Case Investigator’s Interview Tool: Talking with People about COVID-19

Introduction

• May I speak with [respondent name]?
• Am I speaking with [respondent name]?
• Hello, this is [interviewer’s name], from [xxxx health department], calling for [respondent name]. How are you today?
• [For minors] Who is your parent/guardian? How can I reach your parent/guardian?
• What language(s) do you feel most comfortable speaking?
• [If language barrier and interpreter available] We can work with an interpreter (provide information on if that person will be connected or if someone will need to call back).
• [If language barrier and team member who speaks the individual’s preferred language is available] A team member who speaks (language) will call you back.
• I am following up with you to discuss an important health matter. This call is private and intended to assist you with this matter.
• Is now a good time to talk privately? If not, what time works best for you?
• If you are not available now, let’s schedule some time to talk about an important health matter/ your recent test result.
• We want to check in on your health and make sure that you can get the referrals and resources you may need and answer questions that you may have.

Verifying Identity

• [When available, the case investigator should follow local procedures for verifying identity.] It is important for me to ensure that I am speaking with the right person. What is your full name and date of birth, please?
• Before we get started, I would like to make sure that the information we received is correct. Please spell your full name. And what name do you go by/what do people call you? What would you like me to call you?

Confidentiality and Privacy

• Before we go into detail, I want to be sure you understand that everything we discuss is confidential. This means that your personal and medical information will be kept private and only shared with those who may need to know, like your healthcare provider. [Note to Case Investigator: Please consult local data-sharing policies between healthcare providers and health department.]
• What questions do you have about your privacy/confidentiality?

Reason for Call

• The health department received a report that you may have been tested/diagnosed with COVID-19. We follow up with people with COVID-19 to make sure that they have the information they need to keep themselves and their family safe. We also reach out to their close contacts to notify them of exposure so that they can get tested and quarantine if indicated to prevent the spread of COVID-19.
• Choosing to help us slow the spread of COVID-19 helps protect you, your family, and your community. It is important that you isolate at home and tell your close contacts that you have COVID-19 right away so that they can also stay at home and get tested.
• I would like to review some important questions with you, so we can provide you with support and work together to stop the spread of COVID-19 in our city/county/town.

Q&A with Person Exposed to COVID-19

• What questions can I answer for you before we start?

Introduction

• The next information that we will cover includes questions about you, where you live and who you live with. This information will help us make sure that your demographic information is correct and find out the best way to contact you.

Demographics

• I know that I already confirmed your name. Are there any other names that you go by or that your medical information may be under (for example, maiden name)?
• What is your gender?
• What is your race?
• What is your ethnicity? Are you of Hispanic origin?
• Do you have a tribal affiliation? If so, which tribe?
• [For women] Are you currently pregnant? (If yes) how far along are you (months, weeks)?
• What is your [any other locally specific sociodemographic information]?

Locating and Contact Information

• Where do you live (or stay)? What is your address?
• [If person indicates that they ‘live on the street’ or are homeless] If you don’t have a regular place that you stay, where is it best to find you? (Probe for cross streets, site description, name of building/shelter, where they receive mail, etc.)
• Who else lives with you? (Who else stays at that address?)
• How many people regularly stay at that address?
• What is your cell phone number? Who else might answer that phone?
• What is the best number for me to reach you? Who else might answer that number?
• What is the best time to contact you?
• What other ways do you like to communicate? (for example, email, app)

Work

• What do you do for work (name, location[s], hours)?
• Where do you work (name, location[s], hours)?
• Where else do you work (name, location, hours)?
• What other things do you do to earn money besides the job you just described?
• When was the last time you were at work?
• Were you feeling sick when you were there?
• How does your workplace protect people from COVID-19? (For example, providing masks for employees, establishing social distancing space with markers for employees/customers, “screening” for temperature and COVID-19 symptoms upon entry, putting up clear plastic dividers between employees or between employees and customers, providing hand sanitizer, signs about COVID-19 and how to prevent it, increased cleaning and disinfection)

Emergency Contact

• In case of an emergency, if I could not reach you, who would I call? What is their number? What is that person’s relation to you?

Introduction

• I’d like to talk about your recent test at [testing provider]. Have you heard back about the results?
• [If person with COVID-19 has NOT been notified of test result] Your test came back positive for COVID-19. I’d like to talk to you about what this means so that we can work together to keep you as healthy as possible and prevent the spread of the virus.
• [If person with COVID-19 HAS been notified of test result/diagnosis] I’d like to talk about your COVID-19 diagnosis so that we can work together to keep you as healthy as possible and prevent the spread of the virus.
  There are some things that you can do to manage your symptoms at home. I would like to take a few minutes to talk with you about the virus, find out your symptoms, and discuss how we can support you during this time. I can also answer questions you have about your illness.

