'The (case) numbers that we're seeing in the news, you can triple it'
Author of the article: Brittany Gervais
Publishing date:Sep 05, 2021 •
Health-care workers at the Richmond Road Diagnostic and Treatment Centre COVID-19 testing location. Friday, April 23, 2021.
PHOTO BY BRENDAN MILLER /Postmedia
Contact tracers in Alberta are speaking out against the province’s decision to stop doing full investigations of COVID-19 transmission in the province, which they say is resulting in higher infections and more pressure on an already overwhelmed health-care system.
Among other responsibilities, contact tracers file lab tests of positive cases of COVID-19 to the province’s database, follow up with close contacts to ensure those who were exposed get tested and isolate, and notify schools and other organizations of reported outbreaks.
But on July 29, Alberta’s chief medical officer of health Dr. Deena Hinshaw announced Alberta Health Services (AHS) scaled down case investigation and contact tracing teams, and that contact tracers no longer notify close contacts about exposure to COVID-19.
Since then, Alberta has seen case counts skyrocket from 1,626 to 13,495 cases. R-values between Aug. 16 and 22 range from 1.16 to 1.23 provincewide, meaning every infected person will infect at least one other person.
Of the new cases reported from Aug. 26 to Sept. 1, about 83 per cent are classified as “unknown,” meaning contact tracers have not determined how they were spread.
Calgary emergency room physician Dr. Joe Vipond has been contacted by several contact tracers in Alberta in recent weeks, all voicing their frustration with not being able to collect more information from positive cases.
About 50 per cent of transmission from COVID-19 occurs with asymptomatic or pre-symptomatic people, Vipond said. That’s one of the reasons why this is such a difficult disease and why contact tracing is essential.
“Even in Alberta in the first wave, contact tracing was an incredibly important part of the disease management and it seems to be given up here,” Vipond said.
According to a new study in the Journal of the American Medical Association, which studied how Taiwan did so well triumphing over COVID-19, case-based policies like contact tracing and quarantining, in combination with population-based approaches, led to that country’s success. As of Sept. 3, the island nation of 23.5 million had 106 active cases.
In Alberta, close contact information is no longer collected as part of the standard case investigation, unless the case is connected to such high-risk settings as acute and continuing care facilities.
The contact tracing workforce has decreased, with redeployed staff returned to original positions and some temporary contracts ended early, according to AHS. As of Aug. 31, there were approximately 1,300 case investigators and contact tracers.
Currently, investigators only ask about the person’s demographics, details about their employment, school or daycare, whether they attended these places in their incubation or infectious period, and whether the virus was acquired in the community or from a hospital, according to AHS.
“In recent weeks COVID-19 cases in Alberta have increased and we have scaled back up accordingly, with current and casual staff,” wrote AHS spokesperson Kerry Williamson in an email to Postmedia.
“Many staff who have temporary positions ending this fall have been receiving offers to extend their positions. We have been and will continue to extend temporary positions, as needed.”
The consequences of the policy decisions made by the province will mean COVID will spread rapidly through Alberta’s unvaccinated population, which includes kids under 12 years old, Vipond said.
“What possible reason could the province have to allow this to happen to the poor citizens of Alberta that, unfortunately, trusted them to govern?”
‘People need to know’
Postmedia was contacted by two contact tracers who wanted to speak out against the way Alberta is handling contact tracing amid the fourth wave of COVID-19. The identities of the tracers have been changed because they were not authorized to speak publicly about their experiences.
Angela has been working on the case investigation side of contact tracing for about a year. Most investigators from the past year are gone now, and work has become “very, very hectic,” she said.
“Pretty much everyone is burnt out, and I know a lot of cynicism has set in for a lot of people,” Angela said. “I feel like I’m working for the bad guy, it doesn’t feel right. People need to know.”
Even if information about close contacts is offered to investigators — if they attended a wedding or visited a family member, for example — tracers can’t collect that information.
If someone tested positive after coming back from a vacation, she can’t notify airlines about potential exposure. A parent is concerned that they’ve exposed their young daughter to the virus, but since she doesn’t have symptoms, she can’t be tested and doesn’t have to be kept home from school.
The province has ended its isolation hotels program, so tracers don’t have any resources to help people isolate, she said.
“Anything that is not in our script, we’re not supposed to write down. It’ll be deleted during the review process. I’ve heard of flight attendants who worked while infectious but there’s nothing we can do with that information,” she said.
“It’s driving me absolutely bonkers that it’s this weird secrecy thing, where we’re just calling and asking three questions and people think that we’re still tracing, and that they have all the information.”
Alberta Health confirmed that as of mid-August, travel information is no longer collected routinely as part of case investigation and therefore, flight information is not available to report to the federal government.
“The government has put a blindfold on us and we’re literally flying blind.”
Rachel works on the administrative end of contact tracing efforts, triaging data submitted from local and provincial labs, and filing reports into the province’s database.
Since the province’s announcement, she said her team has been cut down by half. Her contract ends this fall and she said she still doesn’t know if her contract will be extended. AHS has also advised contact tracers to look at other job postings within the organization.
“They’re encouraging us to go elsewhere. That’s really dangerous to me,” she said. “Do you think that if we lose all our tracers, and they go work elsewhere, do you think they’re going to be able to come back with all the shortages that we’re seeing everywhere else?”
Almost 80 per cent of the current active cases are linked to COVID-19 variants, most are linked to the Delta variant, Rachel said. Delta causes more infections and spreads faster than early forms of the novel coronavirus.
“I’m telling you right now, at 1,200 new cases a day, normally, there would be one or two more close contacts that end up being positive that follow from that. The (case) numbers that we’re seeing in the news, you can triple it,” she said.
The only reason tracers are able to keep up with their workload now is because they are only collecting basic information, she said. Unless there’s an outbreak, the province isn’t tracing cases in schools, in workplaces, or close contacts.
“I think a lot of people are going to get sick. There are going to be a lot of unnecessary illnesses, and we’re going to really overwhelm the ER and ICU,” she said. “We just threw the masks away and said, ‘To hell with everything.'”
On Friday, AHS CEO and president Dr. Verna Yiu said the province is postponing some non-urgent surgeries and procedures across all five health zones. In Alberta, 95 per cent of ICU beds are occupied, Yiu confirmed.
bgervais@postmedia.com
Twitter: @BrittGervaisAB
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