Spike in Covid-19 cases makes contact tracing harder

With multiple instances of record single-day spike in Covid-19 cases over the last two weeks, tracing contacts of positive cases has become a challenging task for

With multiple instances of record single-day spike in Covid-19 cases over the last two weeks, tracing contacts of positive cases has become a challenging task for the district health department. As new infections have nearly doubled since mid-October, the health department has set a three-day target to complete the process.

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“Strict contact tracing is crucial within a stipulated time period in the current situation. If it is not done effectively, then at a certain stage of the pandemic outbreak, all preventive norms fail. That stage of outbreak has to be prevented,” said Dr Virender Yadav, chief medical officer.

Contact tracing is done to identify close contacts of people who test positive for the infection, as they may have been infected prior to the onset of symptoms. For this, 206 rapid response teams (RRTs) (163 in rural and 143 in urban areas) under different primary health centres (PHCs) are already at work. It comprises ASHA, ANM or Anganwadi workers, who are accompanied by a lab technician.

Prior to the recent spike in cases, the activity could be completed in a day or two, unless there were incomplete addresses as they had to be located by the police. “Now, when the new infections have almost doubled in less than two weeks, our target is to contact trace people within three days. Any incomplete address would lead to further delay,” Yadav said.

Several studies show that a single positive patient can have over 36 contacts. However, across the country contact tracing is mostly restricted to family members.

In Gurugram, at least four to seven closest contacts of patients are traced. The state health department shows that contact tracing in Gurugram in the last couple of months has been above 90%.

Yadav said that nearly 40% of new cases are family members of patients. “Earlier, people were reluctant to get tested. Now, when one family member develops symptoms, the entire family gets itself tested in private labs and they all turn out to be positive,” said Yadav.

According to him, this has slightly reduced the burden of contact tracing and sample collection.

Experts say that contact tracing alone cannot control the transmission of infection. It can be mitigated only if it is integrated with precautionary norms like moving out of the homes only if necessary, maintaining physical distance in markets, using face mask, practising hand hygiene and avoiding large gatherings.

To reduce the transmission through potential carriers, Yadav said that the department has changed its strategy. “Earlier, when the case were below 300, only a final list of new infections was shared with the team under different UPHCs. Now, we release the first list in the morning hours so that the team could work on it and the second list in the evening, which they can trace the next day,” said Yadav, adding that each RRT team covers 15-30 houses based on the cases recorded in their area.