”
When a person tests positive for COVID-19, their electronic health record and a copy of the lab report are sent to the local health district. In the Brazos Valley, that information is simultaneously sent to the Operations Center in Bryan. From there, a case investigator calls the person with COVID-19 to find out their hospitalization status, demographic information and smoking status as well as information about whether they’ve traveled in the past 14 days, the types of symptoms they’ve experienced and preexisting health conditions such as diabetes, respiratory disease and heart disease. Then the investigator asks the person to list everyone with whom they had close contact over the past 14 days.
Contact tracers call each of the contacts collected to notify them of their exposure to COVID-19. During each interview, the tracer asks the person how they’re feeling, what symptoms they’ve experienced and if they’ve been tested for COVID-19. If they have been tested, the tracer obtains the results. If they have not been tested, the tracer recommends that the person go get a test within three to four days of their exposure and isolate themselves until they receive the results. If their test comes back positive, they recommend isolating for 14 days and/or until they are symptom free for three to four days without medication.
In order for contact tracing to significantly slow the transmission of COVID-19, contact tracers and case investigators must be able to collect all needed information from the people they contact. Clendenin and the public health district urge everyone to answer unknown calls during this time, particularly if you know you have COVID-19 or have been in contact with someone who has COVID-19.
“Case investigation of all positive cases, collecting information on their symptoms and facilitating contact tracing to encourage isolation and best practices for managing the virus, are among the most important efforts we have to combat the pandemic, today,” said Santos Navarrette, Director of the Brazos County Health District.
Positions at the Operations Center are targeted to workers who have been dislocated due to COVID-19 economic impacts, those seeking a new career opportunity, and those of varying age groups or veteran status who are looking for a good wage job opportunity that helps the community.
“Our leadership at Texas A&M has been visionary,” Clendenin said. “They realized early on that when you’re bringing in the numbers of students that we anticipate being Aggies in the fall, that could lead to a significant impact, not only on the Texas A&M community, but on the greater community at large. This is one example of how they’re trying to find ways for us to have class face-to-face and provide our students an exceptional educational experience as close to normal as we can in a safe and effective manner.”
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