Contact tracing and communication during a global pandemic

I was finishing my third year of medical school in March 2020 when everything changed. One day I was in a large lecture hall learning about medication reconciliation, and the next day all classes had been canceled. Clinical rotations were canceled; licensing exams were canceled. I was training to be a physician in the midst of a pandemic and felt helpless knowing I could not care for the many people facing dire circumstances.

Then I began contact tracing.

In April 2020, I learned that the San Francisco Department of Public Health was recruiting medical students to help with contact tracing. By the next week, I was conducting my first contact tracing interview. The man who answered the phone was skeptical and distant at first—to him, I was a faceless stranger calling with concerning news. As we spoke, however, his guard began to melt away.

I shared that we were there to support him and offer assistance however possible. We were there to help him, his loved ones, and his community stay safe.

He said he was scared. He was worried for his children; he was worried for his parents. He was working two jobs and was afraid he would be fired if he quarantined. He was afraid he would not be able to provide food for his family. As we discussed potential solutions and resources, I was reminded of prior clinical encounters with patients. In our short time, through open communication, we formed a type of therapeutic alliance based on trust.

I learned so much from the people I spoke with during my year as a contact tracer. I saw the many different ways that the social determinants of health shape our realities. When I began the Master of Science in Global Health program at UCSF, I was fortunate to meet incredible teachers and mentors who offered me the opportunity to explore the social determinants of health from different perspectives. I learned about the complex systems underlying the health inequities I witnessed while contact tracing, conducting COVID-19 outreach calls, and engaging in clinical rotations.

At the same time, I learned to recognize and evaluate potential points of intervention. With each contact tracing session, I saw the important role of communication and language firsthand. Through my capstone project, I am now studying the impact of language concordance—contact tracer fluency in a contact’s primary language—on contact tracing outcomes. Under the mentorship of Michael Reid, MD, MPH, MA, and Alden Blair, PhD, MSc, through the UCSF Pandemic Initiative for Equity and Action, I am evaluating the impact of language concordance on the likelihood of contact tracing interview completion, COVID-19 testing, and utilization of isolation and quarantine support services among adults who speak Spanish as a primary language in San Francisco.

As I prepare to return to my final year of medical school, I am grateful for the people I have met, the stories I have heard, and the perspectives I have gained over the past year. Whether caring for patients, conducting research, or volunteering in the community, I will continue to search for ways to address the social determinants of health and further our efforts toward health equity.