Sample Script for Calling a Case-Patient (Positive with Covid)

1. Start the conversation:

“Hello, my name is ______________ and I am calling from the [Specified] Department of

Health. Could I please speak with name of case-patient?”

2. Explain the purpose of the call:

“I’m calling to collect some follow-up information regarding your recent lab test result.
Before we begin, I just want to confirm your date of birth and address, could you share
those with me?”
• If yes, just confirm.
• If hesitant, give them a piece of the information you have so that they can provide the rest
such as the year of birth or town of residency.
• If still hesitant explain that this call is part of efforts to control the spread of COVID-19.
“All of the information we talk about will be kept confidential and only people who need
to know will have access to it. The information is only used to help us stop the spread of
COVID-19 and make sure you are healthy. Everything is entered into a highly protected
data base. Is it ok if I continue?”

3. Ask if they know their diagnosis:

• Determine if they have already been told they have COVID-19, and what their health
care provider already told them. If not, inform them of the result that their SARS-
CoV-2 test (from xx/xx date) came back positive, indicating infection with this virus.
Be sure to pause for a moment to let them process the information and validate the
feeling they may express before proceeding.

4. Explain the next steps:

“I would like now to follow up on your diagnosis with COVID-19. I also want to go over
next steps in taking care of yourself and preventing infection in others. I will ask a number
of questions to get all the information that is needed to best determine how we can help you.
Questions I will ask will cover some basic information about you, any symptoms you have,
exposures you may have had before becoming sick, and contacts you may have had since
you became sick. Is now a good time to talk? This is a very important part of stopping the
spread of the virus, and I appreciate your time and help to do this. What questions do you
have at this point?”

• If now is a good time, continue with the interview.

• Try to get the case-patient to do the interview while you have them on the line. If that is not
possible, schedule a time that works for the case-patient or surrogate, and call them back
then.
5. Start the interview:

“Thank you. We will get started. Feel free to stop me at any time with questions or if you
need to get off the phone.”
• Start interview.
• If interview questions are being answered by a surrogate record the surrogate’s
relationship to the case patient.

6. Conduct interview, covering areas in the case form including:

“I would like to tell you how COVID-19 spreads. It is spread through close contact with a
person who is infected with the virus that causes COVID-19. Sometimes it is spread for a
short time through the air when an infected person coughs or sneezes.”

“Have you had any symptoms of COVID-19? If yes: I will go through a list of symptoms so
you can tell me if you have had them recently. “

“I will now ask what dates each symptom started.”

“Do you have a health care provider?”

“Where was your test done and what date was it done?”

“Do you have any other current medical conditions?”

7. Identify close contacts:

Complete a systematic review of household, work, social contacts, beginning 48 hours

prior to symptom onset. Identify congregate settings, mass gatherings, and facilities that
provide healthcare where expanded follow up may be needed. Discuss contacts with the
case, identifying definite and possible close contacts and information about the
circumstances of that contact (date, location, duration, etc.). Names, phone numbers,
addresses, social media handles and other relevant information about these contacts
should be collected.

“I want to assure you that we will not release your name to your contacts, and you are
not required to personally notify them of their potential exposure. It is very important to
let your household contacts know that they should stay home and quarantine for 14 days
from the date of their last exposure to you.

We would like to collect information on anyone who you have been in close contact
(within six feet for most than 10 minutes) or in proximate contact with (more than six feet
but within an enclosed space for one hour or more), beginning two days prior to your
onset of illness (or diagnosis/test date) and up until you started self-isolation. We are
particularly interested in learning about anyone who is a household contact, those over
65, immunocompromised, or those living or working in a congregate setting serving a
vulnerable population (i.e., healthcare facility, shelter, or jail). We will reach out to your
 contacts to notify and follow up with them. Your name will not be released to your
contacts.”

