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EuLfYgFRQEii32IBUaBI0A moocContactTracing-module-2 PDF
EuLfYgFRQEii32IBUaBI0A moocContactTracing-module-2 PDF
EuLfYgFRQEii32IBUaBI0A moocContactTracing-module-2 PDF
for COVID-19
Emily S. Gurley, PhD
Johns Hopkins Bloomberg
School of Public Health
Learning Objectives
► Calculate how long a case should isolate and how long a contact should quarantine
► Describe the connection between the infectious period and isolation and quarantine
2
Contact Tracing for COVID-19 Prevention
Copyright © 2020 Johns Hopkins University and Emily Gurley. Except where otherwise noted, this
work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 license.
A Case of COVID-19 Requires Action
4
Public Health Prevention for COVID-19
If we can limit contact between people who are infected and others, we can limit
opportunities for the virus to be transmitted
5
Timeline of Infection: Infectious Period
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 6
Timeline of Infection: Infected Contact
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 7
Timeline of Infection: Window of Opportunity
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 8
Isolation and ► Stopping one
R0 = 2
Quarantine Can transmission chain
can prevent many
Have a Big future cases
Impact on
Reducing
Transmission
Copyright © 2020 Johns Hopkins University and Emily Gurley. Except where otherwise noted, this
work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 license.
Cases and Contacts
► Case ► Contact
► Someone who has COVID-19 ► Someone who had contact with a case
► Usually has a positive laboratory test while they were infectious
● During their illness
► Suspect or probable case ● 2 days before their illness began
► Someone exposed to a case who ► Three kinds of contact
develops symptoms, even if they have ● Physical contact
not had a test yet ● Close contact: within 6 feet for 15+
minutes (10 or 30)
● Proximate contact: more than 6 feet
but in the same room for an
extended period
2
Isolation vs. Quarantine
► Isolation ► Quarantine
► Keeps sick people separate from ► Restricts movement and contact of
healthy people healthy people who have been
► Restricted to home or hotel exposed
► Separate space in hospital to limit ► For 14 days since the last contact with
contact the person who is infected
► For duration of infectiousness
● 2 days before onset
● At least 10 days after onset of
illness; symptoms must be
improving and no fever within the
past 3 days
3
Calculating Isolation and Quarantine Duration
Copyright © 2020 Johns Hopkins University and Emily Gurley. Except where otherwise noted, this
work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 license.
How Long Should a Case Be Isolated from Others?
► Short answer:
► Ideally, as long as they are infectious
► Longer answer:
► Until they fully recover
● By the time they are diagnosed,
they will already be sick
● Must monitor their symptoms
● Are no longer infectious after they
recover
**At least 10 days after symptom onset
and if other symptoms have resolved
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 2
Defining Their Infectious Period: Call the Case
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 3
Defining Their Infectious Period: Illness Onset
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 4
Defining Their Infectious Period: Calculate
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 5
Defining Their Infectious Period
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 6
Defining Their Infectious Period: Follow-Up
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 7
Identifying Contacts in Their Infectious Period
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 8
How Long Should a Contact Stay in Quarantine?
► Short answer:
► Ideally, as long as they could be
infectious
► Longer answer:
► 14 days following the last contact with
someone who is infectious
● Almost everyone who is infected will
develop illness within 14 days
► Last contact may have been days ago
► Contact may be ongoing
**If they have developed symptoms,
should be considered a case
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 9
How Long Should a Contact Stay in Quarantine?: Call the Contact
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 10
How Long Should a Contact Stay in Quarantine?: Last Contact with
Case
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 11
How Long Should a Contact Stay in Quarantine?: Calculate
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 12
How Long Should a Contact Stay in Quarantine?: 14 Days Since Last
Exposure
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 13
Contacts Who Live With Cases May Need to Quarantine Longer
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 14
Contacts Who Live With Cases May Need to Quarantine Longer:
Illness Onset
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 15
Contacts Who Live With Cases May Need to Quarantine Longer:
Calculate
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 16
Contacts Who Live With Cases May Need to Quarantine Longer: 14
Days After Their Last Infectious Contact
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 17
Identifying High-Risk Situations
Copyright © 2020 Johns Hopkins University and Emily Gurley. Except where otherwise noted, this
work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 license.
Important Terms
► High-risk subpopulation
► A segment of the population that has characteristics that increase the risk of infection
or severe disease
2
Factors that
Increase Risk
for Infection
and Severe
Disease
Image source: Center for Teaching and Learning, Johns Hopkins Bloomberg School of Public Health. 3
Dense Contact Environment
4
Dense Contact Environment: Examples
5
Difficult to Contact Trace and Identify Exposures
6
Difficult to Contact Trace and Identify Exposures: Example
7
Difficult to Isolate or Quarantine
► Unwilling to cooperate
8
Difficult to Isolate or Quarantine: Example
9
Higher Risk of Infection and Severe Disease or Death
10
Higher Risk of Infection and Severe Disease or Death: Example
► May be more likely to get infected due to close ► Example: assisted living facility
contacts ► Congregate living situation
► Most residents over 60 years of
► More likely to have underlying medical age
conditions (heart disease, respiratory ► Multiple levels of care,
conditions, poor immune system) including skilled nursing
facilities, which care for
► May get exposed to the virus multiple times individuals with illness or injury
11
Contact Tracers Must Help Identify High-Risk Situations
12
Summary
Copyright © 2020 Johns Hopkins University and Emily Gurley. Except where otherwise noted, this
work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 license.
Summary of Contact Tracing
► We can stop transmission of COVID-19 if we can identify cases and their contacts quickly
and get them to limit their contact with other people
► Cases should isolate themselves as long as they are infectious—for at least 10 days after
they become ill
► Contacts must quarantine for 14 days after their last contact with an infectious patient
► Some cases may have close contact with many people because of where they have been
or where they live, and these situations should be immediately reported to your
supervisor