Covid-19 Contact Tracing Playbook

Introduction
COVID-19 Contact Tracing Playbook

Published by Resolve to Save Lives, an initiative of Vital Strategies

As U.S. states rollout plans to gradually reopen society, there are four essential actions that
governments must commit to—and invest in—now so they can reopen society as quickly
and safely as possible while preventing another explosive spread of the COVID-19. (Figure
1)

Contact tracing will be a key component of any successful suppression effort to “box in”
COVID-19. In contact tracing, local and state health departments quickly identify people
infected with COVID-19 using widely implemented testing programs; instruct infected
people to isolate; find and notify their contacts; and support these contacts so they can
quarantine for 14 days. Read about "Box it in"...

Figure 1. Box It In
Contact tracing is a tried and true public health measure that has been successfully used to
contain communicable diseases, such as HIV, sexually transmitted infections, and
tuberculosis. As in all public health responses, tools must be adapted to meet the
challenges of each microbe. Contact tracing for COVID-19 must be executed on a
significantly larger scale, adapting to unique challenges of the virus including
asymptomatic spread. Countries including China, Germany, South Korea and Singapore
have all done this successfully.

It is urgent for U.S. state and local health departments to quickly prepare and implement
contact tracing to box in COVID-19.

4 STEPS

Contact tracing for COVID-19 includes four key steps:

1. Identify and notify cases of their confirmed or probable COVID-19 status.

Provide instructions on isolation and treatment.
2. Interview cases and help them identify the people they were in contact with
during their infectious period.
3. Locate and notify contacts of their potential exposure, interview them to see
if they have symptoms, offer testing if they do (and if they don’t), and
arrange for care if they are ill. Provide instructions on quarantine.
4. Monitor contacts and report daily on each person’s symptoms and
temperature for 14 days after the person’s last contact with the patient while
they were infectious.

This process continues until the end of any possible transmission chain has been reached.

9 DOMAINS
A successful COVID-19 contact tracing program comprises of nine domains:

1. Contact tracing protocols and forms.

Effective contact tracing protocols clearly define processes around isolation for cases
and quarantine for close contacts. This includes whether isolation and quarantine are
legally mandated or voluntary, priority thresholds for in-person outreach (e.g.,
congregate settings), definition of close contacts, determination of how to manage
laboratory-confirmed and probable cases, definition of the social supports package and
eligibility, and arrangement of clinical linkages for contacts. The public health
workforce conducting contact tracing and case investigation will rely on clear and
precise forms and scripts to guide activities and communication with cases and
contacts.

2. Public health workforce.

Thousands of people will be needed to properly conduct the four contact tracing steps
noted above. The approach relies on rapid and efficient recruitment, training, and
deployment under the management of the state, local and/or territorial health
department. Workforce training should include knowledge and skill-based exercises in
order to create rapport, address concerns and barriers to contact elicitation or isolation
and quarantine, and appropriately assess support needs to ensure adherence with
public health recommendations.

3. Digital and technology solutions.

Digital applications (or apps) can facilitate the massive scale-up of contact tracing that
will be needed to help to box in COVID-19. Apps can augment traditional public health
activities, for example by rapidly finding cases' contact information, sharing their
contacts more easily, and providing isolation and quarantine support. All digital
solutions must be driven by people trained in public health response, explicitly support
workflows for contact tracing, and adhere to the highest privacy standards. Governance
of data systems, ownership and stewardship of all case and contact-related data
collected, maintained or disseminated must remain the responsibility of the applicable
local public health authority. Customer Relationship Management (CRM) solutions will
provide an infrastructure by which the public health workforce functions optimally.

4. Case reporting.
The success of contact tracing to interrupt disease transmission hinges on the
timeliness of case identification. The sooner a case is identified, the sooner the
 contacts can be elicited and notified of their exposure, thereby reducing the chances
that they will further spread disease. Effective contact tracing relies on timely and
complete case reporting by public and commercial laboratories and medical care
providers; and linking these reports to health departments’ case management systems.
COVID is a nationally notifiable disease and must be reported to public health.
Electronic Lab Reporting (ELR) from commercial and clinical labs when integrated with
disease management systems of the health departments would reduce the time to
beginning a case investigation and subsequently identifying contacts.

5. Clinical consultation.
Cases and contacts may require symptom management advice and clinical
consultation during isolation and quarantine periods. Some people may have
telephone or video access to their regular primary care provider. For those who do not
have access to a regular primary care provider, health departments should establish a
pool of providers for on-call clinical consultation by telemedicine.

. Services to support people in isolation and quarantine.

Support for contacts in quarantine and cases in isolation can improve people’s safety,
comfort, and adherence to isolation and quarantine guidance. For many contacts,
provision of basic resources, such as daily check-in phone calls, health education
materials, masks or face coverings, thermometers, hand sanitizers and gloves, may be
enough. For others, “wraparound services” (including food, laundry, pharmacy services,
garbage removal services) may be necessary. Financial supports may be needed to
help those in quarantine and isolation meet basic needs and to compensate for lost
wages. When people who care for children, older adults or other dependents are put in
isolation or quarantine, the people they care for could be left in untenable situations.
Alternative caregiving services should be provided in these situations.

7. Facilities for out-of-home isolation and quarantine.

In some situations, people with COVID-19 or their contacts may be unable to isolate
safely at home. Health departments should define criteria for offering alternative
housing in these instances. Out-of-home accommodation for isolation or quarantine
periods may be necessary for people who live with high-risk individuals, are
precariously housed, unsheltered or experiencing homelessness, live in congregate
settings, or who otherwise cannot remain in their current residence. Existing facilities in
the community, such as hotels, single-room dormitories, or temporary housing facilities
 can be contracted with to provide this service.

. Public communication.
For contact tracing to be successful, the public must understand that their participation
and adherence to public health recommendations (including isolation and quarantine)
are essential to suppress the epidemic, protect the health of people in the community,
and reopen society. Health departments should establish themselves as credible and
trusted information sources and managers of the crisis. Best practice communication
strategies include daily press briefings by a trusted source, engaging with trusted
community leaders and officials to adapt messaging to the local culture and context
and to reach out to their communities, leveraging media outlets, hosting a hotline (or
other way for the public to ask questions), and producing and sharing educational
resources (such as FAQs and fact sheets).

9. Metrics and monitoring.

Routine monitoring and assessment of contact tracing efforts will reveal whether the
process is functioning as intended, whether the program is achieving the goal of
reduced disease transmission in the community, and if not, what changes should be
made. A dashboard can track key performance indicators.

