All but two Oregon counties have started to ease coronavirus restrictions. To join the rest of the state, Washington and Multnomah counties are rushing to hire dozens of people to work as contact tracers.

Both counties have been deluged by applicants. But finding the right candidates for the job is tricky, said Christine Keating, a public health nurse and contact tracing supervisor for Washington County.

These workers help keep outbreaks from growing by finding out who an infected person has been near, connecting sick people to support so they can quarantine, and helping those who have been exposed get tested. The job requires an unusual combination of skills.

“Contact tracers really need to have an understanding and be part of the community that they’re calling,” Keating said. “We really need contact tracers that speak the language of the people they’re calling, understand the values and the culture of the people they’re speaking to. They need to be able to gain trust and rapport really quickly on the phone, and have very strong interpersonal skills and interviewing skills.”

In this Wednesday, May 13, 2020 photo, Maria Fernanda works on contact tracing at the Florida Dept. of Health in Miami-Dade County, during the new coronavirus pandemic, in Doral, Fla. In state after state, the local health departments charged with doing the detective work of running down the contacts of coronavirus patients are falling well short of the number of people needed to do the job.

In this Wednesday, May 13, 2020 photo, Maria Fernanda works on contact tracing at the Florida Dept. of Health in Miami-Dade County, during the new coronavirus pandemic, in Doral, Fla. In state after state, the local health departments charged with doing the detective work of running down the contacts of coronavirus patients are falling well short of the number of people needed to do the job.

Lynne Sladky/AP

This work has existed for decades in Oregon on a limited scale, but before the coronavirus pandemic most contact tracers were focused on sexually transmitted infections. COVID-19 presents a much greater scale and more complex set of issues, Keating said.

“With a sexually transmitted infection, a person takes a risk by having unprotected sex, and then they get infected with something,” she said. “With COVID-19, your risk is just being within 6 feet of someone that is infected, and that is not something that generally we think about as a risk in this world.”

The virus can spread far more rapidly to far more people than contact tracers have typically had to manage. And people who are infected or exposed also face significant hardship when they’re asked to quarantine.

“People need prescription drugs picked up, they need groceries,” she said. “Some households will be able to manage that because they’ll have outside people that can help them with that — a family member or friend that’s outside of that isolation. But not every household is able to do that. We know that a lot of the people that are burdened with this infection really are low income frontline workers, and when they’re not working, they’re not being paid. And requesting them to quarantine is a huge burden on their families.”

In order for contact tracing to succeed at its goal of stemming the spread of infection, workers may help the families they interview get access to rent assistance or financial aid to cover utility bills, Keating said.

“People are in crisis. This is trauma that is happening within family systems, and a good contact tracer is able to work through those barriers with that person,” she said. “If you can get them talking about what actually is the barrier to staying home when they’re in that infectious period, that is key. And that is the skillset of a contact tracer.”

Washington County aims to train and hire 32 people for the job by Monday, which is when it hopes to enter Phase 1 of reduced COVID-19 restrictions. Multnomah County, which aims to enter the first phase of reopening on June 12, is about halfway through hiring 122 contact tracers.