Open and honest communication is currently one of the most invaluable tools we have to slow the spread of Covid-19, experts say: Promptly notifying those around you if you test positive helps others know if they need to quarantine, alter their social behaviors, and get tested. But the protocol for sending out this kind of alert isn’t always so clear. How do you know when to start notifying people — after you test positive or the second you have a scratchy throat? Who needs to know? And what’s a contact tracer’s role in all of this? Here’s what the experts say about whom you should notify — and when — if you test positive for Covid-19 or are experiencing Covid-like symptoms.
When should you say something?
If you test positive for Covid-19, it’s crucial to quickly inform those with whom you’ve had (masked or unmasked) contact. But should you really wait for an official diagnosis to make those calls and send those texts? Or should you start even sooner, when you feel symptoms associated with Covid? While more disclosure is generally better than less, cold and flu season is complicating matters because it’s hard to tell which illness you may be coming down with. “It will be important not to freak each other out at every turn,” says Kumi Smith, PhD, an assistant professor of epidemiology and community health at the University of Minnesota. “My personal practice would be, if I’m reaching a point where I am considering getting a test, then that’s when I’d start to let people know.”
That said, other experts prefer earlier action, like Susie Welty, an academic program manager and contact tracing expert at UCSF: “I’d recommend letting your close contacts know as soon as you start to feel symptoms. Whether it’s Covid or the flu, it doesn’t really matter. They’re both infectious and you should act the same either way.”
Whom to notify
If you test positive or start feeling ill, Smith says, “The first thing to remember is not to panic and not to blame yourself or feel guilty. This is a very contagious virus and it spreads in ways that we just aren’t prepared for. There’s a lot that is out of our control.”
After you’ve self-isolated, put together a list of everyone who needs to be contacted. According to Welty, the time frame you need to consider begins 48 hours before you first started showing symptoms. Or, if you were asymptomatic at the time of being tested, go back 48 hours before the positive test. Contact anyone who you were less than six feet apart from, (masked or unmasked) for approximately 15 minutes or longer. “That doesn’t have to mean talking — just close contact,” she says. “And it doesn’t have to be a consecutive 15 minutes. It can be over the course of a day.” Intimate partners, household members, and anyone whom you’ve shared utensils with should always be promptly notified.
People who you’ve been around who you don’t know personally (waiters, grocery store clerks, uber drivers, etc.) fall into a gray area. Welty says contact tracers won’t typically notify these types of contacts because interactions are typically brief enough that their risk of infection remains quite low. That being said, some social establishments (like restaurants) are being diligent about collecting patrons’ contact information for this exact reason. If you want to be extra cautious and considerate, Smith says it wouldn’t hurt to give the places you’ve been to a call to tell them you tested positive. If they have contact information for customers who were there around the same time, they can notify them.
As uncomfortable as these conversations may be, being transparent about your diagnosis is crucial not only to the health and well-being of those closest to you but to their loved ones as well.
What to expect from case investigators and contact tracers
On average, you should expect to get a call from a case investigator within 24 hours of receiving a positive diagnosis. However, the scope of contact tracing programs varies dramatically throughout the country. If your local health department’s program is limited or your area is currently experiencing a surge in cases, it may take longer for someone to get in touch. A quick reminder: “Anyone who asks for your social security number or any kind of insurance information or anything related to personal details beyond your health status and date of birth is most likely a scam,” Welty says.
You can expect them to ask about your symptoms, if you’re getting the treatment you need, and whom you’ve been in close contact with. “You’ll give those names over and that will be handed off to the contract tracing team,” Welty says. Then, they’ll reach out to those people to tell them they’ve been exposed and should quarantine and will give them whatever the testing guidelines are needed,” Welty says. (Contact tracers will protect your identity, though Welty says that many contacts can figure it out for themselves.)
While contact tracers can break the initial news to the contacts you provide them with, you will be able to notify your friends, family, and co-workers faster than a contact tracer is able to. You also will not be informed as to who a contact tracer has or has not been able to get in touch with, so if you want to be 100% sure, it may be best to alert them yourself. “Contact tracers are having to prioritize and triage cases. They also have to do it only during working hours,” says Smith. “The sooner people know, the sooner they can alter their behaviors and make decisions informed by your current status.”
How to actually share the news
Notifying people about a positive Covid-19 diagnosis can come with a sense of shame and fear of how they may react. To this, Smith offers an important reminder: “I don’t think we should see this as a personal or moral failing but rather a public health responsibility that reminds us that we’re all in this together.”
When sharing the news, Smith recommends using language like, “‘I don’t know that I necessarily gave it to anyone, but I care about your health and I want to make sure that you and I don’t end up becoming part of a transmission chain that we don’t otherwise stop. And so for that reason, I’m giving you a call.’”
As uncomfortable as these conversations may be, being transparent about your diagnosis is crucial not only to the health and well-being of those closest to you but to their loved ones as well. “If someone is about to go visit with an elderly family member and they knew that you just tested positive, then they might change their plans,” Smith says. “The more we can communicate with each other openly and without public shaming or rejection the better. You can’t predict what your friends will do, but you can do your best to protect any future contacts that your friends will have.”