The COVID-19 Contact Tracing Playbook provides actionable technical guidance, including
implementation checklists and tools, for each domain of a successful contact tracing
program. U.S. state and local health departments can use this playbook to rapidly set up
and implement contact tracing programs for successful COVID-19 containment.

LIVING DOCUMENT
This playbook is a dynamic, “living” document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Glossary
CASE
Refers to a person with probable or confirmed COVID-19 infection.

CONFIRMED CASE
Meets confirmatory laboratory evidence.

PROBABLE CASE

Meets clinical criteria AND epidemiologic evidence with no confirmatory laboratory

testing performed for COVID-19; or
Meets presumptive laboratory evidence AND either clinical criteria OR epidemiologic
evidence; or
Meets vital records criteria with no confirmatory laboratory testing performed for
COVID-19 (Source: CDC)

COVID-19
The name of the disease caused by the novel coronavirus, SARS-CoV-2, and is short for
“Coronavirus Disease 2019.” (Source: WHO)

CONTACT or CLOSE CONTACT

A person who may be at risk for a contagious disease because of their proximity or
exposure to a known case. Exact definition of close contact differs by disease; for COVID-
19, the CDC defines a close contact as anyone who has been within 6 feet of a person
infected with the virus for at least 15 minutes, or has had direct contact with the infected
person’s secretions. (Source: CDC)

CONTAINMENT
Preventing the spread of disease in early stages of transmission through measures such as
early detection and isolation of cases, and contact tracing and quarantine. (Source: WHO)

HIGH-RISK INDIVIDUALS
People at higher risk for severe illness from COVID-19. Based on the current evidence, high-
risk individuals include:

People 65 years and older

 People of all ages with underlying medical conditions, particularly if not well controlled,
including: people with chronic lung disease or moderate to severe asthma; people who
have serious heart conditions; people who are immunocompromised due to causes
including cancer treatment, smoking, bone marrow or organ transplantation, immune
deficiencies, poorly controlled HIV or AIDS or prolonged use of corticosteroids or other
immune weakening medications; people with severe obesity (body mass index [BMI] of
40 or higher); people with diabetes; people with chronic kidney disease undergoing
dialysis; and people with liver disease (Source: CDC)

INFECTIOUS PERIOD
The onset and duration of viral shedding; not yet known for COVID-19. (Source: CDC)

ISOLATION
Used to separate people infected with the virus (those who are sick with COVID-19 and
those with no symptoms) from people who are not infected. (Source: CDC)

PROXIMITY TRACING or EXPOSURE NOTIFICATION

Digital tools that automatically track the proximity of individuals and can notify people who
were in close proximity to a positive case, using Bluetooth technology or GPS coordinates.

QUARANTINE
Used to keep someone who might have been exposed to COVID-19 away from others.
Quarantine helps prevent spread of disease that can occur before a person knows they are
sick or if they are infected with the virus without feeling symptoms. (Source: CDC)

SUPPRESSION
Reducing and maintaining low levels of disease transmission through intermittent
loosening and tightening of public health and social measures (PHSMs); detection and
isolation of cases, and contact tracing and quarantine.

TELEMEDICINE
The delivery of health care services and information via electronic information and
telecommunication technologies.
LIVING DOCUMENT
This playbook is a dynamic, “living” document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Future vision for public health
The COVID-19 pandemic has presented the United States. (and the world) with the most
severe public health tragedy and challenge in over a century. While public health agencies
in the U.S. are well-practiced and have systems in place for detecting and responding to
infectious disease outbreaks, novel coronavirus came with unique challenges, requiring
public health agencies to rapidly adapt and respond at unprecedented scale.

Effective public health epidemic response measures are implemented according to the
phase of an epidemic, with contact tracing as essential measure during the containment
and suppression phases. In the U.S., contact tracing is primarily being used as a
suppression strategy, after wide implementation of physical distancing measures.

The contact tracing systems and practices being put into place now must be evaluated,
refined to incorporate lessons learned, and institutionalized so that they can be rapidly
activated during subsequent outbreaks. When the next epidemic comes, contact tracing
during the early containment phase can stop the spread of disease before it becomes a
large outbreak—and prevent this from ever happening again.

Adaptive response timeline for future epidemics

Click on image to see full size

LIVING DOCUMENT
This playbook is a dynamic, “living” document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Checklists
Contact tracing protocols & forms
Checklist

1. Governance

Establish governance structure and relevant government agencies' roles in contact

tracing. Consider federal, state, county and local agencies.

2. Legal authority over isolation and quarantine

Determine if isolation/quarantine guidelines are mandated by law or voluntary:

Isolation for cases with known positive COVID-19 status
Quarantine for contacts of cases who have been exposed, but whose COVID-19
status is unknown
Provisions in place to refer cases and contacts refusing voluntary
isolation/quarantine to civil authorities for issuance of formal quarantine orders
Work with lawyers to understand legal authority to impose mandatory quarantine
or isolation. States and cities will have different approaches.
If isolation or quarantine guidelines are mandated by law, establish protocols with
processes and consequences if someone refuses to comply.
Include processes for people to appeal mandatory quarantine and isolation
orders.

3. Cases for interview and contact elicitation

3.a Interview and elicit contacts on all confirmed and probable cases. If public health
resources are limited, prioritize confirmed cases. (See CDC guidance on Case
Investigation Hierarchy)
3.b Define how cases will be reported to the health department for contact tracing in a
manner that minimizes time from diagnosis to identification; set targets for timeliness,
e.g. percent reported within 24 hours: (See Case Reporting for more information)
Positive laboratory test result (hospital clinical laboratory, commercial laboratory,
public health laboratory)
Medical care provider referral of probable case pending laboratory confirmation
 Home testing (pending confirmation by public or commercial laboratory)

4. Staffing and workforce strategy

Identify staffing/workforce strategy, within public health department or outsourced and

managed by public health department. (See Public Health Workforce for more
information)

5. Technology-enabled processes

5.a Determine if contact tracing processes will be supported by a digital app; integrate
the app into the disease surveillance system workflow. (See Technology checklist for
more information.)
Data security and data privacy protections need to be built into all technologies
and processes.

5.b Identify which points in the contact tracing workflow can be efficiently automated
and which workflows will be conducted by staff:
Identification of case and notification to public health department
Searching online databases for address, phone number, and other information for
case when not available with case report
Notifying case of diagnosis
Eliciting contacts from case (including importing contact information via app)
Notifying contacts of potential exposure
Daily symptom monitoring of cases and contacts
Preferred method of daily monitoring (SMS, phone, e-mail)
Method contacts and cases can use to alert health department of social service
needs

6. Contact tracing protocols

6.a Develop contact tracing protocols.

