Covid-19: Contact tracers to start looking into where people are infected

Extra information to be gathered about cases labelled ‘community transmission’ up to now

The new inquiries would highlight potential sources of infection, and help to identify people at risk because of the locations in which they are moving about in the community. Photograph: Paul Faith/AFP

The new inquiries would highlight potential sources of infection, and help to identify people at risk because of the locations in which they are moving about in the community. Photograph: Paul Faith/AFP

 

Contact tracers are to begin investigating where people are infected with Covid-19, following admissions this week by the State’s public health team that it cannot tell where cases are happening in the community.

In a letter to Government, the National Public Health Emergency Team (NPHET) said that retrospective contact tracing would gather extra information about Covid-19 cases labelled only as “ community transmission” up to now.

Last night, a HSE source said tracing teams will now play “detective” and investigate in greater detail the movements and contacts of a confirmed Covid-19 case to identify at-risk bars, gyms, restaurants or other locations.

The change comes after Prof Philip Nolan said last week that people are only questioned about their contacts during the 48 hours before they develop symptoms, rather than tracing back to where they could have been infected.

His declaration came after pubs and restaurant bodies complained that they were being blamed for the rise in cases, even though all the HSE’s graphs had laid few such cases at their door.

However, Prof Nolan said cases were tagged community transmission even though they could have emerged first in a restaurant or bar because public health teams did not have the resources fully to identify people’s movements.

In a letter to Government on Thursday, acting chief medical officer Ronan Glynn said that team had endorsed “enhanced retrospective contact tracing” of confirmed Covid-19 cases to ensure the system is “as robust as possible”.

The new inquiries would highlight potential sources of infection, and help to identify people at risk because of the locations in which they are moving about in the community.

Localised interventions

“Such an approach will allow the environments and activities associated with the greatest levels of transmission be more accurately and quickly identified,” Dr Glynn told the Government.

Prof Kirsten Schaffer, president of the Irish Society of Clinical Microbiology, told the Oireachtas Covid-19 committee that public health teams are only asking people with a positive test for the details of the people they have met in the last 48 hours.

This gap, she said, was impeding the development of more refined or localised interventions, though public health doctors said they did not have the resources, or the time for more detailed work.

In the fortnight to 19th September, 36 per cent of cases are linked with community or possible community transmission.

In its guidelines, the European Centre for Disease Prevention and Control says contact tracing should “rapidly identify secondary cases that may arise after transmission from the primary known cases in order to intervene and interrupt further onward transmission”.

Japanese and South Korean contact tracing goes further back to establish where the sick person caught the virus, leading to a greater knowledge of what settings and situations the virus can spread in.

Mental health concerns

Meanwhile, more than 70 mental health organisations have expressed serious concern about the absence of mental health in the Health Service Executive’s Win Plan for 2020, warning that service demand will sharply increase in coming months.

The focus “on keeping people with physical health needs out of hospital beds is welcome and understandable”, said the chief executive of Mental Health Reform, Fiona Coyle, but “keeping people with mental health difficulties out of hospital” is vital, too.

Calling for extra funding to repair “this glaring oversight”, Ms Coyle said mental health will become a bigger problem “over the tough winter months ahead” when access to services will become more difficult.

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