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Security threats in the District have interrupted the lives of countless residents. Law enforcement officials are asking some residents of Capitol Hill to show identification before entering their homes, while numerous businesses all across the city have temporarily closed. National Guard members are stationed as far north as Malcolm X Park.
The impact of the Capitol insurrection on Jan. 6 has reached D.C.’s most vulnerable residents. Safety and logistical concerns related to Inauguration Day led DC Health to cancel home visits to residents who test positive for COVID-19 for at least three days, City Paper has learned. A team of 16 contact tracers that visit dozens of residents homes every weekday because they aren’t responsive by phone won’t perform their usual responsibilities on Tuesday, Jan. 19, or Wednesday, Jan. 20. Home visits were also canceled Friday, Jan. 15. These contact tracers, at times, tell residents they tested positive for COVID-19 or that they are a close contact of someone who has tested positive. They also connect them to resources like food, housing, and unemployment. These are residents who are difficult to reach—some aren’t native English speakers and others may have disabilities.
Contact tracing is one of the best tools public health officials have to slow the spread of the coronavirus. But with contact tracing, time is of the essence. The District’s public safety emergency following the attack on the U.S. Capitol could exacerbate the public health emergency declared over the coronavirus pandemic that’s so far killed 857 D.C. residents. The District is in the midst of the worst days of the pandemic, setting daily records for new cases in December and January.
“Some months ago, we were making about three, four visits a day. Now it can be as many as nine or ten,” says a contact tracer who makes home visits. (The contact tracer requested anonymity because a colleague had reportedly been fired for speaking publicly about working conditions.)
“It’s annoying I had to take a bus across town the other day and it was almost impossible to do. But this is truly galling,” they add. “I don’t blame DC Health for that decision. It makes sense. This is going back to the galling way in which this violence has impacted D.C. residents.”
DC Health confirms that home visits are canceled through Inauguration Day, but did not directly fault the inauguration, as the two contract tracers that City Paper interviewed did. “Home visits are paused through January 20 due to scheduled trainings, other contact tracing duties, and heightened security/street closures near our building/safety considerations,” a spokesperson writes via email.
The two contact tracers that City Paper spoke with learned that the inauguration would impact their work last week, when a supervisor told staff they wouldn’t be able to make home visits due to safety and logistical concerns. DC Health is headquartered at 899 North Capitol St. NE, a block outside the secured perimeter established by the Secret Service for Inauguration Day. While they spend most of their time outside the 4.6 square miles currently under militarized security, contact tracers report to headquarters to pick up materials and return their government cars. Believing they couldn’t guarantee the safety of their workers once they returned to the office, which is less than a mile from the Capitol, management called off home visits, according to the contact tracers.
“I didn’t sign up for easy days,” says one contact tracer. “But I do know some of my colleagues do not feel the same way at all and they are genuinely scared to leave their houses at the moment.”
“I don’t know what the safety issue is. It’s probably the safest city in the world right now. We got 20,000 troops here,” says another contact tracer who also requested anonymity out of fear of retaliation. “The bigger issue is the logistics of maneuvering around the city. But that leaves a certain amount of people who can be positive but don’t know they are because they haven’t been informed by us.”
When thinking of DC Health pausing home visits, the contact tracers recall some of the residents they all were able to reach over the past few months. There was a woman who had no idea she tested positive because contact tracers had been calling the phone number of her deceased husband. Contact tracers had to order five tests to her household because she may have gotten her family sick. They also worry about the residents DC Health will now delay delivering care, which is not always related to COVID-19.
“A lot of this is just data clean up and helping people get connected,” says one of the contact tracers. “But we are also encountering these cases of people who are in dire straits with no one to speak on their behalf, no one going to check in on them, and fortunately we are there and we can actually fill that hole at the moment.”
Contact tracers are not delivering any of the care, but do facilitate it through other government agencies. Each day they don’t work, they get further behind on investigating cases, and this slows down the process of getting services to residents. “Urgency is the utmost importance,” says the second contact tracer. “Things need to get done fast because it’s government … you have to jump through 50 hoops to get anything done.”
In late August, DC Health started having contact tracers visit the homes of residents who test positive. Home visits would help DC Health complete more contact tracing interviews, and slow the spread of infections in hard-hit neighborhoods like 16th Street Heights by connecting residents of crowded households to housing where they can self-quarantine, DC Health Director Dr. LaQuandra Nesbitt explained at an August press conference.
DC Health has had the ability to reach over 90 percent of COVID-19 patients within one day of testing positive since mid-July, but has struggled to complete interviews or get close contact information, according to government data. Home visits offer contact tracers the opportunity to forge some kind of relationship with individuals who are resistant to engage by phone. The work is all the more important now given how many cases the District is seeing.
The District is reporting more cases these days than it had the last 10 months. Since early December, the District has reported a daily case rate higher than at any other point in the public health emergency. The daily case rate has been over 15 cases per 100,000 since Nov. 10, indicating substantial community spread. As of Tuesday, Jan. 19, the District reported 226 new cases.
The inauguration has not just interrupted home visits to residents who tested positive but testing itself. All public testing sites are closed on Inauguration Day. Not as many sites are open Monday and Tuesday. Sites at spaces like firehouses and Judiciary Square enabled the District to complete more than 1 million tests as of this month.
DC Health does not expect the inauguration to disrupt vaccinations, Nesbitt told the Council during a conference call on Wednesday, Jan. 13. Vaccine appointments were canceled Jan. 6, the day of the Capitol insurrection, as were contact tracing home visits.