Determine if contacts will be prioritized for follow-up, including when outreach will
be automated vs. done in-person.
Ideally, health departments should collect information on all close contacts.
Those that do not have the capacity to monitor and test all contacts promptly
 can use a risk prioritization guide. (See CDC guidance on Close Contact
Evaluation and Monitoring Hierarchy)
Determine if contacts will be notified by contact tracers or if cases will be asked to
notify their own contacts directly.
Determine structure for reaching household contacts; for example, in some
jurisdictions it may be allowable to have one point of contact per household vs
treating each household member as a separate contact.
Identify whether and how contacts will be monitored for quarantine compliance.
Determine how and when to test contacts for COVID-19 infection.
As testing availability permits, test all contacts immediately after notification,
and again two to three days before release from quarantine (or if/when
symptoms begin).
Determine how and when testing will be supported, including transportation or
escort if needed.
Determine how to guarantee contact received test.
Testing is recommended for all close contacts. Determine when to trigger clinical
consultation if contacts develop symptoms.
Monitor contacts for symptoms for 14 days after exposure.
Determine if contacts will be actively monitored or will be asked to self-
monitor.
If contact develops symptoms, instruct them to immediately seek clinical
consultation (from regular provider or telemedicine services, as relevant)
See CDC guidance on when to seek medical attention.

6.b Define contact tracing procedure by setting.

Include information on translation, language lines and contacts with
communication impairments

6.b.1 For mass gatherings, e.g. public transportation, concerts, worship services,
weddings, funerals:
Develop health department protocols that trigger epidemiology field
investigation.
Trigger broadcasting/public messaging to reach all potentially exposed
contacts.

6.b.2 For congregate settings, e.g. schools, homeless shelters, jails, prisons, group
homes, workplaces, crowded multi-generational housing:
 Develop health department protocols that trigger epidemiology field
investigation.
Work with field epidemiology team and specialty staff to assess facilities’
infection control policies and procedures in collaboration with
occupational health.
Elevate to enhanced in-person contact tracing procedures.
Collaborate with setting leadership to identify and notify all potentially
exposed contacts.

6.b.3 For facilities that deliver health care, e.g. hospitals, nursing homes, long-
term care facilities, rehabilitation facilities, assisted living facilities, personal care
homes, memory care, inpatient hospice facilities, methadone clinics, inpatient
drug treatment facilities:
Develop public health department protocols that trigger epidemiology field
investigation.
Work with field epidemiology team and specialty staff to assess facilities’
infection control policies and procedures in collaboration with
occupational health.
Assume all facility residents and staff are contacts.
Sort and separate populations by: probable and confirmed cases; infected
and contagious but asymptomatic or pre-symptomatic; not infected but at-
risk.
Identify outside visitors and refer to routine contact tracing.

6.c Determine criteria for other triggers to refer to public health department protocols,
e.g. disease clusters, cases and contacts with complex or extraordinary needs.

7. Confidentiality protocols

Identify and document protocols for maintaining confidentiality during contact tracing,
e.g., any requirements for storage of notes and data, and special considerations when
conducting contact tracing from home. Follow HIPAA regulations.

8. Notification and communication protocols

Identify which communication with contacts can be passive only (e.g. by web, email,
 text, or app interface), or, if resources allow, if all contacts will receive a phone call.
Determine protocols for cases and contacts who do not respond to texts or phone
calls (by risk level).
Consider campaigns to ask people to answer their phones and to engage honestly
with contact tracers.
Establish expected number of contact attempts and if/when in-person outreach to
cases and contacts will be attempted, with safety protocols in place (CDC
guidance).
Identify any other situations in which an in-person home visit may be required.
Determine protocol for in-person visits and incorporate PPE considerations for in-
person communications (CDC guidance).

9. Cross-jurisdictional protocol

Determine protocol for locating and notifying contacts outside of the jurisdiction in
cooperation with the jurisdiction where the contact resides.

10. Ports of entry protocol

Determine protocol for testing and tracing cases at ports of entry.

If border agents identify a case, identify which jurisdiction will be responsible for
care and tracing.

11. Social support protocol

Define wrap-around services to support individuals in isolation and quarantine and

determine eligibility criteria for the provision of wrap-around services. (See Social
Supports for more information)
What criteria are used to determine eligibility?
Who assesses for eligibility, e.g. link to Department of Human Services to
conduct?
What is the process for applying, approving, and connecting person to services?
Warmline for post-quarantine issues

12. Out-of-home isolation

 12.a Determine which cases will be offered isolation out-of-home, and if any will be
mandated.

12.b Determine which contacts will be offered quarantine out of home, and if any will
be mandated.

13. Telemedicine protocols

Arrange clinical linkage including telemedicine support. (See Clinical Consult for more
information)

Implementation Tools

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].

CDC: Health Departments: Interim Guidance on Developing a COVID-19 Case

Investigation & Contact Tracing Plan
Contact tracing workflow schematic
COVID-19 contact tracing steps
Investigation protocol for mass gatherings, e.g. public transportation, concerts, worship
services, weddings, funerals
Investigation protocol for congregate settings (residential), e.g. homeless shelters, jails,
prisons, group homes, crowded multi-generational housing
Investigation protocol for congregate settings (non-residential), e.g. schools,
workplaces
Investigation protocol for facilities that deliver health care, e.g. hospitals, nursing
homes, long-term care facilities, rehabilitation facilities, assisted living facilities,
personal care homes, memory care, inpatient hospice facilities, methadone clinics,
inpatient drug treatment facilities
Protocol for enforcing quarantine or isolation when mandated by law
CDC: Human Infection with 2019 Novel Coronavirus - Case Report Form
Case interview contact listing form (includes risk prioritization)
Draft contact monitoring form
Sample scripts
Massachusetts: Contact tracing scripts

LIVING DOCUMENT
This playbook is a dynamic, "living" document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Public health workforce
Checklist

1. Staffing needs and resources

Estimate staffing needs and resources for scaled contact tracing.

1.a Core contact tracing staff

Case Investigators
Contact Tracers
Contact Tracing Team Leads

Important parameters to consider:

Number of staff needed for case investigation. This includes: locating and
interviewing cases; determining infectious period; eliciting contacts;
providing instructions for isolation; referring to social/medical services.
Number of staff needed for contact notification. This includes: notifying
contacts about exposure; providing instructions about quarantine; referral
for testing; referral for social/medical/human services.
Number of staff needed for case and contact follow-up. This includes: daily
check-in; responding to questions; referral to services.
Number of staff needed to supervise/manage the contact tracing staff.
Consider current and projected needs; to ensure staffing will meet needs
throughout the local epidemic, use upper estimates.

