CONTACT TRACING

Contact tracing, following efficient testing, is a key strategy in controlling the chains of transmission of COVID-19. According to the Centers for Disease Control and Prevention (CDC), contact training entails monitoring patients with suspected or confirmed infection and helping them recall and identify people with whom they had contact during the time of their infection.

Since COVID-19 was recognized to be airborne, identifying close contacts is no longer limited to the persons who were within six feet of an infected person for at least 15 minutes. The more important consideration became the space which the infected shared with other people, especially if the area was enclosed and poorly ventilated, and if the infected person stayed in that area for a prolonged period of time. Under these conditions, individuals in the same space can be considered close contacts based on the new findings on how COVID-19 transmissions occur.

The contact tracing system involves a wide range of health human resources across government agencies and the private sector. The scale of the workforce must be responsive to factors such as, but not limited to, the daily number of cases in the community and the number of contacts identified. Healthcare professionals and contact tracers need to be educated on the core principles of case investigation, policies on patient data privacy, and the personal health risks that the job entails.

Contact Tracing Process

patient interview, self-isolation, daily follow-up on health condition/status, referral to support services for basic needs and/or medical providers

Contact Identification

Contact Notification

contact self-isolation, test (if symptoms occur and/or if available), daily follow-up on health condition/status, referral to support services for basic needs and/or medical providers

Contacts with no symptoms will be asked to self-quarantine for 14 days and will be advised to be tested. Contacts with symptoms will be required to self-isolate for 10 days upon onset of symptoms and will be referred for testing and proper medical care. Regardless of the results, contacts will still be asked to observe 14 days of quarantine as recommended by public health authorities. As a guide for the public, the Philippine General Hospital (PGH) crafted a Quarantine and Isolation Calendar should a person be advised to undergo self-quarantine or isolation.

Contact Tracing as a Specialized Skill

To effectively execute contact tracing, the workforce must be trained and equipped with requisite knowledge and skills such as:

Contact Tracing Data

The data collected from the contact tracing activities should be integrated with testing and treatment procedures, as well as with wider data management systems that serve as basis for public health reporting and interventions. LGUs need to utilize technology that is available to them to enhance contact tracing, case management, and reporting.

Digital tools can be further used for real-time exposure notification. This is achievable through the streamlining of electronic capture and management of patient and contacts’ data, and integration with wider surveillance systems. Voluntary use of Bluetooth and GPS on the part of citizens can augment traditional contact tracing efforts and directly inform them of their potential exposure to COVID-19-infected people.

Barangay Health Emergency Response Teams (BHERTs)

In the Philippines, a granular approach to contact tracing is the deployment of Barangay Health Emergency Response Teams (BHERTs). BHERTs are composed of barangay officers and health workers, members of the local community, and volunteers who are capacitated on the knowledge and skills needed to support contact tracing. One BHERT is assigned for every 1000 people in the community.

By directly liaising with the community, BHERTs can effectively monitor individuals under home quarantine, ensure implementation of precautionary measures in the community, and carry out risk communication activities through the distribution of information, education, and communication (IEC) materials as well as the conduct of public health counseling

Responsibilities of BHERTs

  • Serves as navigator of the Local Contact Tracing Team in locating individuals and their close contacts who may be infected with COVID-19
  • Assists the patient in finding the optimal area for self-isolation at home
  • Facilitates the transfer of the patient to the community quarantine or isolation unit if necessary
  • Monitors the condition of people under quarantine (whether at home or in quarantine facilities)
  • Sends the patient’s recorded symptoms to the appropriate officer
  • Ensures completion of the prescribed home quarantine period (14 days) for patients and families undergoing it

🔍 From the Ground: Local practices on Contact Tracing

The local government of Valenzuela heeded the call for intensified contact tracing and launched Mega Contact Tracing Center (MCTC) on August 25, 2020. One hundred MCTC contact tracers were mobilized to augment the on-field contact tracer workforce and further track those who may have been infected with COVID-19.

The local health center conducted a comprehensive training for on-field and in-center contract tracers to ensure that they are equipped to handle COVID-19 patients. They were educated regarding knowledge on exposure, verification, confidentiality, and empathy. Functioning as call center agents, these tracers’ job was to walk callees or individuals through a “triage” after which appropriate response actions are determined. During the training, Mayor Rex reminded the trainees to “treat their patient as their family member.”

The City Health Office mobilized an army of contact tracers through the Barangay Health Emergency Response Teams (BHERTs) composed of Barangay Health Workers, Barangay Nutrition Scholars, and Community Development Volunteers. These teams went house-to-house to conduct checkups with residents and immediately refer potential or suspect cases to the assigned facility and health team for further monitoring and testing.

The local government also developed the ‘Higala’ mobile application used to collect the personal information of clients and visitors to monitor foot traffic when they enter a certain establishment. The application uses a QR Code to collect data which were used to inform citizens in case of COVID-19 exposure.

City Government of Iriga, Camarines Sur Local Chief Executive: Mayor Madel Alfelor

The City Government of Iriga was lauded for launching iContact, the first contact tracing app in the entire province of Camarines Sur. It invites Iriga citizens, visitors, business establishments, and government offices to register on the contact tracing app. By digitizing contact tracing and related processes, Mayor Madel Alfelor aims to lessen the need for physical sign-ups for the purpose of keeping track of any potential COVID-19 patients.

Citations:

Media Commoner, “COVID-19 is Airborne. Spend Less Time in Enclosed Indoor Spaces,” published May 4, 2021, https://mediacommoner.medium.com/covid-19-is-airborne-spend-less-time-in-enclosed-indoor-spaces-df9f262d6388

“Case Investigation and Contact Tracing: Part of a Multipronged Approach to Fight the COVID-19 Pandemic” Centers for Disease Control and Prevention, last updated Dec. 3, 2020, https://www.cdc.gov/coronavirus/2019-ncov/php/principles-contact-tracing.html