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County Adds ‘Medical Investigators’ to Hunt Down COVID Cases



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The Fresno County Health Department knew who to call for help tracking down COVID-19 cases — EMTs laid off because of a dip in service calls during the pandemic.

“American Ambulance and the county agreed we would start out with a team of 15 to do medical investigation. This allowed us to bring back 13 of the 15 EMTs we laid off in March.” — Bob Adams, human resources director, American Ambulance

Now, many of these EMTs are joining the county’s 15-person MIT — Medical Investigation Team.

The MITs are trained specifically to talk to, assess, and document information from patients.

“We just did a bridge to bring some of those (EMTs) on to be trained and do this work at our direction,” said David Pomaville, director of the Fresno County Department of Public Health. “They will have phenomenal insight into how the public is addressing this concern.”

EMTs Bring a Needed Skillset to the Job

American Ambulance hired 15 new EMTs in early March. But, after their classroom training, the call volume fell 25% due to COVID-19.

“I had to deliver the news that we were laying them all off,” American Ambulance Director of Human Resources Bob Adams tells GV Wire by email. “Since then, we have had several conversations with various people at the Health Department and it was identified that our EMTs and Paramedics all have … the skill set needed for Medical Investigation.”

Medical investigation is a little different than contact tracing. Contact tracing is the process of finding and reaching out to the contacts of someone who tests positive for an infectious pathogen.

Adams says medical investigators interview people who have tested positive for COVID-19. From there, they work to identify the person’s contacts and provide them with information on how to care for themselves.

Those identified as having contact with a positive COVID-19 case are put in touch with a contact tracer. The contact tracer then provides information on what to watch out for, when to seek additional evaluation or medical treatment, and how to keep safe.

“American Ambulance and the county agreed we would start out with a team of 15 to do medical investigation,” says Adams.  “This allowed us to bring back 13 of the 15 EMTs we laid off in March.”

The medical investigators are training this week at American Ambulance’s training center in Clovis.

Schools Expected to Help With Contact Tracing

Schools will play a significant role in helping with contact tracing.

“It became very evident to us as we go forward and as we start to bring school systems back in place, that they’re going to become the first point of contact for people to report that they’ve had a positive COVID,” said Pomaville.

Pomaville said this group will include school nurses. The county health department is working with schools on a training program.

“We’re putting together a memorandum of understanding so both parties know the rules of who does what,” said Pomaville. “We’ve been talking with the Fresno County Superintendent of Schools conceptually with this. We have been in touch with Fresno Unified, Clovis Unified, and Sanger Unified on a daily basis.”

Pomaville also says the county is training on a state database that will be deployed across a variety of digital platforms to allow everyone to work collectively on contact tracing.

The Medical Investigation Questionaire