1.b Additional workforce needs

Program Manager
Cluster Outbreak Investigators/Field Epidemiologists
Social Supports/Care Resource Managers
Data/Information Technology Managers
Isolation and Self-Quarantine Monitors
 High-Risk Medical Monitors
Clinical Consultants
“Runners” to deliver care package materials

Cluster and outbreak investigation workforce estimation:

Estimate number of clusters or outbreaks that may need to be investigated

and controlled simultaneously.
Consider current and projected needs; to ensure staffing will meet needs
throughout the local epidemic, use upper estimates.
Estimate the number of staff needed to investigate and control clusters and
outbreaks.
Multiply the expected number of clusters or outbreaks needing
simultaneous investigation and control by the number of investigators
per team (for example, three people per investigation team).
Consider redirecting existing Field Epidemiologists, or other contact
tracing and outbreak investigation and response staff, to fill this role.

Workforce estimation calculators:

Resolve to Save Lives: Contact tracing staffing calculator

George Washington Mullan Institute: Contact tracing workforce estimator

2. Current workforce assessment

Assess the current workforce available to fill contact tracing roles.

Understanding the human resources already available to support the surge contact
tracing workforce will inform hiring needs.
The workforce can come from a variety of existing sources and will depend on
available budget and hiring authority. Consider:
Public health professionals working in other areas of the health department or
in other private or organizations or public agencies may be available to
support
 Local, state and federal employees may be available for redirection
National guard or other volunteers may be interested in willing to support
contact tracing
Match knowledge and skills of individuals with key contact tracing roles and
provide training can support workforce expansion. In addition to specific health
public experience and expertise, look also at transferable skills when recruiting to
scale up contact tracing workforce.

3. Recruitment

3.a Identify the best personnel mechanism and recruitment processes to use for filling
each type of position (e.g., permanent employee, part-time employee, contractor,
volunteer).
Partnering with a private organization, such as a local university or non-profit
organization, to manage hiring and/or workforce operations may be quicker and
easier than doing this through health department mechanisms.
If working with a network of volunteers, ascertain their commitment to ensure a
reliable workforce; if reliable, consider leveraging their existing infrastructure for
personnel onboarding and management.
Consider how to handle staffing when contact tracing needs change, for example
using hourly wages and reserving the right to reduce or scale hours as needed.
See CDC staffing guidance for health departments.

3.b Identify or develop descriptions and qualifications for each position; write job
descriptions.

3.c. Identify or develop processes and tools for assessing applicant qualifications and
rating applicants.
Where available, adapt existing processes and tools.

3.d. Work with human resources to develop mechanism(s) for processing applications.

3.e. Implement recruitment processes.

4. Workforce onboarding and training

 4.a Identify or develop materials and processes for contact tracing staff orientation.
Include orientation to the organization, contact tracing in general, and to the
contact tracing program.

4.b Identify training needs to develop knowledge and skills required for each type of
contact tracing position.
Workforce training should explicitly include privacy protection training.

4.c Identify or develop training methods, curricula, tools and materials for each type of
contact tracing position.

Adapt existing training resources:

ASTHO: Making Contact: A Training for COVID-19 Contact Tracers

CDC: COVID-19 Contact Tracing Training Guidance and Resources
Johns Hopkins University: COVID-19 Contact Tracing (Coursera course)
Public Health Foundation’s TRAIN Learning Network: Catalog of COVID-19
contact tracing courses

5. Workforce management system

Establish management system for contact tracing staff.

5.a. Identify or develop protocols for each type of contact tracing position.

5.b. Identify or establish criteria, measures and expectations for evaluation of workers
in each type of contact tracing position.
Virtual coaching and mentoring are suggested to provide opportunities for
continuous quality improvement.

5.c. Identify or develop methods and systems for collecting data and producing
reports for worker evaluation.
Ensure the selected metrics are available for export and reporting in the tools
adopted for the contact tracing workflow.
6. Staff units

Organize core contact tracing staff into teams, as appropriate. A maximum of eight
team members plus a team leader is suggested.
Size of team recommendation is based on best practices for productive work
group sizes and to enable necessary oversight and support for contact tracing
team members.

7. Liability protections

Confirm that contact tracing staff have protections of civil servants including liability
protections, insurance and/or indemnity clauses.

Implementation Tools

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].

Workforce calculators
Resolve to Save Lives: Contact tracing staffing calculator
George Washington Mullan Institute: Contact tracing workforce estimator
CDC: COVID-19 Staffing Guidance for State, Tribal, Local, and Territorial Health
Departments
Training resources
ASTHO: Making Contact: A Training for COVID-19 Contact Tracers
CDC: COVID-19 Contact Tracing Training Guidance and Resources
Johns Hopkins University: COVID-19 Contact Tracing (Coursera course)
Public Health Foundation’s TRAIN Learning Network: Catalog of COVID-19 contact
tracing courses
Sample job descriptions
Program Director
Contact Tracing Team Lead
Case Investigator
Contact Tracer
Self-Isolation and Self-Quarantine Monitor
Care Resource Coordinator
Clinical Consultant
Sample contact tracing staff orientation and professional development materials
Sample contact tracing staff evaluation criteria, measures and expectations
Sample management materials (supervisory checklists, activities, indicators)
Sample scope of work for service provider contract

LIVING DOCUMENT
This playbook is a dynamic, "living" document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Technology solutions
Checklist

1. Existing workflows and infrastructure

Review existing workflows and infrastructure to identify where investments in new

technologies will be needed (versus where your current solution will be sufficient).
Workforce management
Case management
Automated alerts
Call center and triage
Symptom reporting for isolated cases and contacts

2. Case management system and case reporting

Establish a case management system and case reporting with the following features:

2.a: Automatic flagging and correcting of common errors in case reports

Technologies that enable patients to register electronically during or before their
visit to the lab will help ensure that data seen by contact tracers is accurate

2.b: Integration and processes to get data from providers directly

Probable cases, such as patients diagnosed based on clinical/epi criteria and who
were never tested or whose test results are pending, will enter the case
management system through this mechanism

2.c: Integration with state lab database

Ingest lab reports from the state-level database automatically to speed efficiency
of creating index cases
Auto-clean the data for duplicates and other criteria

