Covid-19 contact tracers hampered by spike in cases

 

COVID-19 | Covid-19 cases have spiked up drastically since the start of the third wave, causing health inspectors conducting contact tracing to struggle to keep up with the number of cases.

A health inspector based in Klang, who spoke to Malaysiakini on condition of anonymity, said the contact tracing process has been delayed ever since the number of cases in Klang shot up.

“Normally within two days, if you are a close contact, you will get a notification to go get screened.

“How quickly the contact tracing process is done depends on the area. For example, Klang is slow now because we have a high number of cases, but in other places, I am sure they are still fast,” the health inspector said.

Even with technology such as the MySejahtera mobile app, which was designed to help track down close contacts, the process is still not as efficient once there is a large number of cases.

The inspector said they do not have the luxury of time to sift through all the MySejahtera records for every patient due to the influx of cases, so they usually do contact tracing by interviewing the index case as well as any other relevant individuals.

This is sufficient, the inspector added, because close contacts are defined as someone who was exposed to the patient for 15 minutes or more, who had less than one metre of distance in between them, had physical contact and was not wearing a face mask.

With the stringent criteria for close contacts, most of the time it is someone the patient personally knows.

On the contrary, technology may even be hampering the efforts of contact tracing, the health inspector said.

“Because there are a lot of cases now, when there is an index case, there are usually a lot of close contacts and when there are a lot, we have limited resources.

“For example, we will use mobile phones to call close contacts but because it is not a landline, some people think we are scammers, so we need to explain to them that we are not.

“If we can’t reach them through a call or they still do not believe us, we will go visit their houses, we will not just leave it be,” the inspector added.

Sometimes, in order to convince people that they are not scammers, they might ask the people to call the official landline to confirm they are working for the Health Ministry.

They may even have to endure having police reports lodged against them for suspicion of being scammers.

Another challenge they face while investigating close contacts is the panic created by people via social media, the inspector said.

People would take pictures or videos of the health inspectors or officers wearing their personal protective equipment (PPE) when they visit a location to investigate close contacts.

Those pictures or videos would be circulated on social media, the inspector said, causing stigma for the location they are visiting.

In turn, out of fear of being stigmatised, those who were visited by the health inspectors will try to get rid of the inspectors as quickly as possible, thus hampering their investigations.

“Sometimes when we send the Health Ministry vehicle to go pick up a person, they will tell us not to send it to their house, they will go further away to be picked up because they don’t want to be stigmatised,” the health inspector told Malaysiakini.

Such instances will make it more difficult for the health inspectors to carry out their duty and will delay the contact tracing process, the inspector said.

Health Ministry director-general Dr Noor Hisham Abdullah (photo) also acknowledged this problem in yesterday’s press conference, saying that their officers are not as efficient at contact tracing when the daily cases increased to three or four figures.

“If the number of cases is two figures or one figure, the public health activities or the capabilities of the officers to curb the spread of the infection is faster and more accurate, that is if the numbers are not too high.

“But when the cases increase to three or four figures, that means the abilities of our officers on the field to carry out their investigations and public health activities are not as efficient.

“This is the challenge we face and we are worried that if the cases increase, then we cannot carry out public health activities quickly,” he had said.

Noor Hisham explained that it usually takes about two days to trace close contacts if the cases are confined to one locality but it would take much longer if the cases were spread out across several areas or even states.

“If it is confined to one locality, it is much easier for us to do. Some clusters, for example, involve not only one area but also multiple states.

“That is more challenging for us to detect them across other states,” he said.

Noor Hisham had then pointed to the example in Sabah, which saw an explosion of cases after the state election.

Though they were initially using RT-PCR tests to detect Covid-19, the results took too long to return as the infection continued to spread, he said.

Thus, they switched to using RTK antigen to test for Covid-19, which could produce results within a day.

Now, he said, Sabah uses about 100,000 RTK antigen tests a month.

“RTK antigen produces fast results and when we have fast results, public health intervention can be carried out as quickly as possible,” he said. - Mkini