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1) Infections come from somewhere, usually melee contact with a hostile anomaly, social fights with guests, or new recruits. Try to keep a mental tab of who has been in melee and if you can remember who, arrest them and interrogate them.
2) Don't use your doctors to test for the infection initially. Infected doctors can rapidly spread it throughout your colony.
3) Arrest everyone near the grey flesh that drops and interrogate them. Interrogations will not only reveal if they're a metalhorror, but will also reveal who infected them and how if you check their health tab.
4) The metalhorrors can infect multiple people before you find out they're in your colony. Don't assume that it's just 1.
5) If you've found a metalhorror infected colonist, arrest their spouse as well.
metal horros forces a player to be highly xenophic and create bases that limit social interaction
which is great if you like that sort of thing but terrible if you actually want to play the game
...guess this is where my Anomaly playthrough ends, then.
Though I'm not sure if it's "fine". Depends on how "random" metalhorror infections are. If you can e.g. just keep your cook(s) and doctor(s) out of melee combat with some types of entities and quarantine new arrivals... that's fine imo (though still needs an option to disable, not sure if the scenario editor has something for that). If that's not enough it sounds like it has a chance to turn into "rock falls, everyone dies".
https://rimworldwiki.com/wiki/Metalhorror#Summary