2.d: Automatic flagging of what cases should be interviewed

Database and processes will need to handle patients getting tested more than
once, with multiple types of tests that mean different things, at many different
 locations

2.e: Prioritize cases

Data helps guide prioritization among positive patients. Examples of data useful
(beyond “test results negative vs positive) include:
Date of test
Type of test
Date of symptom onset (might not be available in lab data, but is helpful for
determining infectious period & original date of infection)
Other test results for the same patient
Other risk factors

2.f: Contact tracers have necessary access for outreach

Contact tracers need access to the database of cases to know who to reach out to.
This does not need to be the same database the health department uses.
If using separate systems, figure out how to get data from the department
database of cases into any database/technology being used by contact
tracers
Identify which of these databases is the “source of truth” on COVID-19 cases.
If it is the department database: develop a process or integration that
allows contact tracers to flag things that are “off” about COVID-19 patient
information, such as a disconnected phone number or an email that
bounces back, and ensure that information can be corrected in both the
database that contact tracers are using and the database being used by
the department for the tracking and management of COVID-19 cases.
Contact tracers need access to data for cases that allow them to perform their
functions.
Consider what other functions contact tracers are responsible for (such as,
assessing needs for social and clinical supports, delivering test results), and
ensure relevant data are accessible
Other risk factors

2.g: Budget
Plan for short-term setup costs
Plan for long-term contract costs for maintaining system
Consider choosing open-source tools to reduce long-term costs
3. Case interviews, contact elicitation and contact investigation

Consider using technology solutions to facilitate the process of case interviews,

contact elicitation and contact investigation.
Technology can deliver of COVID-19 test results and instruct positive patients on
which contacts to notify and how to notify them.
Technology to notify patients that an official person will contact them by phone
soon, to increase acceptance of calls.
Technology can facilitate case interviews and contact elicitation, by having cases
fill out an online form about their close contacts and recent activities and
prompting them to remember contacts or possible exposures.
Resolve to Save Lives is developing digital tools to facilitate rapidly finding
and sharing such contact information. More information on these products
and how to connect soon.

4. Contact prioritization and notification

Consider using technology solutions to facilitate the process of prioritizing and

notifying contacts.
Technology can help sort through and prioritize contacts based on risk. For
example:
Contacts with high risk of being infected
Contacts with high risk of infecting others
Contacts with high risk of developing serious illness
Technology can provide contact tracers with templates for outreach that they can
use for manual emailing or texting of contacts.
This can also be done by automatically alerting contacts using pre-set
templates (e.g. the software sends the text message rather than the contact
tracer using their own phone), or with automated (IVR) calls to contacts.
These interactions can be tracked or automated in a CRM (customer
relationship software such as Salesforce or Amazon Connect) or in your case
management platform, enabling contact tracers to easily see that status of
outreach to contacts.
Technology can help with connecting the contact to testing and/or care, by linking
to COVID-19 testing location finders or telemedicine services.
5. Contact follow-up

Consider using technology solutions for daily follow-up and monitoring of cases and
contacts during isolation or quarantine.
An increasing number of technologies are being developed to support this, such as
CommCare or Sara Alert.

6. Peer-to-peer contact notification

Consider using technology solutions for enabling patients to notify their own contacts
(if they know their identities).
Anonymous and confidential peer-to-peer mass partner notification systems
already exist for STDs and are beginning to be adapted to support COVID-19 peer-
to-peer notification (e.g., Tell Your Contacts).
Templates could make it easier to figure out what to say and automated
suggestions based on timing of test results and symptom onset could make it
easier to decide who to notify.
Technology could enable automated information distribution to contacts about
where/whether to get tested, symptom education and monitoring, guidance on
isolation/quarantine, and available support and services.

7. Recruiting and training of contact tracers

Consider using technology solutions for supporting rapid scaling up of the contact
tracing workforce, including for:

7.a Recruiting and selection

GC Talent Reserve (open source code) is one example of how governments
can use technology to recruit contact tracers who are already government
employees to fill emergency roles.

7.b Workforce training

Online learning platforms will help train the workforce
ASTHO: Making Contact: A Training for COVID-19 Contact Tracers is an
example of how technology can be used to rapidly train entry-level COVID-19
contact tracers.
8. Support people in isolation

Consider digital tools to help cases and contacts to isolate successfully and access
social services.
Websites and apps that connect to social services and support
Resolve to Save Lives is developing digital tools to provide isolation and
quarantine support. More information on these products and how to connect
soon.

9. Emerging Bluetooth technology solutions

Consider using Bluetooth technology solutions (i.e. "exposure notification" or "proximity

tracing") to automate portions of contact tracing, by notifying others who were in
proximity to the case during the infectious period.
For privacy purposes, this technology relies on a “double opt-in”, meaning that
both diagnosed and contacts would have to opt in to be traced or notified.
This technology has potential yet it is in its early stages. It is not recommended
that Bluetooth technology solutions replace traditional contact tracing work for
several reasons:
Coverage is limited to those who choose to participate.
Coverage will be biased, with lower adoption in vulnerable populations due to
language barriers and limited technology access.
Accurate proximity algorithms are still under development, and issues of false
positives and margins of error are unknown.
Ensuring privacy in practice (vs in theory) is unknown.

10. Data security and data privacy protections

Security protections need to be built into all technologies and processes. Each person
who has access to the system should only have access to the information that is
relevant to their particular role.
One technique to help ensure privacy is a log that shows every person who has
looked at any particular record. This can be audited, and anyone can ask for a
copy of their log record at any time.
Protections need to be even more stringent for frontend software of apps for use
by the public.
 Workforce training should explicitly include privacy protection training.
Explore if there are potential legal issues with integration to get data from
providers. A specialist lawyer may need to advise on whether EMR or labs or
coroners are allowed to share data directly with contract tracers under current law,
especially without consent from the patient.
Explore if there are legal issues around sharing information back to another
facility or feeding it into another database. There need to be strict protections that
limit how far the data can go.
Apply CDC’s Data Security and Confidentiality Guidelines to all technologies and
processes.

Implementation Tools

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].

Criteria for evaluating contact tracing apps to ensure privacy

CDC: Preliminary Criteria for the Evaluation of Digital Contact Tracing Tools for
COVID-19
Access Now: Privacy and public health: the dos and don’ts for COVID-19 contact
tracing apps
Data security and privacy guidelines
CDC: Data Security and Confidentiality Guidelines
Core privacy principles of contact tracing programs

US Digital Response (USDR)

The content in this checklist was adapted from the U.S. Digital Response
(USDR) Contact Tracing Playbook.
LIVING DOCUMENT
This playbook is a dynamic, "living" document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Case reporting
Checklist

1. Case reporting

Ensure timely and accurate reporting of all laboratory-confirmed and probable COVID-
19 cases. (See Technology solutions for more information.)
See CDC guidance on Reporting COVID-19 Laboratory Data
See CDC Case Report Form

1.a Ensure reporting system from public health laboratories is operational and meeting
timeliness standards.

