Contact Tracing: Principles

Principles of Contact Tracing

The CDC has identified certain core principles of contact tracing that must be adhered to and we have adapted them for use by UNT:

  • Contact tracing is part of the process of supporting patients with suspected or confirmed infection.
  • In contact tracing, tracers work with a patient to help them recall everyone with whom they have had close contact during the timeframe while they may have been infectious. For the purposes of UNT-sponsored contact tracing this would be limited to other members of the UNT community. We do not trace personal contacts unless they are part of the UNT community. 
  • Contact tracing staff would then notify these exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible.
  • To protect patient privacy, contacts are only informed that they may have been exposed to a patient with the infection. They are not told the identity of the patient who may have exposed them.
    •  Note: these can be challenging calls to make and contact tracing staff must be trained and prepared to share information in a compassionate way, while maintaining patient privacy at all times.
  • Contacts are provided with educational materials, information, and support to understand their risk, what they should do to separate themselves from others who are not exposed, monitor themselves for illness, and the possibility that they could spread the infection to others even if they themselves do not feel ill. This information is sent as an email after an initial phone call.
  • Contacts are encouraged to stay home and self-quarantine for 14 days after their last exposure to the individual who tested positive in case they also become ill. They should self-monitor by checking their temperature twice daily and watching for any of the symptoms of COVID-19, including fever of 100.4°F or greater, persistent cough, and shortness of breath. To the extent possible, contact tracing staff should check in with contacts to make sure they are self-monitoring and have not developed symptoms. Contacts who develop symptoms should promptly isolate themselves, seek medical care, and notify UNT contact tracing staff.

Contact tracing is a specialized skill. To be done effectively, it requires people with the training, supervision, and access to support and resources on and off campus for both patients and contacts. The knowledge base and skills for contact tracers include, but are not limited to:

  • An understanding of patient confidentiality, including the ability to conduct interviews without violating confidentiality (e.g., to those who might overhear their conversations)
  • Understanding of the medical terms and principles of exposure, infection, infectious period, potentially infectious interactions, symptoms of disease, pre-symptomatic and asymptomatic infection.
  • Excellent and sensitive interpersonal, cultural sensitivity, and interviewing skills such that they can build and maintain trust with patients and contacts.
  • Basic skills of crisis counseling, and the ability to confidently refer patients and contacts for further care if needed.
  • Resourcefulness in locating patients and contacts who may be difficult to reach or reluctant to engage in conversation.
  • Understanding of when to refer individuals or situations to medical, social, or supervisory resources.
  • Understanding of UNT policy and knowledge of who to contact with internal questions.
  • Cultural competency appropriate to the local community.

Basic Workflow

  1. Identify symptomatic or diagnosed person
  2. Determine last time on campus
  3. Identify people they came into contact with (either by having the patient provide a list or by looking at staffing rosters
  4. Call each person on the list to notify them of potential exposure
  5. Email contacts guidance

As a part of case investigation process, individuals are asked to provide the names of people within the UNT community that they may have been in contact with in the last 14 days, as well as their level of interaction during that time. These individuals are considered potential contacts of the person who tested positive.

The team member will carefully consider the level of exposure and potential risk to the campus for each person identified as a possible contact. If needed, they will consult with a medical professional from the Student Health and Wellness Center (SHWC), Director of Human Resources (HR) if the person is a UNT employee, and Health Crisis Team (HCT) to determine the appropriate action if contact needs to be made to those potentially exposed. Each instance will be handled on a case-by-case basis. Based on discussions with appropriate personnel, staff will take one of the following actions based on the risk assessment defined above:

  • Minimal or No Risk – do not contact the individuals in question who may have been in contact with the person told to self-isolate (it is determined the exposure was zero to very low-risk)
  • Low-Risk - Make contact with the individuals and direct them to self-monitor
  • Moderate to High Risk - Make contact with the individuals and direct them to self-isolate

The case investigator/contact tracer will reach out to those determined to be a potential contact or close contact to ask the appropriate questions using the UNT-specific Contact Tracing script and Contact Interview form. It is important to speak with cases and contacts in a compassionate and non-judgmental way. It is often necessary to quickly establish rapport when gathering such detailed and personal information. This is done by being professional, courteous, non-judgmental, and kind. Ask questions, but focus on listening and recording all details. People often share many irrelevant details; therefore, contact tracers need to be able to glean the relevant information and ask follow-up questions. Drawing a visual representation of exposure risk can be helpful in quickly determining level of risk. Taking detailed notes and referring to a calendar is very important when recording information and determining someone’s infectious period.