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IFHS Clinic Becomes One Of Two Community Health Centers In Alaska To Support Contact Tracing Efforts

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Unalaska's clinic is one of two community health centers in the state now involved in contact tracing efforts.

According to Melanee Tiura, chief executive officer of Iliuliuk Family and Health Services, six members of the clinic team — including herself — signed an agreement through the Alaska Primary Care Association to become contact tracers through the state. The IFHS team went live with contact tracing on Thursday.

"Since the pandemic began, our clinic has been doing some level of contact tracing informally with our patients, for our patients, and for the community," Tiura said. "In the last month, we've been working with the State of Alaska as they're building their capacity for their contact tracing program. They were asking community health centers if they wanted to be a part of it, and two [centers] in the state, including us, did say that we wanted the training and wanted to be a part of that process." 

Tiura said the team had 20 hours of virtual training, including time to observe and learn the documentation process, which she said is nothing new for clinic staff. 

"If we have a patient with tuberculosis or another infectious disease, this process is natural in healthcare — figuring out the source and figuring out the window of when they were contagious," she said. "It's a formal structure around COVID, because so many cases have happened at the same time. But again, it's not a new process. Just a few new details specific to this particular virus." 

The team's primary focus, according to Tiura, will be on COVID-19 cases identified within Unalaska and the greater Aleutian region, but at times they may also assist with other outbreaks in the state.

Tiura said the contact tracing process is about trying to evaluate where an infected person has been, who they may have come into contact with, and who they may have exposed to the coronavirus, to let those people know what steps need to be taken. Any identifying information is kept private, as it's protected under HIPAA privacy guidelines. 

"People will never know who may have exposed them," Tiura said. "The 'index case,' as it's called, the positive person is very protected in the process. But we're really just trying to figure out if there are exposures, how we can get those individuals tested and isolated so that we don't have community spread."

The contacts at risk, Tiura said, are people that have been within six feet of the infected person for more than 15 minutes over the course of the time that person may have been contagious. She said the contagious period can be a bit tricky to figure out, especially since many cases are asymptomatic.

"It's been interesting for patients to think through where they've been or who they've been in contact with," said Tiura. "I don't think we realize just how social we are, from visiting with neighbors to how much time they spent at a grocery store or workplace, or even how close their workspace might be to their co-workers'. Just thinking through all of those pieces can be difficult. We really do come into contact with a lot of people." 

As of Tuesday, the City of Unalaska hasn't reported a positive case of COVID-19 in the community in nearly a month, and none of the 103 positive cases reported since late May are attributed to community spread. 

Tiura said the biggest thing that's protecting the island from community spread of the virus is that people are adhering to the city's 14-day quarantine requirement. She said that contact tracing is another formal step the clinic and city are taking to reduce risk.

"I think what we've done so far is not sustainable for the long haul. I completely get it," she said. "But it's worked so well for us. Now that schools have been open for their seventh week — it's a testament to the fact that we're doing it and it's working." 

Tiura did not say how many contact tracing cases the clinic team has been formally involved in so far. 

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