Reason for Testing/Health Care Visit

• Tell me about why you were tested [as relevant] or went to [insert specific healthcare provider] to get assessed for COVID-19?
  • Did your symptoms require you to go to the hospital? Emergency Room? Hospital admission? Intensive Care Unit (ICU)? When? How long were you in the hospital?
  • Do you have a scheduled follow up with your healthcare provider? Or are you in communication with them?
• In order to better understand your circumstances, it would help to know if:
  • Anyone has told you that you have been recently exposed to COVID-19? If so, who (e.g., someone at your worksite, nurse from your school, friend told you they tested positive)?
  • You know of anyone where you work or live that has recently been diagnosed with COVID-19? If so, please tell me more about that.

Verifying Testing Information

• [If tested] What type of test did you receive? What were the results? Have you been tested again since that time? What were those results?

Let’s talk about your test results.

• A viral test tells you if you’re infected now.
  • You may have been tested with a swab that was placed inside your nose or throat.
  • If you have a positive test, most likely you are infected with COVID-19 and could infect others, so you should stay at home and take steps to prevent spreading it to others.
  • If you test negative, you probably don’t have the virus right now, but you should keep taking steps to protect yourself and others from getting infected.
  • If you have symptoms, stay home and keep monitoring them. If they continue, call your doctor about getting tested again.
• An antibody test may tell you if you were infected at some point with the virus that causes COVID-19.
  • A healthcare professional will take a small sample of your blood to be tested to see if antibodies are present.
  • If you test positive for antibodies, it is likely that you were infected with the virus that causes COVID-19 at some point.
  • If you test negative for antibodies, it is likely that you have not been infected or have not developed antibodies yet. You can still get infected or may become sick later.
  • The antibody test cannot tell if you are infected now. You will need a viral test to show that.
• All people (independent of vaccination status) with positive diagnostic test results should isolate at home or, if in a healthcare setting, be placed on appropriate precautions.

Verifying Vaccination Status

• Have you already received a vaccination for COVID-19?

If Respondent Says “Yes”: Which vaccines have you received?

• [If the person reports receiving a 2-dose series, such as the Pfizer or Moderna vaccine] Did you complete two doses? When did you receive your second dose? When did you get your booster dose?
• [If the person reports receiving a single-dose vaccine, such as the Johnson & Johnson vaccine] When did you get the single dose? When did you get your booster dose?
• Option 1: All people should isolate for at least 5 days if they have tested positive for COVID-19 or if they are experiencing COVID-19 symptoms.
• Option 2: Since your last dose of the vaccine was not more than 14 days ago/ since you have not received a second dose, you should isolate and watch for symptoms. We can discuss isolation recommendations and resources during our call.

If Respondent Says “No” or Reports Receiving 1 Dose Out of a 2-Dose Series:

• You will be eligible to receive vaccination after you complete your isolation period. We can talk more about linking you to vaccination services after we discuss your current COVID-19 infection.

Disease Comprehension

• Tell me your understanding of being diagnosed with COVID-19. What does that mean to you?
• There is a lot of information out there about COVID-19, and sometimes it is hard to know what is fact and what is myth. What questions do you have for me about COVID-19?

Symptoms of COVID-19

COVID-19 can cause a variety of symptoms. Some COVID-19 symptoms can seem like a common cold, others are more severe, and sometimes people have no symptoms. Please let me know if you have had any of the following symptoms and when they started. [Note to Case Investigator: See Appendix B for a table of COVID-19 symptoms, with space to indicate onset and duration. This information can help to identify people who will need to be referred for medical evaluation due to current symptom presentation.]

• What symptoms are you having? When did those symptoms start? How are you feeling now? [If person states any of the emergency warning signs (for example, trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, or bluish lips or face) refer them for emergency medical attention immediately!]
  • From what you are describing, it sounds as though you should be seen by a healthcare provider to further evaluate your symptoms as soon as possible. You need to call 911 or go to the emergency room. Wear a well-fitting mask when an ambulance comes to get you and during your visit to the medical provider. Let them know that you received a call from the health department to notify you of possible exposure to COVID-19.
• [If yes to symptoms] If you have any of these symptoms, have you gone to see the doctor/ER/ healthcare provider (yes/no).

