As Toronto’s economy begins to gradually reopen, COVID-19 contact tracing could become more difficult for public health to conduct.
On Wednesday, Toronto’s Medical Officer of Health Dr. Eileen de Villa said that following up with contacts of positive coronavirus patients can vary in difficulty depending on how many people the patient was in touch with.
“Back in January, this was much harder, when people were still allowed to go about their day. But this may be the case again as our city opens up,” de Villa said.
“Case and contact management is critical to containing contact spread.”
De Villa said that Toronto Public Health has scaled up its capacity to meet the demands the pandemic has created.
Still, the city sees an average of 150 new coronavirus cases per day.
To date, a total of 11, 652 have contracted the virus with 8,948 recovered and 845 reported deaths.
When the pandemic started, Toronto Public Health had 50 staff for contact tracing. Now, the city has mobilized 550 staff to conduct case investigations.
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The Medical Officer added that Ontario health units were not equipped to manage the pandemic numbers.
Toronto Public Health built a new management system in eight weeks to “better and more quickly” track test results.
De Villa said that along with managing COVID-19, public health has also had to keep track of other communicable disease.
“COVID-19 is different. It’s a new virus to which no one is immune and there are no specific treatments or vaccines,” she said. “Many Torontonians get sick with the virus at a scale we have never seen before.”
De Villa also delved into the process of contact tracing, calling the level of detail required for the work as “challenging.”
Contact investigators asks patients what symptoms they have, when symptoms started, what activities they did, locations visited in the last two weeks and who the patient came into contact with.
“Being asked to recall this detail from two weeks ago, especially when you are sick with COVID-19 is difficult,” she said.
The investigators have strong communication skills, interviewing techniques and memory aids to help people reconstruct the past two weeks.
After this process, public health then identifies where and how people are becoming infected.
And, phone calls are made daily to check in on patients by asking them about general symptoms and their well being as they recover.
When identifying the patient’s contacts, Toronto Public Health also assesses the potential health risk based on an evidenced risk framework.
“We look into what contact is involved. Is it the same household, are they coworkers and if so, what kind of workspace, and how closely do they work together?” de Villa said.
Once this is measured, contacts are then placed into “close,” “non-close” and “casual contact” categories — close contacts are then followed-up with.