1.b Ensure reporting from commercial laboratories and point-of-care testing is

operational and meeting timeliness standards.

1.c. Ensure reporting from providers is operational and meeting timeliness standards.
Consider connecting with health information exchanges to set up system for reporting
from providers.

1.d Ensure that case reports have complete data elements required for case
surveillance purposes, including follow-up with clinical providers where necessary to
obtain required information.

1.e. Ensure cases identified in other settings, e.g., at ports of entry, are fed into the case
management system.

2. Case management lab integration

Ensure case management system can accept all relevant laboratory results and
including contact information for the case, name of provider who ordered the test, and
name of facility that submitted the specimen.
Implementation Tools

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].

CDC: Reporting COVID-19 Laboratory Data

CDC: Human Infection with 2019 Novel Coronavirus - Case Report Form

LIVING DOCUMENT
This playbook is a dynamic, "living" document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Clinical consultation
Checklist

1. Policies for telemedicine

1.a Provide a telemedicine safety net for cases and contacts who not already have
access to virtual health care for the duration of isolation and quarantine.
Cases and contacts will receive basic resources to support symptom monitoring,
such as a digital thermometer. Some people may require symptom management
advice and clinical consultation services during the isolation and quarantine
periods.

1.b Determine eligibility for telemedicine services.

The telemedicine service should be available to cases and contacts without
medical insurance or who do not have a regular primary care provider offering
telephone or video access during the time of isolation or quarantine. Public health
should not pay for telemedicine services for individuals who already have access
to this type of service through their health insurance (e.g., Medicaid, Veteran’s,
commercial insurance).

2. Telemedicine service provider

Contract with a local medical care provider to provide telemedicine services for eligible
COVID-19 cases and contacts.
Depending on the number of individuals needing and qualifying for this service,
contracts with multiple medical care providers may be needed.
Some jurisdictions may have infrastructure already in place to provide
telemedicine consult via a nurse triage line, for example using public health nurses
with health assistants and others doing contact elicitation.

2.a Map medical service providers that already offer robust telemedicine services.
For potential service providers, assess the capacity for number of “visits,”
qualifications of medical providers, costs of services, mode of services (telephone,
 video, mobile application chat, etc.), and language capabilities.

2.b Select and contract with a provider that can rapidly and effectively provide
telemedicine services.

3. Linkage for cases and contacts

Ensure the link to telemedicine services is made for contacts and cases, as
appropriate.
Train contact tracing staff to assess a person’s eligibility for telemedicine services.
Contact tracing staff should provide instructions to people on accessing
telemedicine based on their eligibility.
Consider how to make clinical services available to those without telephonic or
video access (e.g., homeless population).
Consider including a referral process for medically complicated patients that goes
beyond provision of telemedicine services.
Forms and protocols used by contact tracing staff should include questions and
prompts to guide this process.

Implementation Tools

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].

Template scope of work

Eligibility criteria
LIVING DOCUMENT
This playbook is a dynamic, “living” document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Services to support people in isolation and
quarantine
Checklist

1. Budget

Determine available budget for provision of wrap-around services and social support;
prioritize resources and services that can be provided accordingly. Services and
resources should be prioritized based on the needs of cases and contacts.
Collaborate with Medicaid to identify potential funding sources for provision of
supports.
People with fewer resources historically should be prioritized to receive these
supports.

2. Support services

Determine the set of support services and resources that will be made available to
cases in isolation and contacts in quarantine.

2.a Core resources

For many cases and contacts, a brief interaction may be sufficient, including core
resources and hotline support for follow-up. The core resources for all cases and
contacts entering isolation and quarantine should include:
Daily check-in phone calls
Instructions on keeping space clean for those sharing space
A hotline for counseling, information, social services, and medical support
Health education materials
Other (as locally relevant)

2.b Care package

Cases and contacts in isolation and quarantine may require social supports for daily
living. The care package offered could include:
 Access to essentials, such as food, medications, laundry, and garbage removal
services
Access to telehealth and care if ill (See Clinical Consultation for more
information.)
Transportation and/or access to routine medical care or emergency care
Materials, such as a reliable thermometer, masks or face coverings, gloves, hand
sanitizers
Incentives, such as access to high-speed internet, passwords for on-demand
movies, e-books and learning channels, an encouraging note from the mayor
Other (as locally relevant):

2.c Financial support

Financial support may be needed to help those in quarantine and isolation to meet
basic needs:
Stipend from government to those without sick leave or who need to take care of
children or other vulnerable dependents
For people who are employed, work with their employers to provide support, with
possible tax credits

2.d Other supports

Other supports. Consider the provision of other supports that may be necessary to
enable people to adhere to isolation and quarantine requirements, including:
Health insurance navigation
Medicare/Medicaid assistance
Mental health services
Substance use services
Child care services
Transportation services
Housing assistance
Substitute caregivers (to fill in for the case/contact if they are acting as the
primary caregiver for anyone else)
Unemployment assistance
Legal assistance
Negotiation with employers and landlords
Small business support (for cases/contacts who are small business owners)

3. Eligibility criteria
 Determine eligibility criteria for the provision of social supports to cases.

3a. Eligibility for core resources

The core resources should be made available to all cases and contacts entering
isolation and quarantine.

3.b Eligibility for care package

The care package should be offered to cases and contacts entering isolation and
quarantine based on need.
Cases and contacts are eligible to receive the care package if they do not
otherwise have access to the goods or services offered (either they do not have the
financial means or cannot safely obtain the goods and services without putting
themselves or others at risk).
Jurisdictions with available resources may choose to offer the care package to all
cases and contacts.

3.c Eligibility for financial support.

Financial supports should be offered to cases and contacts who:
Cannot perform their jobs while in isolation or quarantine and whose employers
will not provide adequate paid sick leave
Are caregivers (for example, of children or elderly) and cannot provide their
caregiving services and do not have access to fill-in support while in isolation or
quarantine
Other (as locally relevant):

3.d Eligibility for other supports

Other supports should be offered on an as-needed basis to ensure that cases and
contacts can meet their basic needs and to minimize harm and suffering.