  [If yes, contact already seen by healthcare provider]

• What happened at the visit to your healthcare provider? Did you talk about COVID-19?
• Did your doctor/nurse/healthcare provider test or diagnose you with COVID-19? What type of test did you receive?
• What were your test results?
• How are you feeling now?
• We want to make sure that we can best support you, so we will have a health department liaison follow-up with you to discuss your healthcare visit and symptoms in more detail.

  [If contact not yet seen by healthcare provider]

• Given the symptoms you have described, it seems that you should be seen by a healthcare provider.
• Who is your primary medical care provider? What is their office location and phone number? Would you like to reach out to them today or would you like us to have follow-up with you to help with a referral for testing and a medical assessment? What is the best number for them to reach you at today?
• How will you get to your healthcare provider? Do you have a well-fitting mask to wear during transport and while in the office? [Note to Contact Tracer: Discussing and problem-solving challenges, providing local resources is essential.]

  [For all people with symptoms]

• Most people who have symptoms consistent with COVID-19 should get tested. While waiting for test results they should isolate or stay away from others, including staying apart from those living in their household. (See If You Are Sick).
• [Discuss as relevant] Although the risk that fully vaccinated people could become infected with COVID-19 is low, any fully vaccinated person who experiences symptoms consistent with COVID-19 should stay at home and be clinically evaluated for COVID-19, including SARS-CoV-2 testing, if indicated. They should inform their healthcare provider of their vaccination status at the time of care.
• [Discuss as relevant] People who have been diagnosed with COVID-19 within the last 90 days and recovered that develop symptoms again should be tested and isolate until they have received their test results.
• [Discuss as relevant] People with recent exposure, who have symptoms of consistent with COVID-19, should get tested regardless of vaccination status. While waiting for test results, they should isolate or stay away from others, including staying apart from those living in their household. (See If You Are Sick).
• [If no to symptoms] It is good that you have not noticed any symptoms. It can take between 1–14 days for COVID-19 symptoms to show up, and in some instances, people with COVID-19 do not show any obvious symptoms, but they can still spread the virus. Let’s talk about some other risk factors for COVID-19, and then we can talk about next steps.

Underlying Health Conditions and Other Risk Factors

• Some other health conditions may impact how COVID-19 affects the body. Sometimes we may need to do extra monitoring for people who have other health conditions to be sure that we can get them help if they need it. Have you ever been diagnosed by your healthcare provider with any health conditions that might mean you should have extra monitoring for COVID-19? If so, what health condition(s) were you diagnosed with? [Note to Contact Tracer: If the local area is collecting data on specific co-morbidities, you may ask about those specific health conditions after asking this question.]

What You Can do if You are at Higher Risk of Severe Illness from COVID-19Pdf

Recommendations on How to Manage Symptoms at Home

• What kind of information did they give you to help with your symptoms while you are at home?
• We have some useful tips that may help with managing your symptoms. [Note to Case Investigator: Recommend both covering this information verbally and providing a handout via email or hardcopy]:

10 things you can do to manage your COVID-19 symptoms at homePdf

• ChinesePdf
• KoreanPdf
• SpanishPdf
• VietnamesePdf

What to do if you are sick

• AmharicPdf
• ArabicPdf
• BurmesePdf
• DariPdf
• FarsiPdf
• FrenchPdf
• Haitian CreolePdf
• RussianPdf
• Simplified ChinesePdf
• SpanishPdf
• TigrinyaPdf
• UkrainianPdf

Q&A with Person with COVID-19

• What worries or concerns do you have that you would like to discuss? Who have you told about your COVID-19 diagnosis?
• What questions do you have for me at this time about COVID-19?

Introduction

• I’d like to talk with you about setting up a plan for you to monitor your health each day so that we can get you help if you need it. Shall we continue?

Monitoring Agreements and Tools

• Some of the more basic items to help you monitor your symptoms and reduce the chance that others in your house get COVID-19 include a well-fitting mask, gloves, thermometer, 60% alcohol-based hand sanitizer, soap, and EPA-registered household disinfectantExternal.

