Overwhelmed by increase in cases, Montreal public health narrows contact-tracing efforts

Health officials will now only call direct contacts of positive cases, leaving the rest up to the patients.

Health officials will now call only direct contacts of positive cases, but one expert says that isn’t enough

These days, people's contacts have multiplied to the point where public health officials often find themselves contacting dozens of people for every positive case and can no longer keep up. (Graham Hughes/The Canadian Press)

Montreal public health teams will be calling only those who test positive for COVID-19 and those who are at highest risk of doing so, from now on. 

"We will continue to contact people who were in direct contact and those who are at higher risk," Montreal public health spokesperson Jean-Nicolas Aubé told Radio-Canada. 

Normally, when someone tests positive for COVID-19, public health teams work diligently to determine and contact everyone that person had been in contact with, in an effort to slow community spread. 

But since activities resumed, people's contacts have multiplied to the point where public health officials often find themselves contacting dozens of people for every positive case. 

In the last seven days alone, public health officials had to reach out to more than 10,000 people for contact-tracing purposes, with each phone call taking up to two hours. 

But with their teams understaffed, public health says it was becoming impossible to meet those demands.

Instead, Montreal public health officials are now asking everyone who tests positive for COVID-19 to reach out to their contacts themselves. 

But Prativa Baral, an epidemiologist with the Johns Hopkins Bloomberg School of Public Health, says that isn't good enough. 

She would like to see the province go back on its decision not to use the COVID-19 alert app instead. 

"The most effective way of doing proper contact tracing is if you can reach those contacts as soon as possible because you want to limit their interactions with other people, you want to limit the virus from finding additional vectors," said Baral. 

"Using an app, I think, would be the best way forward." 

When the first wave of COVID-19 hit last spring, there were about 150 people working in contact tracing in Montreal. With so many of them being students who have since gone back to school, that number has dropped down to 80. 

Worse still, even when they do manage to trace all contacts, there are many who don't pick up the phone. At a news conference Monday, Montreal Public Health Director Dr. Mylène Drouin said that of the 500 people they called last weekend, only a third responded.

Baral said having COVID-19 patients reach out to contacts themselves makes sense given the shortage in staffing, but is not the most effective way of controlling the virus. 

"We could be doing a lot better. There are multiple outbreaks happening across the province and given the number of contact tracers that we have available in Quebec, they will not be able to trace properly and isolate these contacts properly and that's the number one thing that we need to do," said Baral. 

There are about 750 people tasked with contact tracing across the province — Laval and the Montérégie each have 172, Saguenay-Lac-Saint-Jean has 87 and the Lower Saint-Lawrence and Laurentians each have 50. 

Health Minister Christian Dubé put out a call for help with testing sites and contact tracing. On Thursday, he said about 4,000 people have responded so far. 

With files from Sarah Leavitt and Radio-Canada's Mélanie Meloche-Holubowski

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