Medical Examiner

“It’s Like Putting a Band-Aid on a Bullet Wound”

A North Dakota contact tracer on the state’s coronavirus response.

A medical worker in PPE swaps a man's throat as he stands beside a car.
A drive-thru COVID-19 testing site in Bismarck, North Dakota, on Oct. 26. Bing Guan/Reuters

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When you pick up the phone, you do not want to hear Kailee Leingang on the other end of the line. Not because she isn’t kind—she is. But because her job is to deliver bad news: Leingang is a contact tracer, working in North Dakota, where the coronavirus infection rate has been soaring. “I try and sound as nice as possible just because it is not the most pleasant thing to hear that you have coronavirus,” Leingang says.

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On Monday’s episode of What Next, I talked with Leingang about her job, which is essential, and gutting, and getting harder every day. She’s one of the few people gathering clues about how this pandemic is spreading, so I asked her to tell us what she’s learned. Our conversation has been edited and condensed for clarity.

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Mary Harris: How soon do you know if it’s going to be a good call or bad call?

Kailee Leingang: Basically right off the bat. You can tell by somebody’s tone of voice if they are not happy with you and they do not want to talk to you. The whole time, I’m trying my best to change their mindset. I’ll make a couple jokes when it’s appropriate. I’ll ask them about their life.

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Have you met someone who’s changed in the course of this, someone who started out as resistant to what you had to say and then gradually became less so?

Yes, one person came to mind. Unfortunately, they are one that passed away. They were not happy with me at all. They didn’t think that this was a big deal. They didn’t think that they needed to be concerned. It was a cold. It was just a virus. And then as things progressively got worse, that’s where it came in: OK, this might be real. The constant calling and questioning of, Is this OK? Should I go in? Should I go in? Should I go in? Unfortunately, eventually they did go in, and they didn’t leave the hospital alive.

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Oh, that must have just gutted you.

It did. Yes, that was one that I didn’t hear from for a while, and then I kept trying to reach out and wasn’t hearing anything. I ended up being able to contact family and got told that they were on a ventilator. And that was basically the sign that this isn’t going to be good. This is going downhill. Especially the people that I have personally gotten to know—or I shouldn’t say personally but have been more connected with—I will call their family and just say, I’m so sorry for your loss, this is horrible and I’ll send flowers or a letter or something like that.

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Is that what you anticipated when you became a contact tracer?

Not at all, no. I anticipated maybe a couple deaths that I would have been involved in, but the volume of deaths that are coming in and the amount of deaths that I have been a caseworker for is very unexpected.

In addition to being a contact trader, you’re also a nursing student who does weekly clinical shifts at the hospital in Grand Forks. When you go from the outside world to inside the hospital, does it feel like you’re going to the moon or something?

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Yeah, kind of. They’re struggling. The staff is so run down. Then you come back out, and it’s like a whole different world because outside it seems like, Oh, no cares in the world, it’s all fine. And you go in the hospital and nurses are being floated to all different types of floors that they’re not supposed to be in, because there’s no staff to help the people. And most of the floors are full of people that had COVID and now they no longer are infectious with it, but they have the repercussions of it, whether it be strokes or pneumonia or blood clots in their lungs. It’s horrible.

You started your job back in August, when things were still pretty manageable. How did it work? Would you just get a list of numbers at the beginning of the day?

We would get assigned cases and then you’d call the cases and go through the whole interview. Eventually towards the end, you would get to that contact list—their close contacts. You’d give them the definition and ask, Who fits this in your life? Then you would get their names and their phone numbers. And then once you get off the call with the case, you have to call every single contact and let them know that they need to quarantine for at least 14 days. It was doable. And it wasn’t terribly hard. It’s very systematic.

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When did you sense the job changing and ramping up?

There were more and more cases, and so it seemed like it got busier and busier. As soon as you finished one case, you had to go to another case and then another and then another. When it changed drastically is when we were notified that we are no longer contact tracing and we no longer are contacting any close contacts. We are only calling cases.

How did you get that notification? 

We have weekly meetings that we have to go through. And in our meeting, we basically got a notification from our manager saying, All right, we are no longer contact tracing. You are now just talking to cases and getting their information and telling them that they need to contact their contacts and not us.

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How did everyone react when they got that news?

I was upset. Nobody wants to call their friend and be like, Hey, sorry, I’m positive. And you need to quarantine for 14 days. It’s not a comfortable conversation to have with anybody, much less your family or your friends. And when you’re telling your friends that, it’s not as official or as serious, compared to when a state contact tracer calls you.

So I think to me it was hard to accept. It was like, Oh, my heavens. This is just going to make the numbers go up more. People aren’t going to call their friends or their family and tell them. I can see how people would be embarrassed or be discouraged from doing that. It made me scared. I understood the reasoning behind it and why we had to switch to this, but it scared me. Still does.