Responding If Symptoms Get Worse

• Sometimes people with COVID-19 can have complications. You will need to be aware of what is happening with your body so that you can tell if you have any emergency warning signs (including trouble breathing; persistent pain or pressure in the chest; new confusion; trouble speaking; trouble swallowing; impaired coordination; inability to wake or stay awake; or pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone, or numbness/paralysis on the face/arm/leg). If you have any of these or any other symptoms that are severe or concerning to you, please call your medical provider or go to the emergency room right away. If you call 911 or go to the emergency room, tell them that you have COVID-19 and wear a well-fitting mask when an ambulance comes to get you or if you visit a medical provider.
• What is your plan if you develop new symptoms or start to feel sicker?
• Who do you feel comfortable reaching out to if you feel like your symptoms are getting worse?
• How would you get to the emergency room if needed?

Medical Provider and Other Support While Sick

• Where do you usually go when you are sick?
• Who is your primary medical care provider? What medical appointments/procedures do you have coming up? How comfortable do you feel communicating with them about your symptoms?
• Who usually helps take care of you when you are sick? Have you told them about your COVID-19 diagnosis?
• How to Talk to Your Close Contacts

Q&A with Person with COVID-19

• This was a lot of information. What questions did this raise for you about COVID-19?

Introduction

• Now I’d like to talk with you about home isolation, review the recommendations, and identify what you may need to support you and keep you and your family and other household members healthy.
• It is recommended that you stay at home, away from others, in isolation for:
  • [If you have symptoms] At least 5 days from the day your symptoms first appeared, AND
  • At least 24 hours have passed since resolution of fever without the use of fever-reducing medications, AND
  • Other symptoms have improved
  • [If you do not have symptoms] At least 5 days from the day you were tested and found to be positive for the virus that causes COVID-19 (SARS-CoV-2)
    • Have you begun home isolation? When did that start?
    • [As relevant] In some instances, people who are severely immunocompromised may have different circumstances and determining when you can be around others (end home isolation) may need to be guided by your healthcare provider. Let’s talk about how this may apply to you.
    • [As relevant] In some instances healthcare personnel have different return to work criteria. Let’s talk about how this may apply to you.
    • Let’s discuss how you can prevent spreading the virus to others. What do you know about spreading the virus to your family and other people? What do you know about home isolation?
• How COVID-19 Spreads
  • Being in isolation means that you will not be able to go to work or the grocery store or other places around town.
  • Since the main way that COVID-19 is spread is through breathing in droplets of the virus through the air, it will be important to keep your family and other household members safe. This will mean that you will have to stay at home (isolate) in a separate part of the house from others who live with you, preferably in a bedroom by yourself, and use your own bathroom that no one else uses during this time. Let’s talk about what this looks like for you.
• What to Do If You Are Sick
• Isolate If You Are Sick
  • If at all possible, you should avoid contact with people at higher risk for severe illness (unless they live in the same home and had the same exposure as you), regularly wash your hands, and follow other measures outlined in the CDC guidance.

You will need to limit your interactions with people in your household. When interacting with others in your household, you should wear a mask over your nose and mouth. Your caregiver should also wear a well-fitting mask when caring for you. Children under age 2 or anyone who has trouble breathing should not wear a mask. Regularly wash your hands and follow other measures outlined in the CDC guidance. [Note to Case Investigator: Case Investigators should verbally review updated CDC guidance with the person during the interview and send information in a link or handout afterward.]

• To minimize your contact with others, if at all possible, stay in your room and have food, other necessities, and recreational items left outside the door. We will talk more in a few minutes about whether you have someone at home who can do these things and if you need more help.
• There are a number of things you can do to protect your family and other household members. I will provide information on how to clean and disinfect your home (for those sharing space with others).
• Cleaning and Disinfecting Your Home
  • It will be important to identify other people to assist you with daily life activities during isolation. You will need to stay at home, and therefore, you will need others to support you in grocery shopping, picking up medications, and caring for others during this time.

Assessing Concerns

• What would home isolation look like for you?
• Does this sound like something that would be hard or easy for you? Why? What could you do or what support would you need to address the hardest parts? Do you need access to any resources to help you with completing home isolation?
• What would be helpful for you to better understand or remember the instructions about home isolation?
• Would you like us to follow up with you after you receive your COVID-19 vaccine to provide any additional support needed?

