The Government has trained a small army of people in contact tracing, the key human-led offensive weapon in the battle against Covid-19. But as things stand major question marks surround the efficacy of the system, at least in its Irish context, suggests Cianan Brennan.
Since the first case of the coronavirus was confirmed on Feb 29, roughly 2,000 people have been trained as contact tracers, based out of nine centres around the country.
At the start of the pandemic just 40 people were employed, outside of public health, to trace the contacts of those infected.
Last Tuesday, May 5, just 40 people were once more working to trace the movements of those new confirmed cases, which numbered 211 on that date. So, in effect, each person working the system on that date had five infections to deal with. The previous day the figure was 71.
Asked about that seeming under-utilisation of resources at the daily briefing of the National Public Health Emergency Team (NPHET) in Dublin, the HSE’s Dr Siobhan Ni Bhriain explained that the amount of people deployed for contact tracing is flexed depending upon the need on any one day.
Chief Medical Officer, Dr Tony Holohan, meanwhile explained that at any one time there are between 60 and 80 “expert” contact tracers operating out of the public health system — with the truly onerous or “challenging” cases generally sent their way.
Nevertheless, despite the fact that confirmed Irish cases appeared to spike once more over the weekend, jumping from their lowest level in six weeks, 137, on Thursday to 236 on Sunday, there appear to be two real issues with contact tracing here — one of perception, and one of speed.
The fact is that having just 2% of those available to contact trace working on same when we’ve supposedly reached the HSE’s much-vaunted goal of conducting 100,000-plus tests per week isn’t good optics.
The average number of tracers deployed for viewed ending May 2 was 70. Last week's figure was 81. To be fair, the issue of under-utilisation may evaporate now that the case definition for the virus once more allows most anyone who wants one to get a test.
Speed is the more important problem here however. For two months the HSE has been telling us that test turnaround times were dropping. When people were waiting for nearly four weeks to get a result, we were told that average waiting times were between 7 and 10 days. Now we’re told the average wait is 2.5 days. In my understanding , the wait time at present is closer to a week.
So we’re being told one thing but experiencing another. That doesn’t engender trust, particularly when the trend is consistent. And if people don’t trust, they won’t comply.
Worse still is the turnaround times. Contact tracing takes a number of days — if a test takes even four days, you’re looking at the guts of a week before an infection is traced, and that’s assuming everything goes smoothly, which it hasn’t been. At that point, the benefits of contact tracing are surely moot.
In order for the process to be effective, the turnaround time for test-to-result has to drop once more to a 24-hour window at most. That is the HSE’s first true challenge at present. The other is to be more truthful about it.