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I wonder too if you felt like while the work was getting harder, you were also able to figure some things out through your job. You could begin to unravel the mystery of where someone might have contracted the virus or what kind of events might have spread it.

Yeah. Where did you go? Were you at a house party? Did you go out to eat somewhere? Did you just go to the office and your whole office has cases? It was almost like being Nancy Drew for the virus.

Was there a time when you were able to figure something out like, Oh, it was the wedding, or Oh, it was that dinner?

A lot of it came down to working in offices, like the whole office is a case.

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So what does your job look like now?

Now it’s only cases. So I wake up, I have some coffee, I have some breakfast, log on, and get a list of people to start calling. I’ll call them, get their information, get their monitoring set up so I can see how they’re doing, answer any questions, give them their “I need to isolate” letters—so they can show that to their employer if their employer needs proof that they cannot come into work—and tell them, OK, reach out if you have any questions. This is my phone number. You can call me or text me at any time.

I wonder if you can talk about how your conversations have changed with people from when you started in August until now.

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People are more resigned now. You call them and you say that you have COVID, and obviously the people are upset. It’s still an upsetting thing to hear. But it’s everywhere. Every single place that you can go right now, if it’s at a gas pump, if it’s to Walmart or Target, if it’s just to your neighbor’s house to have a dinner, it’s everywhere. One of our screening questions that we have to ask is, Do you have any idea where you could have gotten this? And their answer is always, Honestly, it’s a mystery. I’ve had some of the safest people that they’ll say, I have been so careful. I have worn a mask since Day One. I have not gone anywhere. I don’t go to restaurants. I don’t go to bars. I don’t go to parties. I don’t see anybody. I’ve been locked down, and they still get it. And it’s almost like a defeating thing to hear. It’s heartbreaking to be the one to give that news and then to just hope that they’re OK.

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The hard thing is when you’re calling a mom—I’ve had single moms to three kids, and all the kids are sick, and she’s sick, and she’s miserable. And then I’ve had families of five where Mom and Dad are sick, and all the kids are sick and miserable, and they just don’t know what to do. Immediately what comes to my head is what happens if one of these parents has to go into the hospital? How much strain is that going to put on that poor family dynamic? Obviously, that’s not something that I share with the cases. I don’t want to scare them. I want them to remain as calm as possible. But I think at this point, when people get told they have coronavirus, that’s one of the fears that comes into their head.

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You and your own family were exposed to COVID in the past few weeks, is that right?

My parents both were cases. I actually had seen them, so I was exposed. I was a contact, I needed to isolate, which I did, and then basically I kept calling them. I called them every day just to check in. My father has some health conditions, so I was very worried about that. My mom was OK. She was doing fine. But it was concerning. I ultimately started getting some symptoms, so I’m like, Here we go.

Did you ever talk with the people you were contact tracing about your own sickness or your parents’ sickness?

Yes, the ones that I was closer with, if they were really struggling and they were really upset about being in quarantine, I would say, Look, I get it. I’m in quarantine right now, too. I was able to say, My own parents are going through it right now. I understand your fears. We’re going to get through it. We’re in it together, as cliché as it is at this point.

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When I look at what happened in North Dakota, it just kind of suffuses all of the decisions, especially from government—where the governor held off on a major restrictions on people and put some loopholes in the restrictions he did put out there. I wonder if you would pinpoint something or someone that’s failed here.

I feel like the government for North Dakota is failing. It’s not going well at all. There’s not enough economic support for businesses to actually shut down when they should. We finally have this mask mandate, but it’s too late for that. That will help the spread, of course—masks work—but the amount of people that are sick, it’s like putting a Band-Aid on a bullet wound right now. It’s sad because I don’t think the health and well-being of other people are being prioritized. What scares me even more is what’s going to happen when this is all over.

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What do you mean by that?

We’re going to have so many people that have passed away and so many people that are traumatized, whether it be from being sick themselves or if it’s people that have had family members pass away that passed away by themselves alone, or if it’s health care workers or front-line workers in general. And so what scares me is what are we going to be left with.

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It’s a little startling to hear you speak like this, because when we got on the phone, you had this manner that I very much think of as a nurse manner—very efficient, happy, chipper, can-do. Any time I’ve been in a hospital, I feel like I’ve met someone like you and they’ve made my experience better. But it sounds like this has pushed you to an edge.

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That goes for a lot of people at this point. You put on the strong face and the smile and all of that. But it’s important to also recognize the pain that’s behind this and the tragedy and all of the ugly sides of it, because there’s a lot of ugly sides to it. And if people don’t hear about that and they don’t talk about that, nothing is ever going to be done. Nothing’s ever going to be understood.

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