Assessing Living Situation

• It may be helpful to talk about what kind of support you might need during isolation.
• Let me just double check the address where you are staying. (confirm address).
• What does your living situation look like? [Note to Case Investigator: Probe for type of living environment, such as single flat, apartment, house, group home, treatment facility, single room only hotel, condo, tent encampment, etc.] How many rooms, bedrooms, bathrooms? Are there shared common areas (for example, kitchen/dining room/living room/laundry/elevator)?
• Tell me about the place where you live (Prompts: House? Apartment?). Who lives there with you? What are their names, ages, and relationships to you? (Make a list, see Appendix C)
• Who else stays there from time to time? When was the last time they were there? What are their names/ages?
• How many children do you have? What are their ages? Where do they live? When was the last time you saw them?
• Does anyone in your household have other medical conditions? If so, who and what medical conditions do they have that concern you?
• Would it be possible for you to have access to your own room and bathroom?
• How safe do you feel in your current living situation? Have you ever felt threatened or hit, or hurt by someone who you live with? [If the person feels unsafe or answers yes to the second question] We have resources to support you [make domestic violence referral-insert local information].
• Is there an alternate place that you could stay?
• Would you consider moving to an offsite location to support you and protect your family/ household during your isolation? If this were an option, what would be your concerns?

Assessing Other Supports

• When you think about what I have just described, what comes to mind? What challenges do you see? What kind of support would you need to overcome them?
• What do you think will be the hardest thing about isolation? How will you deal with that?
• Do you have access to fresh water and enough food?
• How will you prepare your own food? Who can assist you with getting meals?
• How will you get other household supplies (e.g., toilet paper, soap, etc.)?
• What medications will you need to take? How long until your prescription needs to be refilled?
• Who do you provide care for in your household? Children? Parents? Older person? Sick person? Is there someone else who can take on that role?
• What pets or animals do you have in your household? What kind of supplies will you need for them during your isolation? Is there anyone else who can take care of your pets or animals? If you have pets, treat them as you would other human family members to protect them from a possible COVID-19 infection. In accordance with the Americans with Disabilities ActExternal, service animals are permitted to remain with their handlers.
  • COVID-19 and Animals Frequently Asked Questions.
• You may be off from work during home isolation or may be able to telework if that is a policy at your workplace and you feel healthy enough to continue working. How will you approach this discussion with your employer? Will you be getting paid sick leave from your employer?
• What concerns do you have about the financial impact that home isolation will have?
• What types of medical or other important appointments do you have scheduled over the upcoming weeks? Let’s see how we can work to support you with those appointments.
• What supports might you need during your isolation period? [Local resources should be listed and discussed.]
  • Food
  • Childcare
  • Housing
  • Prescriptions
  • Non-COVID medical care
  • Support with stress, resiliency, mental health
  • Substance use treatment/support groups
  • Translation/interpretation
  • Assistance caring for someone else
  • Transportation
  • Disability accommodations
  • Financial assistance
  • Communication (cell service, internet)
  • Other

Release from Isolation

When you can be around others (end home isolation) depends on different factors for different situations.

• If you have symptoms, you can be with others after
  • At least 5 days since symptoms first appeared AND
  • At least 24 hours with no fever without fever-reducing medication AND
  • Other symptoms of COVID-19 are improving
• If you had no symptoms and continue to have no symptoms, you can be with others after 5 days have passed since the date you had your positive test.
• If you develop symptoms after testing positive, you can be with others after
  • At least 5 days since symptoms first appeared AND
  • At least 24 hours with no fever without fever-reducing medication AND
  • Other symptoms of COVID-19 are improving
• If you have a weakened immune system (immunocompromised) due to a health condition or medication, you might need to stay home and isolate longer than 10 days after symptoms begin. In some circumstances, further testing may be needed. Talk to your healthcare provider for more information.

[Note to Case Investigator: Jurisdictions can find additional information on the discontinuation of isolation in CDC’s Contact Tracing Guidance.]

• [If not up to date on vaccines] We would like to connect you to vaccine services upon your release from isolation.
  • How do I find a COVID-19 vaccine?

There are several ways you can look for vaccination providers near you.

• Visit Vaccines.gov to find vaccination providers near you. In some states, information may be limited while more vaccination providers and pharmacies are being added. Learn more about COVID-19 Vaccination Locations on Vaccines.gov.
• Text your zip code to 438829 or call 1-800-232-0233 to find vaccine locations near you.
• Check your local pharmacy’s website to see if vaccination appointments are available. Find out which pharmacies are participating in the Federal Retail Pharmacy Program.
• Check your local news outlets. They may have information on how to get a vaccination appointment.

Disclosure Coaching

• Given that a plan for social distancing will need to be set in place as well as supports to assist you while you are on home isolation, it will be important to think about how to talk about this with those in your household.
• Who in the household have you told about your COVID-19 diagnosis or test? How did that conversation go?
• Who in the household are you planning on telling about your COVID-19 diagnosis or test? What do you expect that discussion to look like? [Note to Case Investigator: Offer coaching if appropriate.]

