ASU student part of contact-tracing team on Fort Apache reservation

An Arizona State University student spent his summer participating in a contact-tracing program that helped reduce the spread of COVID-10 and likely saved lives.

Grant Real Bird, a senior majoring in environmental resource management, worked as a contact tracer on the Fort Apache reservation in eastern Arizona, where he grew up. The job was part of an initiative by the Indian Health Service and the Johns Hopkins University Center for American Indian Health to aggressively reach out to White Mountain Apache community members and not only find people who might have the virus, but also those who were sick without realizing it. Those people could then be treated before their symptoms worsened.

The contact tracing teams included medical personnel and community members, such as Real Bird, who are well known and know the language.

The program, with a photograph of Real Bird, was featured in the New York Times on Aug. 13.

The work was sometimes difficult.

“It affected everyone in my community,” he said. “We had a curfew. But people were still breaking the rules and that was frustrating.

“It was causing a commotion so we talked to them and said, ‘Hey, you don’t want to endanger your loved ones like your grandma or your mother.’”

But it was a moving experience.

Grant Real Bird

“At the end of the day, I was helping my people, the Apache,” he said.

Real Bird, who is now back at the ASU Polytechnic campus, answered some questions from ASU Now:

Question: How did you come to be a contact tracer on the Fort Apache reservation?

Answer: I previously worked with Johns Hopkins during my freshman year. I met a physician there and I really enjoyed the program. She knew I was from the Apache community and knew that I knew people there. So she emailed me out of the blue in early May and said they had a contact-tracing position.

I saw how rough coronavirus was getting and I wanted to do anything to help.

I had an internship for the summer and was going to try to do both, but I ultimately chose the contact tracing because I knew it would be so critical in the fight against COVID.

Q: What was a typical day like?

A: It was very exciting work.

We went through training and we had to look inside a data set within Indian Health Service records.

We would start around 8 a.m., when we got our cases. We would look them up and call them. If we weren’t able to get ahold of them, we would look up their address and go out with a nurse or a pharmacist or a physician and visit them. We would see how they were doing and ask them questions about the past week – who have they seen and where have they gone?

We would give them bleach, masks, gloves and a cleaning bucket so they can properly clean their house. We also did welfare checks where we checked their vitals to see how they were doing; we would check their baseline symptoms, their temperature and use a pulse oximeter. We did five to 10 of those cases a day.

Q: Was it difficult to tell people that they tested positive?

A: Yes, especially some of the older folks. When you tell them, they have this look of shock on their faces.

Sometimes people were puzzled, sometimes devastated. I saw people cry. Some said they took all the precautions. Some people get angry or upset.

I understand because it’s a huge inconvenience to be quarantined and to worry about getting sick.

You have to break the news gently and ask if they have any questions. The nurse would ask about underlying conditions or if they were on blood thinners. Are they on dialysis? If they do have underlying conditions and meet certain criteria, such as being over 60, they’re placed on the high-risk list and at that point the doctor will do a home visit or call them.

Q: Did you help the contact-tracing teams find their way around?

A: A lot of them worked for Indian Health Service and they know the community, but at my rez, there are a lot of dirt roads and unmarked roads, and you can’t just punch something into Google maps.

I was an unofficial guide because I grew up there. Doing this job, I learned a lot about who lives where and what goes down. When you talk to people and find out who they’re related to, you’re able to find people in areas that you had no idea existed.

Q: The New York Times story described how people without symptoms turned out to be quite sick. Did you see that firsthand?

A: All the time. People would say, “I’m OK.” But it turned out that their oxygen level while sitting down was 87 or 84. And we had to tell them, “No, you need supplemental oxygen.”

We tried our best to get them to the ER because there’s a lot that can go wrong. They can get long-term brain damage.

It was very worrisome, especially if it was an elder. We told them right away, “You need to go to the ER,” and tried to do it in a way that didn’t scare them but that they knew it was not OK to have an oxygen level below 90 while sitting down.

Q: When you visited people who had tested positive, were you ever nervous about getting the virus?

A: Yes. When I was first on the job I had to test somebody under the supervision of a doctor. There were five people in the household and he said, “I’ll show you how to do it.” He taught me the procedure, how far back you go with the swab and how long you hold it. So I gowned up and had the N95 mask and a face shield and I inserted the swab into the guy’s nose.

And I felt scared that there could be a chance it could be positive. I thought, “What if he sneezed? I could get COVID all over me.”

But I took all the precautions. I stood to the side. If I got sneezed on, I would take off the gown and spray myself.

Q: Did you see a change over the summer?

A: Our (positive) case count went from 50 to 100 cases a day to the day when I left, we had no cases that day.

It couldn’t have been possible without the work of the doctors and nurses and pharmacists and physicians’ assistants and the contact-tracing team.

Everyone really stepped up and had this interdisciplinary work ethic where we all worked together.

Q: Did the experience change your perspective?

A: It’s had a huge impact on me. I’ve seen how hard people in health care work and how much they sacrifice.

I’ve definitely had an awakening of where I want to go in my career.

Being with the Indian Health Service, I saw how the registered nurses and physicians and physicians’ assistants worked. I also want to see what it’s like outside the reservation. I’d like to shadow a physician or volunteer at a hospital while I’m down here.

It’s hard to put into words how grateful I am for the work they’ve done. And I know I was part of it in terms of finding people and transferring specimens and helping out.

It was so great to see people working together toward a common goal, especially in a nation that’s so divided right now.

Top image by Pixabay