Nathaniel Stringer, a contact tracer for the Malheur County Health Department, writes down information between calls recently. Stringer said his job is rewarding as he helps those with Covid find resources and information. (The Enterprise/Pat Caldwell).
ONTARIO – Nathaniel Stringer measures success one day at a time.
As a Covid contact tracer and case investigator for the Malheur County Health Department, he encounters triumphs and tragedies at unexpected times and in surprising ways.
One day he helps a single mother isolated at home and out of work because of a Covid exposure. She has a utility bill to pay.
Another day he works to find a hotel room for a local resident exposed to Covid who can’t isolate at home as health authorities want.
“That’s the pay off and it’s a good feeling,” said Stringer.
Other days are marked by tragedy such as when Covid symptoms worsen and the infected person dies.
Those days linger for Stringer.
Stringer is one of 10 contact tracers and case investigators who are prime to the health department’s effort to control the spread of Covid. Contact tracers work seven days a week in staggered shifts as they track down people who are at risk of spreading the virus.
Stringer jumps into his work every morning in a conference room at Four Rivers Cultural Center. His weapons to fight the virus that has wreaked havoc across the country and the county are a laptop, a phone, paper and a pen.
Every case is different, he said, and each one can gobble up an entire morning as Stringer calls a person with a positive Covid test and then attempts to track down their contacts.
“Isolation and quarantine can be a real burden on anybody, and we realize that. For myself, I acknowledge that I understand this will be a difficult time and I want to do the most I can to help them get through this as easy as possible,” said Stringer.
Stringer and his teammates divide up the duties. Some of the health department workers only do contact tracing or just case investigation and sometimes they do both, said Stringer.
“If I get too busy, I will perhaps do the case investigation and get names of contacts and have one of the contact tracers who only does that get ahold of the contacts,” said Stringer.
The process begins each morning, said Stringer, when information about lab results of positive Covid cases arrive.
The positive Covid lab result is assigned a case number. That case number is stamped onto a contact tracing or case investigation sheet that is handed out by the team leader.
The leader also fills out the case investigation form with the name, address and phone number of the individual who tested positive.
From there, Stringer goes to work on the phone and often combines case investigation with contact tracing in a single phone call.
Stringer said, for the most part, people he calls at this point already know they are positive for Covid.
“Where they were tested will have already reached out to them. There is the rare occasion where we end up breaking the news,” said Stringer.
The phone call Stringer makes usually has two parts.
“When I call the positive case, that is actually a case investigation. The contact tracing doesn’t happen until I talk to them about who they had contact with, so it is two-fold,” said Stringer.
Stringer said his routine is the same with each call. His first step, he said, is to ask about symptoms.
“Then I talk to them about quarantine times, isolation periods and talk to them about pre-existing health conditions. I talk to them about where they have been in the two weeks before,” said Stringer.
Stringer said he also asks each individual if they have traveled recently.
“I ask them if they’ve been to any large gatherings. Do they know where they might have been exposed? Do they know anyone who they’ve come in contact with who has Covid-19?” said Stringer.
The questions help Stringer and the health department determine whether the case of Covid was contracted from someone else in the home or out in the community.
“I also talk to them about the last day they worked. A lot of times, people are leaving work because they feel sick,” said Stringer.
Stringer said then he works with the individual who tested positive to “figure out their work schedule two days prior to when they started to feel sick.”
“Lots of times we have to call businesses and ask who was working a shift with that person,” said Stringer.
Symptoms, he said, vary “from someone who doesn’t feel a thing to someone with every symptom in the book. If I would guess, about 60 percent have a fever. The most common symptom, about 90 percent, is loss of taste and smell. A bad headache is also really common.”
Stringer said the number of cases he traces or investigates each day fluctuates from two to eight
“It is not just talking to the person they have been in contact with. It is getting letters out to employers of the person we are asking to quarantine,” he said.
Stringer said as he calls and chats with people one sentiment is common.
“Hearing how surprised people are when it hits so close to home,” said Stringer. “They will say, ‘Oh, I didn’t think this could affect us the way it did,’” said Stringer.
Stringer said occasionally people he calls have “some strong beliefs about” Covid.
“In any community, you will run into people who are not real open to speaking to any agency about any situation. A lot of times they are curious about how we got their information. So, we explain we are public health and Covid response,” said Stringer.
Rarely, he said, do people yell at him.
“At the beginning maybe more so,” he said.
Now, he said, the virus has circulated so much in the community that everyone knows someone who caught it.
“It has hit closer to home at this point,” said Stringer.
While Stringer and his colleagues find reward in helping people, tragedy also lurks.
One case stands out for Stringer.
A 41-year-old local mother of three school-age children with a minor underlaying health condition but was otherwise healthy who fell ill from Covid in the “middle of the pandemic,” said Stringer.
String said the woman’s chances of recovering appeared good.
When she died after fighting Covid for a short time, Stringer was shocked.
“It was really difficult. It catches you off guard, especially with someone like that where you are not thinking it is going to be major. This virus is just so unpredictable,” said Stringer.
In other cases, the virus hits a family that is on the cusp of poverty or faces other challenges such as chronic health problems.
“It can be difficult to separate yourself from that work once you get home. You are talking to people who are in scary positions. Sometimes they are hospitalized, or they lose a family member. So, it can be heavy on your mind,” said Stringer.
Stringer said he can overcome the down days because “I already have a passion for helping people in tough situations.”
“I care about it enough and see the difference we make and when you are able to help people, they are grateful,” said Stringer.
The memory of 41-year-old mother puts added emphasis on how crucial it is for the right information to be disseminated to the public, he said.
“I wish we were in a place where people just understood, or people knew, how dangerous and scary this can really be,” said Stringer.
News tip? Contact reporter Pat Caldwell at [email protected] or 541-473-3377.
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