CONTACT TRACING
REPORTING FORMS
• Form A:
• Case Investigation Form
• Form B:
• COVID Patient Information Checklist
• Form C:
• Close Contact Line List
Case
Investigation
Form
Case
Investigation
Form
Case
Investigation
Form
CONTACT
TRACING
FORM 1
Page 1
CONTACT
TRACING
FORM 1
Page 1
CONTACT
TRACING
FORM 1
Page 2
CONTACT
TRACING
FORM 1
Page 2
CONTACT
TRACING
FORM 3
Signs and
Symptom
s Log
Form
You may access the New
Contact Tracing Forms thru
this link.
https://bit.ly/CTNewForms
• Case investigators and contact tracers need to:
 Immediately identify and interview people with SARS CoV-2 infections
and COVID-19 (i.e., disease)
 Support isolation of those who are infected
 Warn contacts of their exposure, assess their symptoms and risk, and
provide instructions for next steps
 Link those with symptoms to testing and care
https://www.cdc.gov/coronavirus/2019-ncov/php/principles-contact-tracing.html
Time is of the essence.
Identifying contacts and ensuring they do not interact with others is critical to
protect communities from further spread. If communities are unable to
effectively isolate patients and ensure contacts can separate themselves from
others, rapid community spread of COVID-19 is likely to increase to the point
that strict mitigation strategies will again be needed to contain the virus.
l
CT New Forms.pptx

CT New Forms.pptx

Editor's Notes

  • #2 FOR COVID KAYA INFORMATION SYSTEM
  • #9 Questions should be designed to elicit the names of: People with direct physical and sexual contact All people who lived with the case (alive or deceased) since symptom onset in the same household All people who visited the case (alive or deceased) since symptom onset (e.g., at home, healthcare facility) All places the case visited since symptom onset (e.g., work, pharmacy, place of worship, extended family, traditional healers) All healthcare facilities visited by the case and all healthcare workers who cared for the case In the event that the case is a healthcare worker, all patients and colleagues of this healthcare worker. In the event that the case has died, all persons who had contact with the deceased person, including those who attended burial ceremonies Anyone else who might have been exposed to the case
  • #11 n this Form, you can see the nature of contact, what kind of contacts (can be seen in the third column starting from the right) these are HH, WS, S, T, A, HCW, O. HH stands for households, WS for work station, S for Sea Vessel, T for travel, A is accommodations whether hotel, bed and breakfast for example, HCW is health care workers, and O is others not mentioned above, that is Form C.
  • #12 COVID-19 CONTACT TRACING SIGN AND SYMPTOM LOG FORM   Contact tracer as well as part of the monitoring team use covid-19 contact tracing sign and symptom log form.   Contact line list form and log form should be aligned with each other.   monitoring should be done twice a day always indicate the date go through each condition for monitoring put a check if the close contact met the condition being asked under the corresponding time of the day (AM/PM) monitoring was done provide the temperature taken     Conditions for monitoring includes:   no signs or symptoms fever (temperature) cough sore throat difficulty of breathing colds diarrhea other symptoms