What is Contact Trace? How to use it with COVID-19

IIn the era of coronaviruses, many epidemiological terms became commonly used. Now that there is “social distance” everywhere, Political “Make the curves flat.” Also, “contact tracking” is pervading everyday conversations as states and local governments are looking for ways to get out of lockdowns that have pushed the economy into stagnation.

But what exactly is a contact trace and how can society help combat the COVID-19 epidemic? Here are the basics of a well-established public health strategy and expectations for coronavirus pandemic use:

What is a contact trace?

Contact tracking is a bit like detective work. Trained staff will interview people who have been diagnosed with an infectious disease to determine who may have been recently contacted. Second, they may recommend potentially exposed people to be quarantined to prevent the spread of the disease. Think of it as part of a public health activity and part of an investigation.

The technology is the “foundation” of preventive medicine, says Dr. Laura Breeher, Medical Director of Occupational Health Services at Mayo Clinic. “Contact traces. We are now in the glory moment of using COVID, because it is so important to quickly identify and quarantine individuals who have been exposed,” she says.

Contact tracking is 2014 Ebola virus outbreak,and SARS outbreak Used in 2003. Sexually transmitted disease And other epidemics such as tuberculosis. Also, due to the globalization of COVID-19, countries such as South Korea and New Zealand are actively using contact traces to control outbreaks.

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How does contact tracing work?

If someone confirms that they have the virus, such as a positive COVID-19 test, contact tracers will try to track the person who has recently been exposed to that person, if he or she may have been infected. will do. Typically, that exposure means staying within 6 feet of a person for more than 10 minutes, says Dr Breeher, but in medical facilities such as hospitals, the bar is lowered to 5 minutes.

Next, the healthcare professional Reaching out Tell all of these contacts that you may have been contacted and tell them what to do next. This includes explaining possible symptoms and instructing you to self-isolate.

What are the limitations of contact tracking?

First, tracking contacts is a tedious process. Interviewing infected patients and contacting dozens of contacts can be time consuming. That’s why contact tracking works best when community levels are low, says Dr. Frank Esper, a pediatric infectious disease specialist at the Cleveland Clinic Children’s Hospital. “When we get to the point where there are a lot of people getting sick with a particular illness, we’ll soon overwhelm the Department of Health and reach out to all those individuals,” he says.

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When a virus like COVID-19 spreads in the air, things quickly get complicated. Contact tracers may try to find someone sitting by air or bus near an infected person, even if the sick person has never met. This is a fundamentally different task from contact tracking for sexually transmitted diseases like HIV, and the contact list for investigators tends to be much shorter and well defined. Healthcare professionals may also have trouble contacting their contacts if the phone records are out of date, or if the infected patient is already too ill to identify recent contacts.

Contact tracking isn’t very helpful if the state or local government has already issued a blockade order, or if most people are self-isolated anyway. “You get over it, that’s what we do [with COVID-19], You can reestablish contact tracking when you get downhill until the number of cases and the number of new cases is much more manageable, “said Dr. Esper. These efforts, coupled with rigorous testing, Potential second wave Prevents the case from jumping again.

Contact trace COVID-19 infection has proven to be particularly difficult, as some infected individuals have no symptoms and the time between infections is relatively short. Nonetheless, contact tracking can be useful in small community settings, such as healthcare facilities and nursing homes, even during a pandemic.

How was Contact Tracking used to combat Ebola

Contact tracking was important during the 2014-2015 Ebola outbreak in West Africa. Efforts to track the incident Liberia Its effectiveness was limited by organizational issues and community distrust of healthcare workers, but at the time it was one of the biggest efforts to date.

Although Ebola was not widespread in the United States, about 29,000 people were monitored by state and local health departments after returning from West Africa. Dr. Breer says the Mayo Clinic has developed a plan for Ebola contact tracking, which laid the foundation for the current COVID-19 contact tracking efforts. Dr. Esper said that the basis of Ebola’s efforts during the outbreak was probably similar to the current pandemic, because Ebola had hardly spread into the air.

How do other countries use contact tracking to combat COVID-19?

Today, many countries are fighting coronaviruses using a combination of older contact tracking technology and more technically sophisticated methods.

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In Korea, which pioneered the development of a contact tracking plan through responding to the Middle East Respiratory Syndrome (MERS) in 2015, a contact tracer interviewed a patient in a mobile phone GPS data, credit card transaction record, surveillance camera. It is combined with the video of. Singapore has introduced a mobile app that uses Bluetooth to log when people approach and uses data to identify contacts after new cases are confirmed. In China, about 9,000 contact tracers have been adopted in Wuhan alone. The Canadian government has also launched a national contact tracking program near their homes, with 27,000 volunteers.

What are US States Doing?

In some US states and cities, efforts are under way to expand contact tracking, and perhaps not quickly enough. San Francisco has announced that it will train a pilot program of technology companies and about 250 outreach workers in the coming weeks. In Massachusetts, the state has introduced about 1,000 contact tracers.

But national efforts may need to be much larger — Some experts We estimate that the country needs approximately 100,000 contact tracers to control the outbreak of COVID-19.

Will the new technology help?

It has become a hot topic recently Joint efforts Between Apple and Google, add software to your smartphone to help track contacts. Google CEO Employing it is optional and emphasized that technology companies do not have any personally identifiable information as part of their initiative.

Some experts doubt Projects will make a difference, citing issues including the possibility of false positive excesses. However, Dr. Esper says the technology holds the promise, even if we identify more contacts than we need.

“It’s better to identify people than to miss people who are or may be infected,” he says. “All contact traces try to find a circle of people who were infected with index patients and those who were not infected with index patients, but they can create and seal a ring to prevent the next level of infection. . “

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Write in Alejandro de la Garsa [email protected].