Contact tracing ‘An important thing for employers to do’

During a recent construction project, workers wore armbands connected to an electronic node network situated across the jobsite.

Project supervisors from the engineering and construction firm Jacobs implemented the technology as a form of contact tracing – a disease control measure with long-standing roots in public health practice that has emerged as a new concept for many employers during the COVID-19 pandemic.

Contact tracing is used to identify, support and monitor individuals potentially exposed to an infected person. If a worker on the project had tested positive for COVID-19 or been exposed to someone who had, in this instance, a report from the device network would have alerted the project manager about the recent job path of the affected worker and determined which colleagues were potentially exposed.

“They like it and feel a bit of relief associated with the wearable technology,” Jane Beaudry, a senior environmental, health and safety manager at Jacobs, said of the workers on the project. “They are happy that that exists. Initially, there were some concerns about ‘Big Brother,’ right, but we told them, ‘Listen, the nodes are only within work zones. Nobody tracks you after work.’ So, we kind of allayed that fear.”

The Centers for Disease Control and Prevention recommends contact tracing for anyone who has come within 6 feet of an individual with COVID-19 for 15 minutes or more within 48 hours of diagnosis. State, tribal, local and territorial health departments bear the authority and responsibility for implementing the measure.

The employer’s role

In June, the National Safety Council released an issue paper and policy position on contact tracing as part of its SAFER: Safe Actions for Employee Returns initiative. The council urges employers to participate in workplace contact tracing in conjunction with public health officials to help curb the spread of COVID-19.

NSC advises employers to:

• Encourage employees to participate in a technology or other system designed to determine employee contacts during the infection period.
• Seek employee buy-in for contact tracing, whether it’s conducted via a mobile app or other means.
• Allow employees who were exposed to the infected individual (identified through contact tracing) to remove themselves from the workplace and self-quarantine according to CDC recommendations.

“With a virus that is as contagious as this and could greatly impact businesses and worker safety and health, being able to determine if somebody was in the workplace who had been infected and then trace who they may have come into contact with is just an important thing for employers to do – to know that they need to do it and then to be able to do it,” said Jane Terry, vice president of government affairs at NSC, who helped develop the policy position.

Proper contact tracing, she added, while vital for all employers, can be especially key to maintaining the health and fluidity of smaller organizations – and, in many cases, the overall health of the general public. “If you’ve got a single or couple of employers in rural areas, you’re really impacting the entire community,” Terry said. “And to be able to ensure that employers have resources to keep their people safe underscores the ability for the community to keep itself safe and healthy.”

 

How it works

Travis Parsons, associate director of occupational safety and health for the Laborers’ Health and Safety Fund of North America, shared Terry’s sentiment during a July 16 webinar on contact tracing basics and applications in the construction industry, hosted by CPWR – The Center for Construction Research and Training. Parsons said although effective contact tracing can be challenging given the bustling nature and wide cross-section of people on a worksite, it’s still a necessity.

“It is not a panacea. It’s not a perfect system,” he said. “But it does help curb the spread of the virus, and we need to do it.”

NIOSH medical epidemiologist Sara Luckhaupt, a participant in the webinar, emphasized the importance of employer collaboration with local health departments.

Under a hypothetical situation, a health department official would ask an individual with COVID-19 about the people with whom he or she recently has had close contact. The department then would alert the contacts and assess symptoms, making sure not to share the name of the infected individual.

“The sooner that you can get a case and a contact who may potentially become a case out of circulation to the general public, then the sooner you can stop the spread,” Luckhaupt said. “The greater chance you can prevent further cases.”

CDC suggests that employers, if they haven’t already done so, designate a COVID-19 coordinator or team within their organization to oversee pandemic-related activities and create a related preparedness, response and control plan.

Employers also should visit and be familiar with their corresponding health department website, along with CDC guidance on case investigations and contact tracing.

CDC recommends that symptomatic or asymptomatic contacts who test positive for COVID-19 be treated and managed as confirmed cases.

The agency advises all close contacts of confirmed or probable COVID-19 patients to be tested for the disease.

Other recommendations:

• Asymptomatic contacts who test negative should self-quarantine for 14 days from their most recent exposure.
• Symptomatic contacts for whom testing isn’t available should self-isolate and be managed as a probable COVID-19 case.
• Asymptomatic contacts for whom testing isn’t available should self-quarantine and be monitored for 14 days after their most recent exposure, with access to clinical care for those who develop symptoms (fever or chills, cough, shortness of breath or difficulty breathing, etc.).

Parsons said workers shouldn’t feel a stigma about reporting symptoms, because contact tracing should be kept anonymous and confidential.

“We encourage our workers,” Parsons said. “They have a role in this. They need to report symptoms. They need to report if they’ve had exposures. Everybody needs to work on this together.

“And the intention is not to interrogate or pass judgment on any one worker whatsoever. It’s to curb the disease and to collect information to keep everyone safe.”

 

Addressing concerns

In its issue paper and policy position, NSC cites the results of an Axios/Ipsos survey conducted in May showing that “only about a third of Americans say they are likely to opt in to cellphone-based contact tracing systems established by the federal government (31%), major tech companies (33%) or cellphone companies (35%).” About half of respondents (51%) indicated they’d participate in a CDC-sponsored tracing system.

The council also references various potential challenges associated with contact tracing. Among them: apps that may violate worker privacy and civil liberties, be illegally used to collect data, hold data for longer than needed, and be used after the pandemic.

To protect the privacy of employees, NSC recommends employers:

• Use methods that provide maximum protection for employee data, seeking apps that keep geolocation data anonymous and encrypted.
• Share the data collected only with public health officials and others who may have come in close contact with the employee confirmed to have COVID-19.
• Establish policies to ensure the data is automatically deleted after it no longer is relevant to the purpose for which it’s gathered.
• Enact specific guidelines for data collection and processing related to COVID-19.

Beaudry said the workers who used the wearable technology during the construction project were informed and trained on the contact tracing methodology. They were required to consent to the use of the technology as a condition of employment.

“This is just, I think, what people are living with now,” Beaudry said. “This is the environment and this is the process that we have to avoid something.”