As Canada reopens, our economic recovery rests on the efforts of contact tracers. No pressure, there.
Ashby, a contact tracer, normally works in a prenatal program: ‘We don’t deal with death’
Ashby asked him about his symptoms, his living arrangements and how he would manage in quarantine. Keshtpour, who later spoke to, recalls telling her he’d had colds that felt worse, and that he would have groceries delivered.
When strict social-distancing guidelines are in place, and people abide by them, a contact tracer’s job is easier: such efforts result in fewer total cases, and those who do test positive don’t have as many relatives, colleagues or friends to track down.
Which is to say, if Canada wants effective contact tracing for nearly 38 million people, the country is going to need to sign up more people to play defence. Last year, before COVID-19 arrived, Alberta Health Services had about 30 employees working year-round on contact tracing—mostly following up on cases of measles or sexually transmitted infections. But when the coronavirus started to spread, the province’s lone health authority quickly exhausted the capacity of this core team.
“I’m not just calling for a temperature check,” adds Sheila Montague, a nurse who handled case and contact management for the first COVID-19 case in London, Ont. It’s about establishing mutual trust to make sure people abide by self-isolation rules, she says, and patience and attention to tone are essential: “The minute you start to preach, you lose them. And if you start to get angry with them, they won’t pick up the phone.
Consider a COVID-19 case that travels the following arc: five days after contracting the virus, the patient starts to experience symptoms; a couple of days pass before that person gets tested, and still another before the result is available. Rewind eight days and you’re at Mother’s Day. Of the situation in London, Summers says: “If someone gets tested the first day they have symptoms, it’ll be four days before all their contacts are called. That’s as good as it’s going to get. What we can’t control is how quickly people present for testing, and if we can reach your contacts.”
Tuite found that even if restrictions are loosened slightly from the days when non-essential workplaces were shut, keeping the spread rate below one would require a majority of symptomatic cases to be discovered through testing, and all known contacts to be traced before they themselves became infectious. For those anticipating the return of live music concerts and bustling workplaces, it’s a splash of cold reality.
Still, as adults return to the workplace and kids to schools or daycares, there’s an added challenge in identifying every person an infected party has been in contact with, as opposed to those merelyto the person who tests positive. If workplaces reopen and public activities resume, then 60 per cent of exposed contacts—known or unknown to the coronavirus-positive person—would need to be traced and isolated in order to avoid a rebound, according to a recent York University study.
But apps only work as long as lots of people are willing to use them. A month after its launch on May 1, the Alberta app had about 200,000 registered users, representing about four per cent of the population. On July 2, Ontario will roll out its own tracing app, one that Prime Minister Justin Trudeau hopes will be adopted by the other provinces and territories, and one he said will be most effective if many Canadians download it. “There are over 30 million smartphones that could take this app in Canada,” he noted, “so we can talk about a significant portion of the Canadian population that could be protected by this app.
As a result, Cavoukian is calling for sunset clauses on government use of tracing apps and the data they yield. “You need something to put a firm stop to this when this pandemic ends, which it will,” she says. “I have no faith in the government holding itself back and returning the additional powers it’s obtained during this period.”
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