ILOILO City – No contact tracing has yet been launched for 1,532 confirmed cases of coronavirus disease 2019 (COVID-19) in Western Visayas. These were part of the region’s total 4,684 cases recorded as of Aug. 31.
“We need to improve our contact tracing,” stressed Dr. Glen Alonsabe, epidemiologist of the Department of Health (DOH) Region 6.
Contact tracing is the process of identifying, assessing and managing people who have been exposed to a disease to prevent onward transmission.
When systematically applied in the context of the COVID-19 outbreak, contact tracing is an essential public health tool that could help break the chain of transmission of this infectious disease.
“Kinahanglan ma-beef up ang contact tracing, especially in Negros Occidental and Bacolod City. Kanubo sang ila na-trace,” said Alonsabe.
Bacolod City had the lowest rate of contact tracing in region at 32 percent, while Negros Occidental had 52 percent.
Of the 1,285 confirmed COVID-19 cases in Bacolod City, contract tracing was launched in only 412 cases. There has been no contact tracing yet for 873 other cases.
In Negros Occidental, contacts of 602 cases have been traced while none yet for 553 other COVID-19 cases.
Contact tracing for COVID-19 requires identifying persons who may have been exposed to COVID-19 and following them up daily for 14 days from the last point of exposure.
So far, according to Alonsabe, close contacts of the region’s 3,152 COVID-19 cases (67 percent) have been traced.
The provinces of Aklan, Capiz, Guimaras, and Iloilo reported having conducted contact tracing in “100 percent” of their COVID-19 cases.
Antique recorded 87 percent contact tracing (39 cases) while Iloilo City, 91 percent (967 cases).
Currently, Alonsabe said, Region 6 has a case-to-close-contact ratio of 1:4 – lower than the ideal ratio of 1:37.
As of Sept. 1, Western Visayas had 566 contact tracing teams composed of 6,258 tracers. However, only roughly half of these tracers (3,321) have completed their training.
The region needs 3,912 more contract tracers, said Alonsabe.
The minimum standard ratio for contract tracers is one personnel for every 800 population, he said.
For contact tracing to be effective, countries must have adequate capacity to test suspect cases in a timely manner, according to the World Health Organization (WHO) in an interim guide issued on May 10, 2020.
Where this is not possible, it said, testing and contact tracing strategies may instead focus on specific high-risk settings with vulnerable individuals, such as hospitals, care homes, or other closed settings (e.g. dormitories).
WHO generally defines a contact as anyone with the following exposures to a COVID-19 case, from two days before to 14 days after the case’s onset of illness:
* being within one meter of a COVID-19 case for more than 15 minutes
* direct physical contact with a COVID-19 case
* providing direct care for patients with COVID-19 disease without using proper personal protective equipment
If contacts cannot be reached, according to WHO, the contact tracing team should ask relatives and friends or explore other means to find them.
If contacts relocate to known locations in the same catchment area, the contact tracing team should visit them.
If contacts move to another catchment area, the contact tracing team responsible for that catchment area should be informed and follow up.
If a contact develops symptoms, the individual should self-isolate, and follow the established referral pathway for testing and treatment in their area, according to WHO.
Ideally, contact tracers are recruited from their own community and have an appropriate level of literacy, strong communication skills, local language proficiency, and an understanding of context and culture, WHO stressed.
They should be recruited from their own communities; they should be familiar with and trained on the basics of COVID-19 transmission, prevention and control measures, how to monitor signs and symptoms, as well as the ethics of public health surveillance and quarantine.
Contact tracers workforce can be drawn from many settings, including local government, civil society, and non-governmental organizations, university students, community volunteers, etc.
According to WHO, medical personnel should not be assigned to perform contact tracing unless circumstances require.
Supervisors should be assigned to all contact tracing teams to allow for technical and logistics support, problem solving, and quality monitoring.
All contact tracers need to maintain a safe distance (more than one meter) when interacting with contacts or suspect COVID-19 patients, and conduct interviews preferably in well-ventilated areas or outside, as recommended elsewhere, stressed WHO./PN