Let’s start with people who live with you. Please tell me the names of people who have
been living with you beginning 48 hours before you started feeling sick [or 10 days before
you were tested if case is asymptomatic] until today. {gets names, asks for contact
information, ask if they work outside of the home and what sort of work they do}. It is
very important to let your household contacts know that you are sick and that we will be
following up with them shortly.

Now let’s turn our attention to where you were 48 hours before you became sick. Again, I
want to assure you that we will not release your name to your contacts, and you are not
required to personally notify them of their potential exposure. Did you work outside of the
home at this time? If so, please tell me about any coworkers you worked with those days
{get names, ask about close and proximate contact, date of contact, ask for contact
information of close and proximate contacts}.

Were you anyplace else within 48 hours of becoming sick [or 10 days before you were
tested if case is asymptomatic] until today? If so, can you tell me about the places you
went and who you were with {get names, ask about close and proximate contact, date of
contact, ask for contact information of close contacts}.

Finally, did anyone visit your home within 48 hours of becoming sick [or were tested if
case is asymptomatic] until today? {get names, ask about close and proximate contact,
date of contact, ask for contact information of close contacts}. Please look at your
calendar, emails, or text messages to help jog your memory.”

Other prompts that can help, if appropriate:

• “Did you go grocery shopping? Run any errands? Meet up with any friends? Stop at
a coffee shop, gas station, bank, childcare. Did you go to church? A healthcare
facility?”
• If yes, for each, ask about how they got there (i.e. public transportation, or if a car,
was anyone in the car with them).
• You can also probe by time: “tell me about what you did 2 days before symptom
onset: morning/afternoon/evening. Then 1 day before symptom onset:
morning/afternoon/evening, etc.”

8. Review isolation and monitoring requirements, and appropriateness of setting

“Since you are positive for COVID-19 it is very important that you stay at home and
distance yourself from others so that you don’t pass on the infection to anyone else. So,
you will be required to isolate, that means stay at home until you are fever free for 3
days and 10 days after your symptoms first appeared. You will also be required to
monitor your symptoms for all the days you are in isolation. Being in isolation is a legal
requirement and your local health department will issue a legal isolation order to you.
Do you agree to allow us to send you the isolation order by email? By accepting the
order this way, you are allowing health officials to spend more time focusing on slowing
the spread of the virus.”

If the person pushes back or refuses isolation, refer the case-patient to a Community
Support Specialist.

“Now I am going to discuss how you should self-isolate to protect others in your
household from exposure. You should:

• Stay in one room away from others, as much as possible. It is particularly important
to stay away from people who are at higher risk of serious illness, such as those who
have underlying medical conditions, are immunosuppressed, are over 60 years of age
or are pregnant. We can discuss alternate living arrangements for you or them if
needed.
• Use a separate bathroom. If this is not possible, clean the bathroom after every use.
All the bathrooms should have a working sink, soap, and paper towels. Do not use
cloth towels, and never share towels with others.
• Stay at least 6 feet from others and wear a facemask if you are around others.
Ideally, there should be a door that always separates you from others.
• Sleep in a private room with the door closed.
• Have food prepared by others and delivered to your door. Use disposable eating
utensils if possible.
• Bag any garbage and leave it outside your door for pick up. It can be put in regular
trash bin.
• Have someone else take care of your pets if possible.
• You may need to have someone else do your laundry.
o Wear gloves if handling the laundry of a sick person. (If no gloves are used
when handling dirty laundry, be sure to wash or sanitize hands afterwards.)
o If possible, do not shake dirty laundry. This will minimize the possibility of
dispersing virus through the air.
o Launder items as appropriate in accordance with the manufacturer’s
instructions. If possible, launder items using the warmest appropriate water
setting for the items and dry items completely. Dirty laundry from an ill
person can be washed with other people’s items.
o Clean and disinfect clothes hampers according to guidance above for
surfaces. If possible, consider placing a bag liner that is either disposable (can
be thrown away) or can be laundered.

