Medical students Henriikka Mälkönen and Matias Posa were among those who completed the first coronavirus tracer course organised by the University of Helsinki, during which 50 students were quickly, in only two weeks, provided with the skills needed in coronavirus tracing.
The course ended in mid-May. Posa already began working for the City of Helsinki in late April when municipalities needed more tracers.
“The goal was to orient the first group of medical students to the work as soon as possible, so some people were taking the course and doing tracing in practice at the same time,” Posa says.
Mälkönen is a tracer with less experience, since she started working in the Infectious Diseases Unit of the City of Espoo only a few days ago. In a situation where other summer jobs, such as research and a clinical training period in Belgium, were cancelled, a new post was helpful.
Both Mälkönen and Posa feel that doing coronavirus tracing provides them with a concrete way of helping amid the pandemic.
“As a corona tracer I can do the most impactful work in the healthcare sector that is possible with my current education,” says Posa, who is a third-year student of medicine.
Tracing involves creative problem-solving and phone conversations
The work of coronavirus tracers begins when a person has tested positive as a carrier and has been informed of the matter by their doctor.
“After this, the tracer calls the patient, enquires about their health and makes a preliminary assessment of risk factors, such as pre-existing medical conditions. If the affected person doesn't need further care, they are put into home isolation. Then begins the assessment and tracking of exposed individuals,” Posa says.
When identifying the exposed, the work starts with family members. Next, the persons with which the affected individual has been in close contact from the day before the onset of symptoms are identified.
Who, then, is considered as exposed?
“As a rule of thumb, those who have spent 15 minutes or more with the infected person in the same space have been exposed,” Posa explains.
Mälkönen talks about how finding the contact details of exposed individuals has, at times, required creative solutions.
“If there’s reason to believe that the infected person may have exposed others at the workplace, the missing contact details are checked with the employer, provided the affected person gives permission. Sometimes contact details are found only after a number of steps. Directory assistance is our last resort,” she says.
Once the details of the exposed have been collected, the calling begins. The tracer calls all exposed individuals, orders them into quarantine and provides relevant instructions. At the same time, the tracer maintains contact with the affected individual and checks on their condition two weeks after the diagnosis.
Posa says that he has learned to use patient information systems in the work. In addition, tracers get to practise how to speak with patients.
“You’re not at your most receptive when you’re ill. The phone conversations have required prompting and drawing out details by relying on interaction skills,” Mälkönen says.
Teacher: Students registered for the tracing course want to contribute
The course organised by the Faculty of Medicine was open to medical students from the third year up. At this point, the students already have basic knowledge of microbiology and viral diseases, as well as clinical experience in, among other things, patient interviews.
According to Helena Karppinen, clinical instructor in general practice and the teacher on the tracing course, students of dentistry and psychology and also one student of logopedics attended the course in addition to medical students.
“The course filled up quickly, as students were eager to contribute.”
The course is worth 2.5 credits for students, while a salary is paid for the actual tracing. The municipalities participating in the organisation of the course are Helsinki, Espoo and Vantaa.
“As students establish a firm link with the relevant municipality in the process, experience in contact tracing can also promote employment in the future,” Karppinen notes.
In addition to carrying out contact tracing, or identifying exposed individuals, in practice, students learn, among other things, to look for, assess and utilise information about the pandemic. Furthermore, they gain information, for example, about viral tests, their interpretation and related difficulties. The basic information the course provides on the SARS-CoV-2 virus helps answer questions concerning the coronavirus when tracing contacts.
“Tracers must be able to look for information, study independently and consult others. In fact, roughly half of the course constituted groupwork-oriented learning. We had visiting specialists answer students’ questions,” Karppinen says.
An international perspective was also included by providing the students with the opportunity to discuss the pandemic situation with medical students from other countries. Henriikka Mälkönen says that she remains in contact with her personal connection, an Egyptian medical student.
Capacity for training hundreds of new contact tracers
Professor Kari Reijula, vice-dean of the Faculty of Medicine, University of Helsinki, points out that the two-week tracing course can be organised again at a later date.
“The number of student tracers can grow into the hundreds. They help free up municipal resources, as those transferred from other positions can return to their original duties.”
In the spring, the University of Helsinki took quick action to remedy the contact tracer shortage. According to Reijula, medical students already began to help the Hospital District of Helsinki and Uusimaa (HUS) in contact tracing in February and March. As the demand for tracers grew, the University established a coordination group together with doctors responsible for infection tracing at HUS, Helsinki, Espoo and Vantaa, initiating the planning of more extensive tracing collaboration.
The goal of this collaboration was to monitor the spread of infections in the Helsinki Metropolitan Area and to direct students of the Faculty of Medicine to where they are needed the most.
Reijula describes the assistance provided by the student tracers in tackling the pandemic as considerable.
“The students need relevant training, credits and work experience in the field, while HUS and the cities of the region gain through the cooperation professional tracers precisely where the urgency is the highest,” he says.