There is growing concern among contact tracers who track Covid-19 infections that the increasing use of automated processes will result in cases being missed.
Contact tracers have been instructed by the Health Service Executive in a new management directive not to collect the names of close contacts from newly infected people on calls unless those people cannot upload details of their close contacts themselves on an online system.
The Covid-19 tracers were told to no longer collect the person’s close contacts but to direct them instead to list their own close contacts on a “List your Contacts” portal.
The new direction was given over the weekend as the HSE’s testing and contact tracing system comes under strain coping with the surge in cases and follow-up calls. The number of daily new cases has increased from about 1,500 a day in early September to more than 3,000 a day over the last week.
The tracers are still expected to collect close contacts if the infected person attends or works in a creche or school, or lives in a nursing home or is a patient in hospital.
They are also expected to collect close contacts if there is a language barrier, requiring an interpreter to communicate with the person, or if the person has a disability.
One contact tracer questioned the new approach, saying that few people listed their own contacts properly if asked to do so voluntarily. The source criticised the change as “a complete abdication of even the most basic public health responsibilities. What is the point of having a test and trace operation if you are not going to trace close contacts?”
The contact tracer said that they were being put under relentless pressure in recent weeks and being forced to take shortcuts such as no longer assessing the health of patients.
“We have moved from a care centre to a call centre with no emphasis on collecting close contacts. It is just a numbers game and getting through the list of positive cases. It is impossible; there are so many cases on the system at the moment,” said the contact tracer.
The HSE’s lead for testing and tracing Damien McCallion said last week that the contact tracing operation was coming under strain with the increase in new daily cases but that “automation” being introduced would improve responsiveness and capacity.
Mr McCallion told the HSE Covid-19 briefing last week that the increasing prevalence of disease and the impact on contact tracing was “a concern” coming into the busy winter period.
He said there were about 16,000 calls made to close contacts over the previous week.
Covid-19 positive cases have been able to list their own close contacts for some time. But from last weekend the practice has been deployed more widely with contact tracers no longer collecting close contacts unless there is a reason the individuals cannot trace their contacts themselves.
A HSE spokeswoman said that it was constantly seeking to improve the efficiency of the contact tracing operation, including developing “an escalation plan” to deal with the sudden increase in call volumes.
The HSE stressed that contact tracing of close contacts was still continuing and that contact tracers would take the names of close contacts over the phone if the cases were unwilling or unable to enter details of their own close contacts through the online system.
“A number of automation processes have been put in place to improve turnaround times for Covid-19 throughout the pandemic, including requesting positive cases upload details of their close contacts,” she said.
“This option is being offered as we have seen from time to time that people may be reluctant to list out all their close contacts over the phone. The HSE would encourage people to provide all of their close contacts to limit the spread of the virus.”