Role of contact tracing as the pandemic evolves

While doubts are raised if it is a futile exercise, State maintains that it is still an important tool

Kerala set the model for the entire nation when after reporting the first three cases of COVID-19 in the country late in January, it set in motion a process to track and trace every possible person who might have interacted with COVID-19 patients and who could potentially become COVID-19 cases later on.

Eight months hence, when the epidemic has evolved to a stage wherein locally acquired infections have almost fully replaced imported cases and the State has been reporting close to 4,500 cases a day, contact tracing may have become a resource-intensive and time-consuming exercise and one which may not entirely be necessary or successful in the current context.

However, the State maintains that contact tracing is still an important tool that can contribute to all other arms of disease containment — surveillance, testing and quarantine — but only that it has become more focussed and evidence-based.

‘Definite role’

“It is true that a general feeling has crept in amongst our surveillance team that they are ‘wasting” their time and energy on a futile exercise, as community transmission of COVID-19 is rampant across the State. Which is why we conducted a reinforcement training for our team members who are doing contact tracing in the districts earlier in the week, to emphasise that there is a definite role for contact tracing, only its character has changed,” a senior Health official said.

“In the earlier days, when our knowledge of this disease was limited, we may have overdone the contact tracing and isolation process. But now, we know that the disease does not spread through a casual contact. The change that has come in now is that there is a clear risk-assessment process and we isolate only high-risk primary contacts on the basis of the kind of contact they had,” he added.

Decentralised

The actual contact-tracing process has also become very decentralised and has moved down to primary health centres, with medical officers and health field staff taking over the contact-tracing process on one side, with parallel investigations by the police on the other.

The process has become cumbersome now that the numbers have gone up several fold. But even one possible case identified and isolated is worth the trouble, officials believe.

There is also the argument that now that patient numbers are becoming unmanageable, the State’s priorities should shift to improving critical care facilities and watching out for the vulnerable patients reaching hospitals so that no lives are lost.

Yet, for a consolidated picture of the epidemic, the State still insists on trying to find the source of infection in every case.

“In the changed scenario, contact tracing has no doubt become an exercise consuming more resources and people, yet, the rationale remains that contact tracing helps us to test the right people and to find possible clusters,” a senior Health official said.

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