Healthy Living: Contact Tracing

You’ve heard these terms being mentioned numerous times in government press conferences and COVID-19 updates – contact tracing, close contacts and casual contacts.  But how does contact tracing work? What’s the difference between a casual contact and a close contact and how does the ministry determine who will be tested? We get some answers in tonight’s Healthy Living.

Marleni Cuellar, Reporting

At the start of August, Belize had a total of fifty-six COVID-19 cases of which twenty-four were active. A mere twelve days later, there are two hundred and ninety-six cases reported, of which two hundred and sixty-two are active.

There are many ongoing efforts to slow and eventually stop the spread of COVID-19 in the country. These include: promoting washing your hands, maintaining social distance, wearing a face mask and even lockdowns in specific parts of the country. But another critical element in stopping the pandemic from spiraling out of control is contact tracing.

Contact tracing is the process of tracking down each person with whom an infected person has come into contact. A team of dedicated health workers have been trained to investigate the ongoing spread of the disease.

Lorna Perez

Lorna Perez, Surveillance Officer, Ministry of Health

“There is a cadre of people who have been trained this includes doctors nurses, other support staff like statistical officers, vector control personnel, lab technicians—it’s a wide sector of members of the Ministry of Health staff.”

Many of these officials have had experience as health detectives. That’s because contact tracing is routine in public health whenever there is an outbreak: as we’ve seen with outbreaks of dengue, pink-eye, zika and even rotavirus. But, in the case of this new disease, and the way it spreads. Their usual approach had to change.

Lorna Perez

“We started looking at what is the safest way for our officers to do contact tracing. At that particular time, we were looking at telephone calls, looking at contacting persons through this medium where you do not have that direct contact with the person because you do not know. In our world of public health, we are used to that face to face interaction where you are looking at that interview you want to see the person. You usually get some hints based on how people behave, how they look at you, you look at the body language.”

Of course, body language helps in gauging how honest people are being in disclosing their contacts. But the experience tracers have been having in Belize is the initial shock of the patient’s diagnosis.

Lorna Perez

“Most people are honest. I mean the shock of being told you’re positive, and then you’re asking it might play on their mind a bit. You know all of a sudden, your brain becomes fuzzy, and you can’t recall, and you’re asking them. You try to establish more or less when they became infected who were your contacts and were you in contact with somebody who was symptomatic, and that might be like a week ago.  Fortunately, some people have come out and disclosed their status on social media. So people hear, and they know, and they call us and say they were with this person on such a date so even if you’re trying to intentionally probably forget certain encounters because it’s of concern to the other people they would call and inform that they have been in contact with somebody.”

Not all contacts will be tested though. That’s because, in their investigation, the tracers will determine whether someone is a close contact or casual contact.

Lorna Perez

“Close contacts are our priority groups; these are the persons that we can’t track as soon s possible. So a close contact is any person who has been exposed to a suspected or confirmed or probable case while this case in the infectious period and this person was not using any personal protective equipment, what you hear they call P.P.E.”

Close Contacts include:

–      people you live with

–      persons you had more than fifteen minutes face-to-face contact without masks and less than six feet apart

–      healthcare workers who at the time of contact were not using appropriate P.P.E.

–      being in a room in a healthcare facility where an aerosol procedure is taking place

–      direct contact with body fluids or lab specimens

–      a passenger within two seats in any direction on a plane, and

–      individuals who share a closed space for more than two hours, but not within six feet of one another.

Lorna Perez

“We usually look at that six feet as the safe distance, so anything less than six feet you would be that close contact.  When you look at casual contact, now, anybody that has had a contact that does not meet the criteria that I mentioned, so if it is less than fifteen minutes if you had on your mask. To the person who is anxious about why I am not being screened or why am I not being called to come in for a screening and why am I not being interviewed again we are screening based on what the person, the case, is telling us. If the person says ok I saw Marleni at the shop we chatted for two to three minutes we chatted and then went on my way we have accessed that and say ok Marleni was a casual contact.”

Close contacts of a positive case are the only ones who are required to be tested. The contact tracers are racing against time to determine those persons, get in touch and get them tested. Because the longer someone who may have the disease stays out there in public with the virus undetected, the more people they can spread it to. Perez shared that they are noticing that older persons have far less contacts than the young.

Lorna Perez

“The minimum is like two to four, and you usually find that among the older folks you know because they usually stay home. They are not around much. You find that young people, people who are out there the contacts, I mean could go up to, we have followed and tested has been thirty to fifty persons especially if they were – parties is usually the place – parties and social gatherings.”

With the recent spike in cases, more contact tracers have been trained. As they continue the enormous task of tracing over 200 cases, they hope that the public can help in slowing the spread.

Lorna Perez

“The virus does not move on its own. You move, the virus moves. We need to slow down. We now people have to go out/. We know people have a job to do probably. Every individual has to be responsible for his or her own health at this point.”

Since close contacts are most likely to be family, coworkers and close friends, the Ministry of Health advises the use of masks and social distance even in these private settings.