• Prohibit visitors who do not have an essential need to be in the home.”

“You are allowed to walk outside of your house on your property, but you should remain
six feet away from others and wear a mask. You should not leave your property, home or
apartment except to get medical care. Do not visit public areas.”
Now I am going to ask you questions about where you live.

• “Please describe the place where you are currently living.”

 • “Are you able to isolate yourself at home (or designated temporary housing) away
from other household members for at least ten days and until symptoms clear?”
• “What other persons and pets currently are living with you?”
• “Is there a way you can live in a separated part of your home during this time?”
• “Is there a door that separates this part of the house from others?”
• “Can you use a separate bathroom from other members of the household?”
• “Is where you live safe from intruders?”
• “Are there shared common areas in the house or apartment?”
• “Do you need to use the same kitchen as other? Can food be brought to you?”

“Please let me know if you have any concerns about being able to isolate. It is important
that we work together to prevent the spread of illness. How do you feel about these
guidelines? Do you anticipate any challenges in following these guidelines?”
If you have concerns about housing for this case-patient refer the person for assistance,
per your local health department protocols.

9. Review plans for monitoring

“As I said, you need to be monitored during the time you will be on isolation. We will be
calling you daily for the next _______ days and will ask about how you are doing, your
temperature, any symptoms and any needs. Do you have a working thermometer?”

(Provide chart for monitoring symptoms and temperature twice daily.) If they do not
have a thermometer, arrangements need to be made to get them one. Notify the
Community Support Specialist.

10. Assess need for social supports and medical care

“As we discussed, you will need to isolate for at least 10 days from when you started to
feel sick. Because you will not be able to go out in public, I want to ask if you think that
you will need help with supplies or resources during this time. For example, it is important
that you have enough food to last until at least next week. Will you need any medications
delivered to you? Do you have enough cleaning or household supplies available? Do you
need any assistance taking care of your pets or children for whom you are the primary
caregiver? Do you need a caregiver to help you with your daily activities?
You may be able to identify a friend, neighbor or family member who can assist you, but if
not, please let me know as soon as possible if you need help. You can reach me to talk
about any additional needs that you may have.
Please let me know if you feel unsafe in your home, now or in at any point during your
home isolation.
Being infected with COVID-19, being in isolation for many days, and all that goes with it is
a very trying experience. We can also arrange for you to talk with a trained professional
if you are feeling anxious or depressed.”
 If the case-patient expressed concerns about meeting their needs or you have concerns
about this case-patient, refer them to the Community Support Specialist.

11. Explain what to do if condition worsens

“I am glad that you feel well enough to be home at this time. However, I want to be sure
we have a plan in case you start to feel worse and think you need to see a doctor. If you
feel that you need immediate emergency medical care, do not hesitate to call _______
(local emergency number). In addition to telling the operator about your emergency, you
should tell the operator that you have been diagnosed with COVID-19. Some signs of an
emergency include:
• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Bluish lips or face
• Bad injury or other emergencies not related to COVID-19”

“Do you have a health care provider? And do you know how or are you able to get in
touch with him or her? Do you have health insurance?”

If yes:
“If you do not feel well, but feel that you do not need immediate emergency medical care,
please call your primary care physician or the XXXX health department to discuss changes
to your health.”

If no:
“I am going to refer you to a Community Support Specialist who can help you find health
care, insurance coverage, or care without a charge.”

If you have concerns about this case-patient, refer them to the Community Support
Specialist.

12. Interview the household contacts immediately, if possible.

• Use the contact tracing interview process.

13. End interview

End interview with “Thank you very much for your time. The information you’ve shared is
very helpful in keeping you safe, protecting those around you, and understanding the
disease. Do you have any questions for me?” Arrange for ideal time of day for monitoring
call? And say when will you call back for monitoring next. Maybe add, if you have any
questions between now and when I talk to you tomorrow, here is a number you can call
or a website with the info we just discussed, etc.
End call.