Ottawa

Public health detectives on the case to limit spread of COVID-19

OPH contact tracers are reaching out to family, friends, neighbours, caregivers, fellow travellers, work colleagues and anyone else who's had sustained contact with people who've tested positive for the respiratory illness.

OPH wants to warn others who may have been exposed before they pass it on, too

Two people wear masks while out for a walk in downtown Ottawa during the COVID-19 pandemic on Friday, May 1, 2020. (Sean Kilpatrick/Canadian Press)

They're modern-day medical detectives, tracking down the people at greatest risk of contracting COVID-19 in an effort to stop the disease's deadly creep. 

Contact tracers are reaching out to family, friends, neighbours, caregivers, fellow travellers, work colleagues and anyone else who's had sustained contact with people who've tested positive for the respiratory illness.

Ottawa Public Health (OPH) now has a team of between 55 and 155 case managers working seven days a week to trace contacts, according to Andrew Hendriks, the agency's director of health promotion.

Before COVID-19, OPH managed with a communicable disease team of just six, tasked largely with tracing such sexually transmitted diseases as syphilis and gonorrhea to prevent outbreaks.

When Hendriks first joined OPH as a nurse, his job was to follow up on cases of tuberculosis, measles and mumps. Now he's risen to the rank of incident commander for OPH's COVID-19 response, a job that includes overseeing the contact tracers.

Ottawa Public Health's Andrew Hendriks speaks to a reporter in 2017. (Trevor Pritchard/CBC)

The process begins when the lab faxes — yes, faxes — a positive COVID-19 test result to OPH, which then contacts the patient to relay the bad news. Then the contact tracer gets down to work, grilling the patient about who else might have been exposed.

"Do they have a recent travel history? Where have they been in the community? What are their close contacts? Their family members? Employer or employee exposure?" All pertinent questions when it comes to slowing the spread, Hendriks said.

The contact tracer follows up with phone calls to anyone who might have been exposed, but they don't reveal the original patient's identity.

 "We don't tell them actually who it is because we need to protect the privacy of the individual case," Hendriks said.

The contact tracers are primarily nurses or people with a background in public health such as inspectors. Many are recent retirees who've been trained to trace contacts.

"It's really attention to detail," Hendriks said. "How long did you spend in the waiting room of the clinic? Were there people around you?"

It does rely on people being forthright and honest with the information that they're providing ... knowing that there is some stigma attached to that.- Andrew Hendriks, OPH

The contact tracers are noticing an improvement as people become more conscientious about physical distancing, Hendriks said.

"Early on in the COVID-19 response … we had upwards of 20 contacts per person … that we would need to follow up with. And now we're into a handful — two, three, four contacts per person," he said. "And it's usually household contacts, not, 'I went to a party."

The contract tracers rely on people's memories, but also on their honesty.

"It does rely on people being forthright and honest with the information that they're providing ... knowing that there is some stigma attached to that," Hendriks said.

Digital contact tracing is an infection control strategy that has been used with great effectiveness in other countries. (Steven Senne/Associated Press)

App coming soon

OPH is launching a smartphone app "as soon as possible" that will help trace contacts more efficiently.

The app, which will be strictly voluntary to download and use, will use geo-location to determine who may have been in sustained contact with a positive case of COIVD-19. Contact tracers will then seek permission to use the smart phone data to send an automated message directly to those contacts, who must also have downloaded the app.

"The user of the application has to consent. We want to be very, very mindful about privacy concerns, and we don't want to ever jeopardize any private information," Hendriks said.

The automated message will ask recipients to self-monitor for symptoms, and to report for testing if they get sick. 

"The more people that are using the technology, the stronger the system will be to notify people," Hendriks said. "We do think that there's enough interest in COVID-19 out there that there will be quite a significant number of people interested in this type of technology."

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