Seven of nine contact tracing centres have been closed

Seven of the nine centres operated by the State for contact tracing have now closed as the number of cases of coronavirus continues to fall.

The number of contact tracers has also fallen steeply with 30 on call at all times, compared with over 300 at the height of the pandemic.

However, ahead of a new round of extensive testing planned for nursing homes, the number of contacts identified by people diagnosed with Covid-19 has been rising since restrictions were eased three weeks ago.

The average number of contacts per diagnosis has risen to close to 3.5 per person in the weeks since May 18th, compared with an average of two when the full lockdown restrictions were in place.

Number of contacts per diagnosis almost double since restrictions eased

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The Health Service Executive said the increase was to be expected as travel restrictions were lifted, more shops, services and businesses reopened and people left their homes more frequently.

It is expected the average number of contacts will rise after the new testing exercise in nursing homes, which follows widespread testing carried out in homes during April and May. There have been more fatalities recorded among residents of nursing homes than any other group or setting.

Cause for concern

The HSE has said that one person last week named a total of 25 contacts when diagnosed with coronavirus, a level that has not been seen since the early stages of contact tracing last March.

Senior officials said the case was an outlier but accepted if the number of contacts for each case began to approach those levels it would be a cause for concern.

When the process commenced in mid-March the average number of close contacts was 20. This dropped very quickly to an average of three and a median of two per person. In the first week after restrictions were eased, the median had risen from two to three, for the first time since mid-March. It has been rising since, as has been the average, which is now moving towards four.

Sources in the HSE said concerns would be raised if the number of close contacts was to rise. “As close contacts have a higher positivity rate, more contacts will lead to higher cases.

“But the concern would arise if we started to see a steady rise in cases over a longer period,” added the source.

With an appreciable drop in the number of new cases in the past few weeks, the scale of the contact-tracing operation has been reduced.

Now, only two of the nine centres that were operating at the height of the pandemic remain open, with enough staff deployed to have 30 available on a seven-day basis.

Scaling up

The first call is always made to the diagnosed person by a clinician. The second and third calls are made to ascertain how many contacts the person has had in the period around diagnosis, and then to contact those people to inform them they have been in close proximity to a person with coronavirus.

With wide testing due to restart in nursing homes in the coming weeks, it is expected there may be a short-term need to scale up the operation. There are also contingency plans to bring in more contact tracers quickly should there be further surges of the virus in the coming months.

In all, some 1,500 people were trained to be contact tracers before and during the outbreak. However, given that there were no dramatic spikes in the spread of the disease, no more than 200 to 300 were used.

Plans are afoot to put contact tracing on a permanent footing, in one or two centres with a small number of core staff, who will be able to deal with monitoring future viral outbreaks or a second wave of coronavirus, either regionally or nationally, and tracing contacts.

The service will be designed, said officials, to be scaled up quickly should the need arise.