Q&A with Person Exposed to COVID-19

• What other concerns (for example, someone may be sick, someone may have a pre-existing health condition, kids are little and may be upset to be separated) do you have regarding the home isolation instructions? Let’s discuss some steps to take that may address your concern(s).

Introduction

• Now I would like to discuss your close contacts and identify who may need to be notified of exposure so that they can get tested and quarantine to prevent the spread of COVID-19.
• Some of the early symptoms of COVID-19 can look similar to other illnesses. You may have been out and about not even realizing that you were sick. Many times, people continue to live their lives normally when they think that they have a common cold or when they are tired.
• To stop COVID-19 from spreading in the community, we will need to discuss who may have been exposed. We will need to make sure they get care, if they need it, and have them monitor themselves for symptoms so that they don’t spread it to others.
• Your close contacts could benefit from checking their symptoms each day so that they can get help early if they start to have symptoms. People at the greatest risk of infection and who should be prioritized for notification are those you have been around for a cumulative total of 15 minutes or more over a 24-hour period, during the two days prior to the start of your symptoms (or if you are asymptomatic, two days before your positive COVID-19 specimen collection date), through to the time you start isolation, are at greatest risk of infection and should be prioritized for notification.
• When we talk about who may have been exposed to COVID-19, you should think about people who live in your household; people at work; and people who you interact with during hobbies, social events, and other daily life activities.
• Have you already spoken to any of your close contacts about being diagnosed with COVID-19? If so, how did that go? Who did you speak to?
• You may want to tell some people yourself, and the health department can notify them of exposure and follow up.
  • How to Talk to Your Close Contacts
  • “Hi. I need to talk to you about something important. Do you have a few minutes to talk privately? I was diagnosed with COVID-19 (or tested positive) on xxx date. We spent time together on xxx date, and I wanted to let you know so that you can get tested and protect your family and others within and outside your household. CDC recommends that you stay home, separate yourself from others for 5 days except to get medical care, get tested for COVID-19, and continue to monitor your health for symptoms of COVID-19.”
• It’s important that I emphasize again that your privacy will be protected at all times. The health department will not disclose your name. We will also not disclose information about the people you have been in contact with. We will simply let them know that they may have been exposed to COVID-19 recently, check in with them about any symptoms that they may be having, and refer them to health care or talk to them about how important it is for them to quarantine and watch for symptoms so that they don’t spread the virus to others.

Discussing Contact Elicitation Window

• People you have been around during the two-day period prior to the start of your symptoms (or if you are asymptomatic, two days before your positive COVID-19 specimen collection date) until you meet the criteria for discontinuing isolation, are at greatest risk of infection and should be prioritized for notification. Let’s talk about the people you spent time with, the places that you have gone, and other daily life activities between [date] and [date].
• It is also important to identify where you may have gotten the infection, so identify and protect other people who may have been exposed. Let’s talk about the people you spent time with, the places that you have gone, and other daily life activities in the two weeks prior to the start of your symptoms (or if you are asymptomatic, two days before your positive COVID-19 specimen collection date). That would be between [date] and [date].

Household Contacts

• Household transmission of COVID-19 is common. Most close contact exposures are with family members and other household contacts. Let’s talk again about the place that you live and the people who stay there with you. (Make and review list, Appendix C) Earlier, you talked about [insert the total number of people] who lived there; [insert # of] adults and [insert # of] children that stay there on a regular basis. Who else stays with you from time to time? Who has stayed there recently?
• Let’s talk about each of these people (for example, names, ages, contact information, potential risk for COVID-19 or complications) and then discuss what would be the best way to notify them of exposure. (Appendix C and Appendix D.)
• What other addresses do you use (for mail or to stay occasionally)? When was the last time that you stayed there? For how long? Who did you spend time with?
• Who in your household has been sick recently? (If they identify anyone sick, ask what type of symptoms, when started, for how long?)
• Have they gone to the doctor or to get tested for COVID-19? (If yes, when, where, and results?)

