Montrealers who test positive for COVID-19 are now being asked to self-trace their contacts who are at moderate risk of exposure because overwhelmed contact-tracing personnel are busy trying to reach the high-risk ones, the regional public health department has confirmed.
The self-tracing measure is temporary, said Jean Nicolas Aubé, a spokesperson for the health and social services agency for Centre-Sud-de-l’Île-de-Montréal, which encompasses the Montreal public health department. He added that the measure is the direct result of the sudden spike in new COVID-19 cases last week.
“Obviously, the current situation is exceptional and it’s not permanent,” Aubé said. “The number of cases nearly quadrupled very rapidly.”
The number of new positive cases in Montreal leaped to more than 200 per day between Friday and Sunday, leading the province to raise the level of alert on the island to orange .
Around 7 p.m. on Sunday, Mylène Drouin, the director of the Montreal regional public health department, sent a memo to personnel informing them that contact-tracing efforts would now concentrate on reaching 100 per cent of the new people testing positive for COVID-19 and all of their close contacts who are at high risk of exposure.
For contact tracing to be effective in slowing virus transmission, contact tracers have to reach an infected person and then their close contacts within 24 hours of a positive test result.
Since the start of the pandemic, a close contact has been considered someone who was within two metres of the infected person for more than 15 minutes.
High-risk contacts are people who live under the same roof as the infected person and people who have kissed or had intimate relations with them, Aubé said.
“We’re putting the emphasis on tracing for positive cases’ high-risk contacts, and for moderate-risk cases we’re asking exceptionally during a short period for the cases to contact them to tell them to isolate for 14 days and to go get tested after seven days,” he said.
The public health department continues to carry out epidemiological investigations in businesses where an infected person wouldn’t know the people they may have exposed to the virus, Aubé added.
Contact tracing is taking longer these days because tracers are getting less co-operation from people who test positive for COVID-19, he said.
“Our teams are facing major challenges because they have to convince people to collaborate with their epidemiological investigations,” Aubé said. As well, some people don’t provide accurate or complete contact information when they get tested, he said.
“It’s very time-consuming for our teams.”
The Quebec health department recently reported that 25 to 30 per cent of people testing positive for COVID-19 aren’t co-operating with contact tracers.
“People have to answer,” Aubé said. “When we call, it’s an opportunity to slow the transmission of the virus. It’s extremely important that they answer. Every minute counts. The faster we can get in touch with people with the virus, the faster we can reach their contacts and slow the transmission.”
The surge in COVID-19 cases also coincided with a decrease in the number of contact tracers because many of the additional tracers who were hired this spring and summer were students who have returned to their studies, Aubé said. The number fluctuates according to needs, he said.
Before the spike last week, the Montreal public health department had 80 contact tracers working each day, Aubé said, including 60 people from the public health department and 20 employees from a private firm that was hired to help this summer. However, there were 150 contact tracers a day during the summer, he said.
Since the orange alert was declared, the number of contact tracers is back up to around 135 per day for Montreal, Aubé added, including more than 100 people from the public health department and 35 from the firm. And more are being recruited and trained, he said.
“We’re continually hiring, we’re continually training personnel to increase the capacity of the public health department,” Aubé said. “We’re always looking for more people.”
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