WDH: Overview of COVID-19 Case Investigation Process
April 9, 2020
When the Wyoming Department of Health (WDH) gets a positive test result, the provider who submitted the test and the local public health office are notified right away. The provider then notifies the patient.
The WDH epidemiology staff or county public health staff interview the positive individual by phone. The interviewers strive to complete case interviews immediately following the notification of a positive test result. In some rare instances, this can be difficult. For example, patients who are hospitalized and intubated may not be able to participate in an interview. Similarly, patients who are out-of-state residents or those who do not have up-to-date contact information can be difficult to reach quickly.
As part of the interview, the individual who tested positive provides information about their close contacts so county public health and state epidemiology staff can determine who may be high risk contacts. The epidemiology staff consider a high risk contact as someone who spent more than 10 minutes in close proximity to the positive individual in the 48 hours before symptoms began until such time as symptoms abated.
The positive individual receives isolation orders and high risk contacts receive quarantine orders. When the isolation order for a positive individual is lifted, they are considered “recovered.” The WDH COVID-19 website shows recovered numbers in total and by county.
Many people have trouble with the concept of who is deemed a “contact.” Epidemiology staff know there are people, especially in smaller towns, who know the positive individual (despite efforts to protect identities). The WDH and local Public Health Nursing offices take multiple calls every day from people claiming they were exposed to the case and questioning why they weren’t contacted. If county public health staff or the epidemiology staff did not identify someone as high risk in an interview, then they will not be contacted.
To date, in nearly all of the case investigations that county public health or epidemiology staff have conducted, cases are interviewed the same day as the lab report is received. High risk contacts are also immediately notified, to the greatest extent possible.
The WDH has increased staff assigned to conduct contact investigations at the state level. Epidemiology staff also work with local county public health partners for assistance with contact investigations. Each day, county public health offices get an update with the information on cases and quarantined contacts. County public health offices have been sharing that information as they deem necessary and appropriate to protect the public health and safety.
There may be a point in the future when contact tracing will no longer be an effective measure to slow the spread of the virus, due to the number of positive cases statewide. To date, the WDH does not believe that is yet the case. Contact tracing does not stop the virus, but it can reduce the incidence and alert epidemiology staff to more-critical situations.
Please remember, there are likely more cases than we can currently test and identify throughout the state. The WDH does not want to encourage people to assume they are safe based on low case numbers in certain areas. Everyone across the state needs to follow the public health orders, stay home as much as possible, and take common sense steps to protect themselves and others even if there are no cases or a small number of cases in their community.