The Challenge of Contact Tracing

One of the logical ways to prevent the spread of any highly communicable disease is to isolate those who may have been infected. This includes all those that they may have come in contact with and likewise testing, isolating, or putting these people under quarantine. Unless you have implanted microchips in people that allow you to monitor their movements, you would have to rely on an old school system — asking the right questions, either on paper, in person, or through a digital app. 

Many countries that are seeing a continuing increase in positive cases have somehow failed to trace the infection effectively. Not surprising because it is indeed an enormous task. Several steps must be done diligently and systematically. 

First, you would have to monitor and record every person in and out of your community. The problem — there are so many exit and entrance points. Unless you are very good at programming protocols, there is a big chance that one or two or five thousand cases may fall through the cracks. 

Second, you would have to set up a way to retrieve the information of any person that passed through your access points when you get the news that they have been infected. If you are using a digital system that automatically captures information in a database for easy retrieval, the process becomes ten million times easier. But imagine holding on to thousands of papers/forms with manual written entries (some of which may not be legible or worse, deliberately incorrect) and then rummaging through them to find out if a person known to be infected among those that passed through your gates. 

Going around the metro, one would notice that some establishments have set up their contract tracing system. It involves asking anybody that goes inside the establishment to complete a short printed form. The form asks your name, address, contact information, and questions on your general health and well-being – basically to check if you have some symptoms of the infection. There are also questions about your recent trips, mostly centered on international travel to or from anywhere in China. After completing the form, you surrender it to the person in charge, and you go about your merry way. 

So, if I get the symptoms in a couple of days, get tested and validated that I have contracted Covid-19, I would have to tell the health official that I have been to this and that place. Here it gets tricky – the health official should now notify that area to check their records and perhaps advise all the people in the same facility while I was to get tested. If they cannot do this, then the people who may have been infected would not know that they may be carrying the virus. 

Contract tracing forms at the airport and other transportation hubs in the country are no different. These are physical forms that are collected and are hopefully stored systematically and adequately. 

I wonder if they ever conduct a test to see if the setup works.  

There are ways to improve contract tracing, of course, and it may not even require hiring thousands of workers to do it. One way is through a digital app that runs on mobile and internet technology. 

Several groups have come up with very promising models, and all of them are worth considering and possibly adapting.  

After retrieving and confirming the necessary information, i.e., the third step is that a person may have been in contact with somebody who tested positive. The government must then find a way to reach this person, explain the situation, and ask him or her to go through testing and isolation and get additional information about his or her movement. From there, the cycle continues. The data they get must be validated, the people who may have been infected duly notified, and the other persons they may have unknowingly infected, must be informed, tested, isolated. 

If this process appears endless, it is because it is. Hence, the community quarantine and lockdown, as well as social distancing and personal protective equipment – face shields, masks, etc. — all these measures have to work side by side. 

By limiting movement, the spread of the virus can be contained at least long enough for the contact tracing to achieve its objectives. Otherwise, the contact tracing will prove pointless because those that have to be tested, isolated, or quarantined are going about their business and further increasing the need for additional contact tracing.