Workplace

• Many people spend a lot of their time at work. Sometimes, people work very close together with the colleagues or customers, travel together for work, or have shared workspaces or commonly shared surfaces that can transmit the virus. Let’s talk about the work that you do and your work environment to see who may need to get tested or evaluated for COVID-19.
• Earlier we talked about what you do for work. Let me just confirm. I have it listed as [name, location, contact information]. Let’s talk about who from work may need to be evaluated for COVID-19.
• What was your last day of work? Did you feel sick on that day?
• Have you called out sick since then?
• What have you told them about your diagnosis/test results?
• Tell me about your work. What do you do there? What is your work schedule? Do you work full time or part time?
• How do you get to and from work? (Prompts: Ride share, employer-sponsored bus, carpool, etc.) Who do you travel with?
• What is your work setting like? (Prompts: Is everyone in one room? Do you work in a cubicle? Do you have your own office? How many people are onsite together? Do you have a shared workspace? Do you have a shared breakroom? Do you have an onsite cafeteria? Where do you eat lunch?)
• (Special Circumstances in the Workplace) Some workplaces have a higher risk for spreading illness if someone is sick with COVID-19. Places where people live together in close contact, known as congregate living environments (hospitals, long-term nursing facilities, assisted living facilities, group homes, mental health hospitals, correctional facilities, homeless shelters), or large factory settings often require an environmental assessment by health specialists to make sure that protective measures are put in place, so more people don’t get sick. Would you describe your workplace as a congregate living or work environment? In what area(s) of the facility do you work? [Note to Case Investigator: Appendix E is a job aid to assist with a “facility-based” elicitation process.]
• Do you work with the same people all the time or do you often work with different people? What does that look like?
• Do you provide services in different settings (for example, air conditioning repair for businesses, physical therapy for nursing homes, carpentry in personal homes)? What locations have you been onsite recently?
• How often do you have meetings? What meetings have you attended between [date] to [date] and who was there?
• How often do you travel during the workday? Have you traveled with anyone from work recently? [Probes: For meetings? Supply pickup? Site visits? Vehicle pickup?] If so, who did you travel with, when did you travel, and where did you go?
• Who at your work has been sick recently?
• Who else do you know (your family or friends) who works there?

People, Places, Activities and Events

• Let’s talk about your daily activities from [date] through [date]. Let’s talk about people you shared time with, the places you went, and the events you attended. [Note to Case Investigator: See Appendix A for a list of potential contacts and locations to discuss, and Appendix C, Appendix D, and Appendix E to assist with information gathering.]
• Why don’t we start with the day before you started isolation. Where did you go on that day and who did you see?
• You told me that your first symptom (name of symptom) started on [date]; that looks like a “Monday/Tuesday” around the time you first began to feel ill. Let’s think back to the two days before that. What were you doing then?
• [If not mentioned as part of the household] Who is your partner/significant other? When did you last see them?
• What family or friends have you had over recently? Gone to visit recently? Where did you go? Who was there with you?
• When was the last time that you talked to your neighbors in person? Or helped each other out with something?
• Who do you know who also has COVID-19?
• Has anyone else told you that you may have been exposed to COVID-19? Who would that be? When did they let you know? Who else do you know who has been sick?
• If you look through your contacts in your phone, who else comes to mind that may need to be evaluated for COVID-19?
• Do you have a calendar or other schedule that you use? If you look through your calendar in your phone, what were you doing from [date] to [date]? Who were you with at that time who may need to be evaluated for COVID-19? How did you travel there?
• Do you use any apps on your phone regularly that may provide clues to your whereabouts? If you look through your phone, at some of those apps (for example, Facebook, Meetup, WhatsApp, Telegram, Foursquare, GirlCrew, Instagram, Google Maps, Let’s talk about your daily activities from [date] through [date]. Let’s talk about people you shared time with, the places you went, and the events you attended. [Note to Case Investigator: See Appendix A for a list of potential contacts and locations to discuss, and Appendix C, Appendix D, and Appendix E to assist with information gathering.]
• Why don’t we start with the day before you started isolation. Where did you go on that day and who did you see?
• You told me that your first symptom (name of symptom) started on [date]; that looks like a “Monday/Tuesday” around the time you first began to feel ill. Let’s think back to the two days before that. What were you doing then?
• [If not mentioned as part of the household] Who is your partner/significant other? When did you last see them?
• What family or friends have you had over recently? Gone to visit recently? Where did you go? Who was there with you?
• When was the last time that you talked to your neighbors in person? Or helped each other out with something?
• Who do you know who also has COVID-19?
• Has anyone else told you that you may have been exposed to COVID-19? Who would that be? When did they let you know? Who else do you know who has been sick?
• If you look through your contacts in your phone, who else comes to mind that may need to be evaluated for COVID-19?
• Do you have a calendar or other schedule that you use? If you look through your calendar in your phone, what were you doing from [date] to [date]? Who were you with at that time who may need to be evaluated for COVID-19? How did you travel there?
• Do you use any apps on your phone regularly that may provide clues to your whereabouts? If you look through your phone, at some of those apps (for example, Facebook, Meetup, WhatsApp, Telegram, Foursquare, GirlCrew, Instagram, Google Maps, dating apps, social networking apps), what events did you attend or people did you meet from [date] to [date]?
• Tell me about your recent activities. When was the last time that you:  (for example) had your hair done? Went out to eat or out for drinks? Took a class? Volunteered? Took public transportation? Exercised with others? Celebrated an occasion? Did a group activity? Who else was there? Who may have been sick at the time?
• Where have you traveled in the last (contact elicitation window period)? Tell me about that trip. Who was with you? Where did you go? How did you travel? Where did you stay and who did you stay with on the trip?

