How a Michigan county is saving hundreds of hours of work while tracking high-risk COVID-19 contacts

The first person to test positive for COVID-19 in Ottawa County, Michigan, was in close contact with about 70 other people during the time they might have been infected. It fell to the local county health department to contact those 70 people and monitor their symptoms to ensure they didn’t become infected with the fast-spreading virus.

But Spencer Ballard, Environmental Health Supervisor at the department, realized that task would soon become impossible. The department nurses would need to call each person who came into contact with an infected individual every day for up to 14 days, or more in some situations, and each call would take about 10 minutes.

Ottawa County—Michigan’s eighth largest—boasts a rapidly-growing population of nearly 300,000. Ballard knew the number of people who tested positive for COVID-19 would grow exponentially, and the nurses charged with calling high-risk contacts still had their normal jobs to do.

So the department got to work putting together a solution on the Qualtrics XM platform they then linked with their own case management system. Instead of calling each person every day, the department nurses approach each close contact of a COVID-19 case and explain that they will receive a text or email from the health department every day for 14 days.

Cases and their close contacts have reported their daily status about 5,000 times, saving over 800 hours of staff time

Individuals then share their current health status and any developing symptoms. If they don’t respond for three days or they mention they’ve been experiencing symptoms for at least two days, the system triggers an action for one of the nurses to call that person and follow up.

“They just click the link, answer two questions with their thumb, and we have all the information we need to inform the next day of decision making,” Ballard said.

On the first day the system was live, 31 people responded. That saved 5 hours of staff time, Ballard added. Now about 370 people respond per day, and to date, cases and their close contacts have reported their daily health status about 5,000 times, saving over 800 hours of staff time. Other counties within the state have recruited volunteers or college students to make these calls, and some haven’t been able to track close contacts at all.

“Whatever they can do, they’re doing. But they’re overwhelmed for sure,” Ballard noted, adding that he’s grateful Ottawa County had a system in place early on to manage the load.

And as the Ottawa County health department tracks their close contacts, they’ve also been able to find several who developed the virus during the time they were monitored, Ballard said.

The daily query also goes out to those who have active cases of COVID-19 and asks similar questions about their symptoms, as well as an additional question about whether they’ve stayed in isolation. If a respondent says they’ve broken isolation, they’re given the opportunity to explain why.

“If it is a person that’s all by themselves and they say, ‘I left isolation because I had to get food or groceries,’ then we can follow up with that and link them to resources so they don’t leave their house,” said Addie Hambley, Environmental Health Manager at the department.

There’s just no way that they’d be able to do it if they had to call all of our contacts every day.

The department also uses Qualtrics CoreXM to manage staff that are working from home or experiencing symptoms, as well as canvas dozens of long-term care facilities to gauge the need for personal protective equipment (PPE) and other supplies. That information has allowed the county to minimize risks by sending in-demand PPE to the right places.

Qualtrics software enabled the county health department to begin prepared, Ballard said, especially since the workload is likely to grow exponentially.

“Our nurses, oh my gosh, they’re over the moon about it. Because there’s just no way that they’d be able to do it if they had to call all of our contacts every day. They just wouldn't be able to do it,” Hambley said.

In fact, many of the nurses envision using the same system for other cases moving forward.

“They’re like ‘Why didn’t we make this years ago?’” Ballard said.