April 07, 2020
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Meet 2 ‘gumshoe detectives’ on the frontlines of the Maine CDC’s coronavirus fight

Troy R. Bennett | BDN
Troy R. Bennett | BDN
Maine Center for Disease Control Epidemiologists Sarah Bly (left) and Sara Robinson are two of the “gumshoe detectives” at the health agency investigating transmission of the COVID-19 virus.

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AUGUSTA, Maine — Sara Robinson is used to talking about the new coronavirus all day and sometimes into the night.

Robinson, the program manager of Maine CDC’s infectious disease epidemiology unit, said in a Thursday interview that she got a call recently from a patient at 12:30 a.m., worried they were not doing enough to protect their friends and family from infection. Other times it is emergency rooms looking for guidance on a patient. Calls can come as late as 2 a.m.

“You never know what keeps people up at night,” she said.

As coronavirus cases increase across the state, epidemiologists including Robinson and her team face the critical task of tracking the virus, known as COVID-19, and figuring out where it might go next. The information they gather can make the difference in how fast the virus spreads by making Mainers aware of whether they need to take precautions.

 

[Here’s what to do if you think you have coronavirus symptoms]

Maine CDC Director Nirav Shah, the public face of the state’s coronavirus fight, calls them the “gumshoe detectives” of the department. Their work is equal parts clinical and intimate, balancing the need to get as much detailed information as possible from their subjects while comforting them and giving them advice on keeping their loved ones safe.

The state reported 52 positive tests for the virus on Thursday, just a week after Maine announced its first confirmed case. Before the outbreak, state epidemiologists tracked foodborne diseases, vaccine-preventable diseases and tick-borne illnesses. Robinson said her team has been split in half to focus on the virus and not lose sight of other duties.

Though the coronavirus afflicting the state is new, state epidemiologist Sarah Bly said the process — formally called “contact tracing” — is the same. Bly starts by contacting a patient’s health care provider for more information before interviewing the patient. It is generally the patient’s provider who advises a person to self-isolate if they believe a person could be sick.

Her timeline begins two days before their symptoms started — what she called the “infectious period” — until the time they self-isolated. The federal CDC says some spread of the virus can occur during this time, but people are thought to be most contagious when symptomatic.

[Not all who want to get a coronavirus test can. Here’s why, and what to do if you can’t.]

Bly tries to get as much information as she can, asking who patients were in contact with and where they went. People often stay in touch as they recover.

“One of the best things about this job is that I get to listen to people’s stories,” she said. “So I say, ‘Tell me what you’ve been doing, tell me where you’ve been. It’s really just, I want them to just tell me about their life.”

Depending on what they say, Bly follows up with employers or places a patient has visited and makes recommendations as to what they can do to protect themselves. Investigations rarely end on a defined point, Robinson said.

“The fun part about investigations is that it’s always evolving,” she said. “Somebody will remember two days later, ‘I forgot that I went out to dinner with somebody else.’”

The work can be arduous and, as Robinson’s late-night calls demonstrate, difficult to walk away from. Bly said she tries to unplug from the news when she goes home, avoiding things that “may keep me up at night,” although she is available for phone calls if necessary.

That sense of flexibility and teamwork is crucial to getting through the days, Robinson said. Whenever she needs a “little happiness,” she turns to “Janelle,” a pastel-blue “emotional support” jellyfish knitted by a co-worker. It hangs from a corner of her desk.

Though Robinson and Bly have experience in tracking down the origin of contagions, they said it’s too soon to draw patterns or to project how the virus will play out in Maine. Robinson said they have started seeing household clusters. Shah has said community transmission is occurring in Cumberland County, where the majority of cases have been reported.

For areas including Hancock and Penobscot counties, which saw cases for the first time this week, there is not enough information to draw conclusions yet, Robinson said.

“We’ve had the flu around for a very long time and we still don’t know what it’s going to do as a season,” she said. “This is also a relatively new thing and I think we need to be prepared.”

Watch: Symptoms of the coronavirus disease


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