Person of the Week
Noreen Saunders: Making Contact in the COVID Era
Noreen Saunders, a physical therapist and rehab supervisor for Westbrook Visiting Nurses and Public Health, says successful contact tracing relies less on medical knowledge and more on empathy. (Photo by Rebecca Kieran )
When it comes to contact tracing for COVID-19 in Westbrook, Noreen Saunders is pretty much a one-woman show.
A full-time physical therapist and rehab supervisor for Westbrook Visiting Nurses and Public Health, Noreen initially offered to volunteer as a contact tracer. Zachary Faiella was only a few months into his job as the town’s public health director when COVID hit. And as the pandemic added to, but didn’t preempt, all the other work his department had, Noreen saw it as a way to help take a load off as well as give back to the community.
Ultimately, the town has been able to pay her for her work via a grant, but the roughly 20 hours of contact tracing per week, which she does in the mornings, late afternoons, and on weekends, are on top of a full slate of homebound clients and her responsibilities as a supervisor of four additional physical therapists, three occupational therapists, two speech therapists, and two social workers.
“Contact tracing...complements my work as a physical therapist as educating a person about their health and wellness,” she explains. “It’s been a core part of both of these jobs. So it’s kind of a nice overlap.
“And contact tracing really holds the story for the virus spread,” she continues. “And that, along with testing, really is the key to stopping the spread of COVID.”
By determining where a person with a positive COVID-19 test has spent their time, who they might have come in contact with, and who might have been the source of their infection, a contact tracer can inform others who might be infected, encourage them to get tested and, if they do test positive, instruct them on how to quarantine. These are the primary methods of keeping the virus from spreading.
“It’s a true and tried method,” Noreen explains. “Contact tracing...has gone back for hundreds of years, all the way back to the bubonic plague. It was used with ebola, with AIDS, a lot of STDs.”
To do the work, Noreen logs in to a database of all positive test results of Westbrook residents. Then she picks up the phone.
“You just start developing relationships with people that you’ve never met,” she says. “And you’re providing emotional support, as well as guiding them through this period of isolation.
“The goal, really, for a contact tracer is to reassure the person, educate them, and assess any needs that they might have,” she explains. “Some of it is financial hardship [or] they might need food during this time, because they can’t get out of the house. So we do try to make referrals for that. Some may even need a thermometer. Zach was able to get a large amount of thermometers, so sometimes I’ll drop a thermometer off at someone’s house.”
As opposed to training in healthcare, the primary qualification for a contact tracer, Noreen says, is empathy.
“Empathy is really the key to doing contact tracing work, as well as being able to really be detail-oriented in gathering information so you can get to the bottom of everything,” she says. “You want to assure the person that the information is private, as well.
“You’re dealing with very sensitive information,” she adds. “You’re asking people sensitive things about their health; you’re also asking about their date of birth and other family members...So you have to be very careful with how you word it. There’s definitely no room for judgment or bias. It’s just very objective information.”
Not only is the information confidential, it’s also anonymous. The contact tracer doesn’t call the gym and say, “John Smith has tested positive for COVID-19 and was in your spinning class last Tuesday.”
“Some people don’t want to ‘out’ the sources,” Noreen says. “Part of our role is to let them know how necessary it is to find the source of where [the infection] came from so you can really slow the process of it.”
Because Noreen sometimes encounters a language barrier, the Public Health Department has arranged for her to use a translation service. This works as a three-way telephone conversation and helps to eliminate any misunderstanding between Noreen and the person with whom she’s communicating. Noreen has had Portuguese, Spanish, and Bengali translators on calls.
“The other big part of what we do on contact tracing is when you call the person, you do an assessment, a physical assessment, and you ask them what their symptoms are,” she explains. “There have been quite a few calls where the person has said that they’re really having difficulty breathing, or they’ve been vomiting a lot. And so we make the recommendation that they should seek medical attention.”
In some cases, the person on the end of the line might not have gone to the emergency room had it not been for that prompting. That can be true especially for those who live alone.
While it’s unclear whether any of the COVID variants have made an appearance in Westbrook—the database only provides information that there was a positive test and not the strain of the virus—Noreen says there have been more people lately who are unclear as to how they were infected. They feel they’ve been doing everything right—wearing masks, social distancing—and still got sick.
“The new symptoms are more like cold symptoms,” she says. “They either think they have a sinus infection, or that winter cold or runny nose, [but] it’s indeed COVID.”
These symptoms could develop into something worse.
“And then other times it just stays mild—cold symptoms throughout the duration,” she says. “Then there’s the distinct symptom of that loss of taste or smell that’s associated with COVID.”
That particular symptom is telling and could be—but isn’t always—an indication that the infection could develop into something worse.
Current Centers for Disease Control & Prevention recommendations not only provide guidance on how to wear a mask properly—ensure that the mask is snug against the face, for instance—but encourage double masking. One way to do this is by wearing a disposable surgical mask under a multi-layered cloth one. The recommendations are easy to find via an Internet search for “CDC double masking.”
Noreen was eight years old when she decided to become a physical therapist. Family friends who lived near them on the Jersey Shore had a teenage daughter who was in a serious car accident.
“She was just a very lively, outgoing person,” she says of the teen. “And then this—she was paralyzed and had a brain injury.
“My mother was the caregiver for the family,” she explains. “So when I’d go over to the house, this physical therapist would come and help [the girl] walk and do exercises and I thought, ‘That’s what I want to do.’
“And it’s interesting that it’s homecare where I ended up, too,” she adds.
Noreen first got an associate’s degree in physical therapy at Fairleigh Dickinson University and then a bachelor’s in physical therapy at UConn. While a UConn student, she worked as a Nautilus instructor at a local YMCA, which is how she met her husband.
They settled in Killingworth, where she still lives, and raised three children. More than 25 years ago, when her kids were still young, she started work as a per diem physical therapist for Westbrook Visiting Nurses. For the past 11 years she’s been the rehab supervisor.
While initially she was attracted to home care for the flexibility, “I really enjoy the one-on-one contact with the patients,” she says. “I can give them my undivided attention for the hour-long session.
“I find it’s a much more personal experience, doing home care,” she continues. “People always feel more comfortable in their home. That’s their place where they really are themselves.”
Last year around this time, it was far more concerning to go into people’s homes because of the lack of information about COVID-19. But the homecare professionals from Westbrook Visiting Nurses are diligent about using personal protective equipment. Patients are asked to let them know if they have COVID-like symptoms or have tested positive.
And, Noreen points out, “We’ve had our vaccinations.”
In a small town, collaboration is key, and Noreen works closely with Faiella, the other Public Health department staff, the Westbrook Senior Center and Social Services Department, and the school district.
“I am in frequent contact with the school system to review quarantine and isolation dates,” she explains. “Information needs to be given quickly to [ensure] that a child does not go to school if they have been exposed.”
Westbrook residents themselves have been a huge help.
They “have been very receptive to the contact tracing calls; I’ve been greeted really warmly by them,” she says, “Many are grateful that someone is monitoring them during the infectious period. Some...are home alone and they’re isolated. They’re not talking to anybody. So they like that reassurance and also [answers to] their questions.
“And I think they like the idea of a local person contacting them,” she continues. “Westbrook is such a small, close-knit community. It’s really nice to have that connection with them.”
Noreen credits Faiella for his support and guidance and says she’s grateful to have had the opportunity to work toward impeding the spread of a deadly virus.
“As much as I have loved doing this work these past months, I look forward to the day when I won’t be making these daily calls,” she says, “because that’s when we know this health crisis has come to an end.”