FIGURE 1.

Depiction of COVID-19 Case Surveillance, Contact Tracing, and Response in King County, Washington, July 2020 to June 2021^a

^aAfter a patient underwent SARS-CoV-2 testing, his or her specimen was sent to a laboratory for analysis. As a notifiable condition in Washington State, laboratories and health providers are legally required to report COVID-19 suspected or confirmed cases to local or state public health authorities along with the following information: dates corresponding to test order, specimen collection, and availability of test results; test result; ordering provider details; laboratory details; and patient date of birth, sex, and address. Laboratories typically submit this information through the Washington Electronic Laboratory Reporting System (WELRS). The WADOH manages WELRS, processes data received through it and other sources, and creates case reports in the Washington Disease Reporting System (WDRS) that are subsequently assigned to CI/CT teams across the state for investigation. During the case interview, PHSKC contact tracers collected the following information: language preference, race, ethnicity, and affiliation with an immigrant community; symptom status and onset; reason for testing; vaccination status; suspected source of infection; participation in WA Notify exposure notification; and detailed information about places recently visited, including worksites, schools, daycares, health care and behavioral health facilities, long-term care facilities, correctional facilities, airports and other modes of transportation, bars/restaurants, gyms, places of worship, salons and spas, and community and social events. This information was subsequently analyzed and summarized for the public, public health decision makers, and outbreak response teams. Cases were also asked to provide the names, dates of birth, and COVID-19 symptom and testing status of each person in their household, as well as other persons they had been within 6 ft for at least 15 minutes during their infectious period. Finally, PHSKC contact tracers discussed the I&Q guidance tailored to the household's circumstance, assessed need for clinical and support services, and referred to support services team accordingly. This figure is available in color online (www.JPHMP.com).