4. Support service providers

Contract with a local care coordination provider to facilitate social supports for
contacts in quarantine and cases in isolation.
Depending on the wraparound services and social support that will be provided
along with the landscape of potential service providers in the community, it may
be necessary to contract with more than one agency.
 Funding must cover staffing and resource needs, where these cannot be delivered
directly by the jurisdiction.

4.a Identify landscape of agencies or organizations that already work in the

community providing similar services. This may include health care providers or social
services providers, religious groups, food banks, etc.

4.b Select and contract with agencies or organizations that can rapidly and effectively
provide the needed wraparound services and social support.

5. Linkage for cases and contacts

Ensure the link to social support is made for contacts and cases, as appropriate.
Train contact tracing staff to assess an individual’s ability to isolate or quarantine
in a safe environment that provides the necessary support (private room and
bathroom, adequate food and water, and access to medication) and keeps them
away from high-risk individuals.
Contact tracing staff should link people with social support and wraparound
services based on their eligibility and interest receiving the supports.
During daily monitoring of cases and contacts, contact tracing staff should
reassess social support needs throughout quarantine and isolation periods.
Forms and protocols used by contact tracing staff should include questions and
prompts to guide this process.

Implementation Tools

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].
Template scope of work
Eligibility criteria

LIVING DOCUMENT
This playbook is a dynamic, “living” document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Facilities for out-of-home isolation and
quarantine
Checklist

1. Budget

Determine available budget and existing resources.

Cases and contacts who are at highest risk for not meeting basic needs in a way
that is safe for themselves or others should be prioritized to receive housing
support.

2. Alternative housing services

Determine alternative housing to support people in isolation or quarantine.

2.a For non-hospitalized cases. On a voluntary basis, alternative and safe housing,
with wraparound and social services, should be offered to all cases who:
live with elderly or other high-risk individual
are precariously housed
are unsheltered or homeless
live in group settings and are unable to maintain physical distance from others
otherwise cannot remain in their current residence
prefer to stay out-of-home
have fewer resources historically

2.b Relocation for contacts in quarantine. Consider offering alternative housing to

contacts entering quarantine who:
live with elderly or other high-risk individuals and are unable to maintain physical
distance from others
are precariously housed
are unsheltered or homeless
live in group settings and are unable to maintain physical distance from others
otherwise cannot remain in their current residence
 have fewer resources historically

3. Accommodation service provider

Contract with existing facilities, such as hotels, dormitories, or temporary housing

facilities (converted convention centers, schools, arenas, etc.) to provide safe
accommodation. Depending on need and size of available facilities, multiple contracts
may be required.
In some situations, there may be cultural norms around inter-generational living
that will preclude individuals from moving outside of their homes despite not
being able to isolate or quarantine safely. If relevant, consider instituting “cultural
brokers” that can work with those populations to develop plans that works for
them, such as video chats while living out-of-the-home.

3.a Develop protocols to prevent spread of infection within facilities.

Single-room occupancy for residents only
OSHA consultation and environmental control assessment
Cleaning protocols for common areas, including bathrooms
Separate exits/entrances for staff and residents; maintain a “safe” area for staff to
take breaks where residents cannot access
Keep confirmed cases, presumptive cases, and quarantined contacts separate
from each other.
Adequate personal protective equipment for staff and residents, including
sanitizers, masks or face coverings, gloves, alcohol-based disinfectants
Meals, clean bedding, and other essentials should be left outside of residents’
rooms; no group meals; no housecleaning services for individual rooms

4. Infection control

Contract with a company to manage infection control or hire infection control

personnel.
With numerous cases and potential cases residing in common facilities, infection
control is of the utmost importance to ensure infection does not spread within the
facilities (including to other residents or staff).
Consider contracting with a health care provider in the community or other
organization familiar with infection prevention and control protocols. If not
 available, explore existing or hire new infection control personnel.
See relevant guidance in CDC’s Interim Infection Prevention and Control
Recommendations for Patients with Suspected or Confirmed COVID-19 in
Healthcare Settings

5. Linkage for cases and contacts

Ensure the link to alternative housing is made for cases and contacts, as appropriate.
Train contact tracing staff to assess an individual’s ability to isolate or quarantine
at home in a way that is safe for them and others.
Contact tracing staff should link people with alternative housing services based on
their eligibility and interest.
People in alternative housing must also be linked to wraparound services and
other social supports, as appropriate.
Forms and protocols used by contact tracing staff should include questions and
prompts to guide this process.

Implementation Tools

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].

Template scope of work (facilities)

Template scope of work (infection prevention and control)
Sample infection prevention and control protocols
CDC: Interim Infection Prevention and Control Recommendations for Patients with
Suspected or Confirmed COVID-19 in Healthcare Settings
Eligibility criteria
LIVING DOCUMENT
This playbook is a dynamic, “living” document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Public communication
Checklist

1. Risk communication and community engagement

Develop a strategy for risk communication and community engagement to support a

successful contact tracing initiative.
Contact tracing can only succeed if people accept it as an effective measure and
participate when appropriate.
The SECURE framework, outlined below, offers an effective risk communication
and community engagement strategy. (See Vital Strategies Draft Communication
Guidance for COVID-19 Contact Tracing for more information)

1.a Support contact tracing corps and skilled contact tracers with training and other
needs.
Contact tracers need to be skilled, experienced, and well-trained for the risk
communication issues specific to COVID-19.
This will ensure that people who engage with contact tracers feel supported and
protected and receive empathetic, culturally appropriate engagement in an
accessible language.

1.b Engage community leaders.

Identify people that communities trust, build relationships with them, and enlist
them as validators of your contact tracing messages.
This may include faith and ethnic group leaders, community leaders, business
leaders, leaders within vulnerable populations, teachers, or public officials, among
others.
Jurisdictions should engage community leaders by:
Establishing a mechanism for feedback to refine messaging and tactics
Sharing communication plans and approaches
Sharing official fact sheets and other communication tools
Encouraging them to participate in press briefings
Encouraging and supporting them to share official public health notifications,
recommendations and other messages with their communities. Community
 leaders can use existing communication channels (such as social media and
email newsletters); new channels can be established as appropriate

1.c Conduct public information campaigns, using mass media, web sites and digital
media to explain contact tracing and its impact..
Engage journalists and consider journalist trainings to ensure journalists
understand the program and are reporting factual and timely information.
Use mass media and digital communication campaigns to build awareness on
how contact tracing is helping us all get to a better tomorrow.
Official health department social media handles, such as on Facebook, Twitter,
LinkedIn, among others, should be used to amplify messaging.
Consider communications campaigns that explain the contact tracing and testing
process and how personal information is protected.
Consider running an “answer your phone” campaign that shows the importance of
answering calls and engaging honestly with contact tracing staff.

