It could be the most important job of our time. And now that after getting a 95% success rate in my final exam, I can proudly say that I am a qualified contact tracer.
What is not clear is how well most people will be trained to take on this important role in Britain.
A contact tracer does the detective work by calling people who are known to be infected with a disease and finding where they have been in the past few days and who they may have met.
The idea is then to track down those they were with and tell them to quarantine.
With the government recruiting 25,000 contact tracers to be at the heart of its new test, track and trace strategy, we wanted to know the type of training they would receive.
Public Health England told us that this was not possible. Instead, I enrolled in the Johns Hopkins University course in conjunction with the Coursera online training platform.
The course, attended by tens of thousands, consists of a series of video lectures and multiple choice tests.
It took me eight intensive hours and I showed up with great respect for the discipline.
As the lecturer put it on the very last page: “Contact tracking is a complex activity that requires attention to detail and problem-solving skills.”
Bet it is?
What became clear is that although technologies like the Bluetooth apps tested worldwide can help, human skills are vital.
The last section, which took me two hours, is about how to speak effectively to the people you want to help.
So what did I learn?
I know a lot more about the signs and symptoms of the disease – for example, that about a third of all patients report a taste and smell loss, although the UK has only just added this to the list of recognized symptoms.
I have learned that of all the places where the disease is most easily spread, nursing homes where vulnerable people are in close contact are at the top of the list.
I now know more about the difference between isolation and quarantine – although the US and UK guidelines are not the same.
However, the key message is how small the window is to alert people who may have come into contact with the infection before they spread it – and how quickly contact tracers need to act.
The slide below tells the story:
Once someone comes into contact with an infected person, it takes five days to become infectious themselves. It is therefore important that he receives a warning as soon as possible.
Stephanie Hare, a data ethicist who also attended the course, says the other lesson that Britain could learn is how important quick tests are.
“Unfortunately, the UK does not have testing features that would allow our population to report on a large scale to symptoms on the first day we experience them, to be tested and to get the results back within 24 hours,” she said.
After learning a lot about Covid-19 and the principles of contact tracking, the course walked me through the process of making a call to someone who either received a positive test or was in contact with someone infected with the virus .
Great emphasis was placed on communicating clearly, but also building relationships with people who receive worrying messages.
Much of the teaching took the form of dramatized phone calls.
We met poor Larry with the hacking cough, and then Annette, the choir member who probably infected him.
We admired Tracer Amy’s empathy – “I hear you, this is a difficult time” – as we giggled at her colleague Drew’s brisk inability to keep interrupting and annoying Larry and Annette.
All contact tracers in the UK process some very sensitive information, which is often done from home on their own computers.
The Johns Hopkins course describes the ethical challenges of contact tracking.
The quiz at the end of the section contained some simple questions: If your topic tells you that one of his last contacts was his girlfriend, should you tell his wife? Uh, no.
But what about the contact who tells you that she spent a lot of time in a pub where you know your friends and family are hanging out?
You can’t tell them you’re in danger, the instructor said.
While this course is about old-fashioned manual contact tracking – the technique to fight the Ebola outbreak and other epidemics – it is also about some of the technology tools that could help.
These include the Bluetooth contact tracking apps that are currently being developed in a number of countries, including the UK.
Given the small window for tracking contacts, automating the process could make it faster and more effective. However, there is also a warning that such apps need high acceptance to be effective – and should be integrated into testing and health systems, which means that contacts receive calls from a human tracer and pings on their phones.
With all the talk of including privacy in apps, users could still get a call from a tracer who asks some deeply personal questions.
Overall, the course offers a detailed and inspiring, but also realistic overview of what can be achieved through contact tracking.
Under normal circumstances, someone with Covid-19 infects between two and three other people outside the lock.
If this can be reduced to just one person, the epidemic could be brought under control.
What is the comparison with Great Britain?
The training process for new contact tracers in the UK has been reported to be rather patchy – a few PowerPoint slides and some scripts that callers can follow.
Isabel Oliver, who oversees the Public Health England contact tracking program, told me that she was not familiar with the Johns Hopkins course, but was satisfied with the training of the recruits here.
“Our training is based on the requirements for our own program,” she said.
“We are very confident that we have a good and robust system. It has proven itself.”
The government originally said that the Bluetooth contact tracking app, currently being tested on the Isle of Wight, would be the key to efforts to control the virus once the lock was released.
It is now clear that an army of human contact tracers will go into battle first, so the quality of their training will be critical.