• CDC recommends COVID-19 vaccination for all people who are eligible. This includes people who have previously had COVID-19. That’s because experts do not yet know how long you are protected from getting sick again after recovering from COVID-19. Even if you have already recovered from COVID-19, it is possible that you could be infected with the virus that causes COVID-19 again.
• Once you are eligible to receive the vaccine, we highly recommend scheduling an appointment to get vaccinated or visiting a vaccination site that does not require an appointment. Once you are eligible for a booster dose, we highly recommend scheduling this appointment as well.
  • People with a COVID-19 diagnosis (with symptoms or a positive test) should wait to be vaccinated until they have recovered from their illness and have met the criteria for discontinuing isolation before getting vaccinated.
  • The federal government is providing the vaccine free of charge to all people living in the United States, regardless of their immigration or health insurance status. Would you like our help with locating a testing site, finding a vaccination site, scheduling an appointment for you, or sending you an appointment reminder?
• There are several ways you can look for vaccination providers near you.
  • Visit Vaccines.gov to find vaccination providers near you. In some states, information may be limited while more vaccination providers and pharmacies are being added. Learn more about COVID-19 Vaccination Locations on Vaccines.gov.
  • Text your zip code to 438829 or call 1-800-232-0233 to find vaccine locations near you.
  • Check your local pharmacy’s website to see if vaccination appointments are available. Find out which pharmacies are participating in the Federal Retail Pharmacy Program.
  • Check your local news outlets. They may have information on how to get a vaccination appointment.
• Safety is CDC’s top priority, and vaccination is a safer way to help build protection. All currently authorized and recommended COVID-19 vaccines are safe and effective, and CDC does not recommend one vaccine over another. The most important decision is to get a COVID-19 vaccination as soon as possible. Widespread vaccination is a critical tool to help stop the pandemic.
• Some side effects are normal for the COVID-19 vaccine. Register for the v-safe After Vaccination Health Checker, a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccine.
• We would like to connect you to vaccine services upon your discontinuation of isolation. What would be most helpful to support you in getting your vaccine? Would you like us to follow up with you after your vaccination to provide additional support, if needed?
• What challenges do you anticipate with getting vaccinated? Will you have any difficulties with transportation to get to a vaccination site? Do you have other caregiver responsibilities, where you can’t leave someone alone? [Note to Case Investigator: Discussing and problem-solving challenges, providing local resources is essential.]
• Is there anyone else in your household that needs assistance getting access to a COVID-19 vaccine?

Check-in, Questions and Agreements

• We have talked about a lot of topics today. I want to take a few minutes to check in on how you’re feeling and discuss our plans.
• How are you feeling about all of this?
• What questions do you have for me?
• How can I (or my agency) be of additional assistance to you?
• I can help connect you with a vaccine appointment once you’re eligible and follow-up to ensure doses have been received, ask if you experienced any side effects, and provide other support.
• What questions do you have about what will happen next with the information that we have discussed?
• So, our daily check-ins start tomorrow. What questions do you have about the time and the method that we discussed?
• And if you start to feel worse, your plan was to….?

Acknowledging the Difficulty and Keeping the Door Open for Contact

• I just want to check in to be sure that you know how to reach me if you have other questions or concerns after we get off the phone. My name is spelled, [insert name], and my phone number is [insert phone number].
• Either I or someone from my team may reach out to you to check in to see if you are ok or whether you’ve connected with the other services we talked about today. They will also protect your privacy. We may have other questions that arise. Just wanted to confirm the best number to reach you is [repeat ‘best contact number’ provided by the person].
• I can’t thank you enough for talking to me and helping us stop the spread of COVID-19 in [location]. I know this is a very difficult time for you and your family, and we truly want everything to go well for you.