1.d Use risk communication principles.

Express empathy often. COVID-19 is scary, and spokespeople should acknowledge
that. People may find it invasive to consider sharing information about who
they’ve been in contact with. Be sure to empathize with the public about the
downsides of contact tracing, while reminding people of the benefits to their
family, neighbors, friends and communities.
Communication that expresses empathy, is credible, provides anticipatory
guidance, promotes action, and shows respect will help build trust.

1.e Respect confidentiality.

Communication on every level needs to address and allay public concerns about
privacy and confidentiality.

1.f Evaluate and improve communication efforts

Assess what’s working and what’s not working to improve communication
messages and strategies.

2. Communications and notifications

2.a Determine messages and channels for relaying messages to cases, contacts and
health care providers.
 Support cases and contacts while in isolation and quarantine to ensure they have
the information needed to stay safe and adhere to public health
recommendations.
Share new information on the COVID-19 situation in the area.
Reiterate and update on health and safety recommendations.
Link to information sources, including official websites, press briefings and
hotline.
Consider using email or text messages for sharing messages (or digital apps
as relevant).
Provide fact sheets, FAQs and other educational resources
Target messages to specific audiences, including COVID-19 cases and contacts,
high-risk communities such as long-term care facilities and group homes, and
health care providers and hospitals.
Make materials available in multiple languages according to local needs.
Send notifications to health care providers when there are changes to procedures
or policies relating to provision of health care, laboratory testing, treatments, or
vaccines.

2.b Consider establishing messages and procedures for community notifications of

exposure.

3. Communication coordination

Establish a centralized mechanism to manage communication.

Depending on the size of the jurisdiction and communication needs, a small team
may be needed to support the various activities and coordinate with external
stakeholders (e.g., community leaders, media outlets).
The centralized mechanism should be linked with health department staff
responsible for monitoring and analyzing the epidemic science and situation. This
will ensure communications are accurate and up-to-date.

4. Advocacy Epidemiology

Develop a plan and materials for advocating for the necessary resources for a contact
tracing program.
 Prepare materials that make the case, and advocate for funding with policymakers
to support contact tracing activities.

Implementation tools:

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].

Vital Strategies: Draft Communication Guidance for COVID-19 Contact Tracing

Key messages
Communication and social media campaigns
Fact sheets
Guidance while in self-isolation and self-quarantine
Sample advocacy briefing for policymakers

LIVING DOCUMENT
This playbook is a dynamic, “living” document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
Metrics & monitoring
Checklist

1. Process indicators

Identify key monitoring and process indicators: (*key indicators)

Speed of contact tracing
*Percentage of cases notified and isolated within 24 hour of case report
*Percentage of contacts notified and quarantined within 24 hours of
elicitation
Proportion of contacts with symptoms evaluated within 24 hours of onset of
symptoms
Completeness of case investigation
Daily proportion of cases whose status has been evaluated
Proportion of cases with no contacts elicited
Completeness of contact tracing
Percentage of cases reached out of cases identified
Percentage of contacts reached out of contacts elicited from cases
Daily proportion of contacts whose status is evaluated
Completeness of testing
Percentage of contacts connected to clinical care and/or testing out of those
who develop symptoms

2. Outcome indicators

Identify key outcome indicators: (*key indicators)

Overall
*Percentage of all diagnosed cases in jurisdiction arising from contacts in
the contact tracing system, i.e., as proportion increases, it means we’re getting
better at capturing and containing exposure before it spreads further
Number needed to interview: number of cases interviewed in order to result in
one contact quarantined
Adherence to isolation or quarantine
*Percentage of contacts who complete their full quarantine period
 Of those who did not complete, proportion who tested positive for COVID-
19 (in jurisdictions where all contacts are tested)
*Percentage of cases who complete their full isolation period

3. Dashboard

Develop a dashboard aligned with IT system and consider how to align the dashboard
with case reporting and case surveillance systems:
Key outcome and process indicators
Total and current cases by status (awaiting outreach; outreach underway;
monitoring and support; closed)
By gender, age group, race/ethnicity
By county, neighborhood, ZIP code, or other meaningful geographic category
Reasons for closure of case (isolation completed; lost to follow-up; referred to
local health department; hospitalized; declined; was never reached; died)
Median number of contacts per case (for cases with at least one contact)
Percentage by risk category (if risk categories are being used)
Percentage by type (individual case; mass gathering; group setting; facility
with healthcare delivery)
Number/percentage of cases with no identifying information
Total and current contacts by status (awaiting outreach; outreach underway;
monitoring and support; closed)
Reasons for closure of contacts (quarantine completed; lost to follow-up; referred
to local health department; hospitalized; diagnosed with COVID-19; declined; was
never reached; died)
Percentage of total and current contacts by risk level (if risk levels are being used)
Staffing indicators
Percentage of positions currently recruited, hired, onboarded, trained by title
Any performance standards, i.e. monitoring calls, etc.
Technology/digital app indicators and data flow indicators, depending on if and
how technology is used
Telemedicine and connections to social support indicators
Communication and marketing indicators

4. Targets
 Set targets for key indicators, including timeliness of case and contact notification and
quarantine, in order to guide adjustments to policies and protocols.

Implementation tools

CALL FOR MATERIALS

The below tools are under development to support health departments in
implementing the steps in the checklist. If you have any of these materials and
would like to contribute to this playbook, please contact us at covid19-
[email protected].

Sample reports

LIVING DOCUMENT
This playbook is a dynamic, “living” document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].
About
About & contact us
Resolve to Save Lives is an initiative of Vital Strategies, a leading global public health
organization and a trusted partner of governments and civil society organizations around
the world.

We help governments strengthen their public health systems to contend with the most
important and difficult health challenges. We bring the best of public health thinking to
design solutions that can scale rapidly and improve lives.

The Prevent Epidemics team from Resolve to Save Lives is committed to making the world
safer from epidemics.

As COVID-19 spreads around the world, the Prevent Epidemics and Vital Strategies teams
serve as timely experts and honest brokers in supporting governments and civil society
organizations around the world in responding to the COVID-19 pandemic

Contact us

[email protected]

Privacy Policy

See our privacy policy at: https://resolvetosavelives.org/privacy

LIVING DOCUMENT
This playbook is a “living”, dynamic document. Global knowledge pertaining to
COVID-19 is rapidly evolving. Feedback and suggestions can be sent to covid19-
[email protected].