Fraser Health's top contact-tracer on coffee-break infections, liars and scaled-back monitoring
VANCOUVER -- As COVID-19 infections in B.C. continue to climb, the public health workers trying to track and stop infections warn workplaces are a major problem at the moment, stretching their ability to stay on top of where and how people are infected with the coronavirus to its limit.
For more than a week, the province’s top doctor has made worrying admissions that British Columbia’s contact tracers are “at the brink” of not being able to keep up with the rate of infections. Now, the top contact tracer in B.C.’s biggest health authority says his teams are having to deal with liars and belligerent people as they struggle to ramp up staffing in the face of exponential growth in infections. The crunch has already forced them to scale back their efforts somewhat.
“Those are things we’ve had to trim down over time because with the numbers and the volumes we’re talking about, every single case potentially could have hundreds of calls associated with it,” said Dr. Aamir Bharmal.
He says Fraser Health contact-tracers used to call every positive case and their close contacts daily, but they only do that in a handful of cases now.
“We’ve had to potentially trim down parts of our assessment and really figure out how we can bring on more staff,” he said. “In the early days, we really had a lot of nurses, for example, that were doing a lot of that tracing. Now, we’re bringing in other, what we call ‘contact-tracing aides,’ and they’re not what we’d call health professionals, but we’re able to hand off some of that type of work so that we’re still able to keep up with the volume.”
The province has been criticized for not publicizing infections at some workplaces or settings, but Bharmal says if public health has contacted every close contact of an infected person, there’s no need to tell everybody about a diagnosis that still carries stigma.
“Those fleeting interactions where someone may have come into an office for a minute and then just picked up a piece of paper and left, those aren’t going to be necessarily the ones we’re more concerned about,” he said.
A close contact is someone who’s been closer than two metres from an infected person for 15 minutes or longer without a mask.
While social gatherings for family dinners or funerals had been a major source of transmission in October, with Thanksgiving being particularly problematic, one of the key problems now is workplaces. While employers are following the rules and have been able to keep people apart from each other or minimize the risk with barriers, contact tracers have found lunch breaks and mingling before and after work are a major source of transmission.
Eating lunch at the same table as someone who seems healthy is a problem. No masks and close quarters can spread the virus easily, because people can be infectious two days before they start showing any symptoms, according to the health authority.
In one instance, Fraser Health interviewed one person who tested positive and discovered some people had been going to work sick for a week; 80 infections were diagnosed at that one workplace, with other outbreaks tied to family members and friends of those employees.
When it comes to how truthful people are with the contact-tracer on the other side of the phone, Bharmal says while staff members encounter a handful of outright belligerent people, they’re more used to dealing with people whose first inclination is to lie about all or some aspect of their activities.
“We encounter people who are really worried because they did something, they went out to a party or they worked while they were symptomatic or they were sick, or they’re worried about their job,” he said. “We also get situations where people are just very fearful and there’s a lot of stigma around this. We let them know this is a safe space, we’re doing this because we’re trying to protect other people. It’s not our job to judge what people did, it’s not our job to publicize this or let their employer know that something happened. We let them know we’re doing this to protect a lot of other people they care for and care about and also who they work with and interact with, too. That certainly does help with some of these situations and helping them realize we’re doing this so that we can break a lot of those chains of transmissions.”