Published: March 25, 2020 10:43:29 pm
While the Integrated Disease Surveillance officials play a major role in this contact tracing, revenue, civic and police are key elements of the process. (Representational Image)
As coronavirus (COVID-19) spreads further, the pressure on the state machinery involved in the multi-layer, multi-agency exercise of contact tracing of patients is mounting by day. This crucial process is considered as key in the battle against the disease.
Public health experts say contact tracing has two purposes. One is to figure out who a sick person caught an illness from, and the second is to find out who they have been in contact with while infectious. When it comes to COVID-19, people can incubate the disease for over a week before they show symptoms and realise they have been infected.
This means they need to backtrack to remember all the people they have recently been in contact with, which can be tricky work. One can be at higher risk of infection if he or she has had face-to-face contact with a confirmed case or shared an enclosed space with them for more than two hours or so, according to health experts.
As an example of contact tracing, in the case of the 41-year-old woman anganwadi worker from Pune who was found to be positive, and is currently in the ICU at Bharati Hospital, a systematic plan was chalked out to trace her contacts. At least 104 persons have been contacted by officials who the woman had connected with in the last fortnight.
According to Pune Zilla Parishad CEO Ayush Prasad, there are three levels – the primary being at the hospital where the patient has been admitted. So, in the case of the 41-year-old woman, the list of people she had connected with in the last 15 days was obtained by the medical officers treating her. From this list, the immediate ones that she was in touch with daily are the high-risk contacts, including family members. Then their contacts are interviewed as well as those they had connected with. These would be at a low-risk.
While the Integrated Disease Surveillance officials play a major role in this contact tracing, revenue, civic and police are key elements of the process.
Any suspected case is first quarantined either at home or a health facility and their swab is sent for testing. If the test is positive for coronavirus infection, then the patient is admitted to a designated hospital — which is Naidu Hospital in Pune’s case — and is kept in isolation till the person is free of infection. As part of the process, civic bodies like the Pune Municipal Corporation (PMC) have set up teams ward-wise to carry out tracing of all contacts of the patient in the near past. The patient’s complete travel and contact history is taken either from the patient in the hospital or his close relatives, friends and office colleagues. This effort is coordinated by the ward medical officer of the area of residence and office, as the case may be.
The team under the ward medical officer directs the contacts to be home quarantined and it tracks the health of contacts for 14 days to observe the symptoms of infection in them. If there are symptoms, then the person is referred for the test.
The traced contact list is also shared with the police to trace the person so that the civic staff reaches out as early as possible through the ward medical officer of the respective area. The local police is also given the responsibility to ensure that home-quarantined patients do not violate the quarantine rule.
A police officer explained, “When a positive patient gives details of the places and people he or she has visited, there is also a possibility that some information is intentionally or unintentionally left out. We cross-verify the details with technical analysis, including phone tracking, and the information that is left out is cross-checked again. Police teams help health staff track people, find their address, contact them and deal with any possible friction that may arise. A large number of police teams are deployed for monitoring the people who have been home quarantined. Until five days ago, our teams along with civic staff used to check in person. But now it is being done through video calls or WhatsApp calls. The patient is made to show us that he or she is at home.”
Staff from Special Branch, Crime Branch, Cyber cell and the local police station have been diverted to these activities. On a positive note, the steep drop in crimes under all heads has allowed police to dedicate almost all its manpower into coronavirus control measures, including lockdown implementation.
The rising number of positive cases of coronavirus infections is putting pressure on the already short staff deputed to trace contacts of patients.
While this process needs a lot of inter-agency coordination, officials from the health department, civic bodies and police are saying that the pressure on their teams is mounting. But all efforts are being made bring in more staff into these activities. “The manpower allotted for contact tracing is much lower in comparison with the workload. The poor attendance of staff is further burdening the on-field staff with continuous work of surveying the area. If the staff is not given at least one-day break from work, then the situation will worsen or the system will be in danger of a breakdown,” said a civic officer.
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