My Summer Vacation: Finally!

The Department of Health is finally posting information about case investigation metrics! Today was the first day that this new metric has appeared; the data starts at the point when they got called on the carpet by the State Legislature for not having enough contact tracers. There is no data from earlier to compare how they were doing prior to that point. They also do not easily provide information on how many people are working for each period; you have to go to a separate page to get that information.

Hyperlink on page goes to graphic showing number of investigators & tracers.

From the description of the metric plus the definitions they listed; I think some of what I am doing is case investigation. Although it seems like they are labeling both case investigation and contact tracing as "contact tracing". Here's what I do know about the process from the work I am doing and what I am hearing from the cases. In the morning we get a form from the Department of Health (DOH) that only has a case number assigned by the DOH tracking system, the name of the case, and the phone number of the "case", who is the person that a lab has identified as testing positive for COVID-19. If the phone number is blank Dave does a bunch of sleuthing online to find a number. We make our "first call" to each case and begin filling out the form, collecting demographic data as well as information on type of symptoms, first date of symptoms, test date, which groups of people the case was in contact with during 14 days prior to symptoms or positive test if the case is asymptomatic, as well as within 2 days of those points. We also gather information about pre-existing conditions that may make the case more susceptible to COVID-19, about their work situation as well as their household situation. We provide information on how to isolate properly, what symptoms to watch out for, & when the case should be contacting their doctor or 911. If our "first call" is not answered we leave a message asking the case to call back; then around noon we call again. We make the 3rd call of the day in the mid-afternoon. If we don't reach the case the 1st day, we call 3 times the next day. And the next. If we have not been able to reach the case by the end of the 3rd day (a total of 9 attempts) it is escalated to another team.

Between the "first call" and the "follow-up call" that our team makes, another team calls the case to collect information to develop a list of "close contacts", or those people the case had been in contact with during the 2 days prior to symptoms and until they were tested, or 14 days prior to their positive test if they are asymptomatic; basically what we were trained to do as contact tracers. That other team then calls the close contacts and advises them on how to quarantine & how long to do so. So I am not talking to the close contacts like I was trained to do, but rather I am talking to the case or people who have actually tested positive for COVID-19 and are in isolation. In our training it was the investigator that did the calls to the cases, not the contact tracer.

The next day following our successful first call, and until the cases are out of isolation, we do "follow-up calls" where we find out how the case is doing, whether their symptoms are getting better or worse, whether they have a new isolation end date based on information from their doctor, how well the case is able to isolate from the rest of the household members, and answer any of their questions they might have on COVID-19. We refer the case to others who may be able to help with resources & support services to help them be successful in their isolation. FYI The term "isolation" is used in reference to a case being separated from non-infected people. The term "quarantine" is used in reference to close contacts who have been exposed to a case but are currently testing negative and must remain separated from non-exposed people during the 14-day incubation period. Your test will come back negative until you are actively shedding the virus in the infectious stage which occurs before you begin to show symptoms. And then there are the people who never show any symptoms; that is part of what is making it so difficult to keep COVID-19 from spreading. It is also why it is so important to wear a mask, practice good hand hygiene, physical distance yourself from others, & avoid gatherings with those outside your household bubble.

I made a beet greens proothie this morning. These beet greens are giving my proothie a slight beet taste, which I enjoy; I think it is because of the anthocyanins that provide that rich beet red color. The stems and veins on this batch of greens have been very dark red.

At work this morning, Dave had me work on follow-up calls. Since we don't reach all of them on the same number of days after they become symptomatic, or are tested in the case of the asymptomatic ones, their isolation end dates are different. I was calling people whom we had completed first calls on 5 days ago, so none of them were near their isolation end date. We try to be upbeat and conversational in an effort to be a positive point in their day; I try to encourage them by giving them a count down to their end date. I also remind them that if their symptoms return & they are concerned to contact their health care provider. Or if the symptoms are severe to call 911; I tell them don't wait for our daily call to let us know something is happening. I was able to reach 12 of the 18 cases I was given.

For lunch I got Eggplant Parmesan from Down to Earth today; the regular vegetarian one. And I used up my gift cards from Lori & Jenny; I will continue to pick up lunch from Down to Earth so that I can have more plant-based meals in my diet. I also tried a little of the Spicy Eggplant & Tofu; it was too spicy for me so I won't be getting that. I will have to ask if they have any handouts on the macros of their deli items; I have not found anything online.

After lunch Dave had me continue with the follow-ups; the file I was working on was cases 2 days after our first call. I was able to reach 10 out of 13 cases. It included one whose wife had just returned from the hospital; it is nice to hear the good news that a COVID patient has gotten well enough they can continue their recuperation at home. So far I have not had any follow-up calls where the case has passed.

I stopped by Maunalani to pick up Dad's photos that someone had called me about last week; I could not remember who it was. They could not find anyone who knew anything about it. I think I will have to call back later in the day and talk to the evening staff.

When I left I decided to stop in at Juicy Brew; it is a vegan place in Kaimukī that I first noticed in January 2018. I had seen that their sign was out so they were open. Today I was able to find parking nearby, unlike last month, but found that you have to do all your ordering online first. I had actually wanted to talk to someone to find out what their lowest carb options were since what I can see online looks like they are fairly high carb. I guess I will have to find a phone number and call to talk to someone; there was no number listed at the storefront.

Looks like I am going to be able to take the Case Investigator Training next week! This afternoon I was included on a series of emails between Alan from OmniTrak and Liz from the National Network of Disease Intervention Training Centers (NNDITC). He sent her additional information which included the contract description of what we are doing and I was approved this afternoon! The training starts at 8 am PST; which means 6 am HST. It's a good thing my body is still used to waking up early for the sunrise birding walks! I am looking forward to the training especially since it sounds like some of what I am doing now is actually investigation rather than contact tracing.

As I was getting ready to make dinner I noticed that one of the orchid sprays had already dropped a blossom. I hope they last long enough so that DT can take some to Lori this weekend.

For dinner I sauteed some baby pac choi with some chicken & beef fajita meat. I also had a green salad with bacon bits & vinaigrette beet spirals.

The Aix weather app forecast was for a dry but sometimes cloudy day today; it was dry but there were very few clouds here. The Tesla app showed a very sunny morning that became cloudier beginning around noon and continuing through the afternoon.

The smooth curve in the morning means lots of sunshine.

LG Green did his weekly COVID update on how we are doing. He included stats for the State's 7-day average of new cases & positivity rate on October 15th (start date of pre-arrival testing program) and today. It is lower today than when the program started. I think he presented that since a lot of people are claiming that the visitors are bringing more disease in with them. I think those people are just paying more attention now than they did before so it looks worse; for me, I'm with the LG on this since I have been closely watching the stats way before October 15th.

There were 78 new COVID-19 cases reported today bringing the total known cases up to 18,044. There were no new deaths reported so the known death toll remains at 244; the current number of active cases is 1250. The 7-day average of new cases for Oʻahu is 60 with a 2.1% positivity rate.