27: New COVID-19 Contact Tracing Info

Amelia Poulin, an ASTHO Senior Analyst for Infectious Disease Outbreak Response and Recovery, details an expanded contact tracing training curriculum for case investigators and teams doing COVID-19 work; CDC’s Dr. Lisa Grohskopf and Joynetta Kelly...

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Amelia Poulin, an ASTHO Senior Analyst for Infectious Disease Outbreak Response and Recovery, details an expanded contact tracing training curriculum for case investigators and teams doing COVID-19 work; CDC’s Dr. Lisa Grohskopf and Joynetta Kelly talk about the coming flu season and possible vaccination fatigue; and we preview an article written by Dr. Esther Muna, Chief Executive Officer of the CNMI Commonwealth Healthcare Corporation, about a looming Sept. 30th deadline for Medicaid funding in the Territories.

CDC Webpage: Influenza vaccine recommendations

CDC Webpage: Flu information for health professionals

ASTHO Training: Making contact – A training for COVID-19 case investigators and contact tracers

The Hill: Devastating decisions loom for the territories if Congress does not act by Sept. 30

ASTHO logo



This is Public Health Review Morning Edition four Thursday, September 16th, 2021. I'm Robert Johnson. 
Now today's news from the Association of State and Territorial Health Officials. 
Flu season is almost here a virus we've not had to worry about since early 2020. The big question this time around what happens when flu skips a year. Dr. Lisa Grohskopf is in the Influenza division at the CDC. 

We don't know for sure what will happen during the upcoming cold and flu season, but some important differences could impact how the season goes, including the fact that COVID-19 vaccines 
are now widely available and COVID-19 mitigation efforts have been relaxed in some places. 
Additionally, the lack of flu over the last 18 months could mean that the population immunity is lower. Adult immunity, particularly among those who were not vaccinated last season may
now partly depend on exposures to viruses two or more seasons earlier and young children, especially around two years old or younger may also have lower immunity to flu because 
they may not have been previously vaccinated or had any natural exposure. 

So this could all set us up for a return of flu and for it to be a severe flu season.


There's been a lot of talk about vaccines this year. Is the CDC concerned that flu vaccine uptake might suffer because of vaccination fatigue?
The CDC's Joynetta Kelly is a public health analyst focused on adult immunization and health equity. 


This comes up a lot in our planning and when we do speak with our national organizations, you know, COVID is the hot ticket item right now. You know, it's the new kid on the block. 
Folk's who've never taken the flu vaccine before, you know, some aren't really thinking about it. Some are just thinking, well, if I get the COVID vaccine, that's all I need even though because that should cover all of it, 
but others are very cautious and they're understanding that you know, COVID and flu together could be terrible. 

It could be a deal-breaker for someone. 
So, you know, we just make sure that we are giving them the information that, you know, Flu is also deadly. It can be deadly. 
It can affect a person who has really terrible chronic conditions or preexisting conditions. 
So we do make sure that we are working to get the message across to communities so they understand that one is just as important to the other. 


Also today, Public Health teams have years of experience working to reach those who may have been exposed to an STD. Now that experience is being tapped to improve COVID 19 Contact 
Tracing practices as part of an expanded training course available online. ASHTO develop the new curriculum in partnership with the national coalition of STD directors. 
Amelia Poulin is an ASTO senior analyst working on infectious disease, outbreak, response, and recovery. She talks about the training in today's morning conversation. 

The pandemic has been with us now 18 or 19 months way too long. We're all ready to be done with it. But during that time, a lot of Contact Tracing has happened. How has that process evolved during the pandemic? 


So, you're right the pandemic has been around for quite a long time. And to that, we have the benefit of collecting evidence and best practices from Contact Tracing efforts to inform, you know,  current and even future efforts. So for example, during surges, we have seen that states might not have enough case investigators and contact tracers to adequately reach out to all the cases or contacts. 
So what do we do in that situation? We're able to now reference CDC guidance on prioritizing cases in contacts. You know, that's something that we, they were able to put together based on evidence from the field. 

Also, you know, private industry partners have developed apps to help automate Contact Tracing so digital technologies might include exposure, notification, or apps that allow you to track the proximity of individuals in relation to a case. So these, you know, guidances and apps were really the benefits of some of these experiences that we're able to reflect on over the past 18 or so months. 


So a lot of improvements in this area, hopefully making the job easier. 


Yeah. I'm not sure about easier, but definitely more efficient and more effective. A lot of states are also looking to see what each other are doing in these areas and building
their trainings a little bit better in that regard as well. 

Speaking of training ASTHO's had a Contact Tracing training program online, and you've just expanded it. What changes have you made? 

Yeah, so the biggest change for the expanded training is to really draw out the role of case investigators in Contact Tracing. So case investigators are the folks that identify the COVID-19 cases and elicit the contacts from those cases. So that's one big expansion that the new training offers we've also, you know, expanded from four to 10 lessons, 
which includes a number of new content areas. So new areas could be effective interviews, active listening, asking questions strategically. 

We also provide a lot more background to public health and epidemiology than was in the previous course. 
And we tried to make the new training or the newer training, a lot more engaging. So we're offering over 30 videos and number of new job aids, 
some interactive images, and some other interactive pieces there as well. 

How do you hope these changes will help people who do this work? 

I think a lot of the new content will be especially valuable, you know, to be an effective case investigator or a contact tracer,
you need to understand the basics of Public Health, COVID-19 what all is involved in a CIA or CT interview case investigation or Contact Tracing or interview. 
So providing this foundation will allow people to have that background. We also offer, like I mentioned, over a dozen new job aids, so learners can download these, 
print them out and refer to them over the course of their work. 

Finally, this morning, the clock is ticking on a decision about how to fund Medicaid services in the US territories. 
Congress has until September 30th to extend funding or risk Devastating cuts in critical healthcare programs. 
Esther Muna leads public health efforts as chief executive officer at the Commonwealth health care corporation in the Northern Mariana Islands. 
She writes about the so-called Medicaid cliff this week in the hill newspaper find the link to her column along with links to everything else we covered today in the show notes. 

Also, remember to follow us on apple podcasts or Spotify, or listen on Alexa or Google assistant. 
And if you have a minute, please take time to leave us a rating and a review. Join us tomorrow morning for more ASHTO news and information. I'm Robert Johnson. 
You're listening to Public Health Review Morning Edition. 


Amelia Poulin MPH

Senior Analyst, Infectious Disease Outbreak Response and Recovery, ASTHO

Joynetta Kelly EdD

Public Health Advisor, CDC

Lisa Grohskopf MD MPH

Team Lead, Vaccine Policy Unit, Influenza Division, CDC

Esther Muña PhD MHA FACHE

Chief Executive Officer and Territorial Health Official, Commonwealth Healthcare Corporation, the Healthcare System of the CNMI