Real contact tracing

The teacher in a California elementary school had not been feeling well but reported anyway for two days of teaching, which included reading aloud to her students. She was unvaccinated but still taught without using a mask.

She got tested and was found infected. Within a few days, 12 students in her class, out of 22 tested, were also found infected, mostly seated in the first two front rows. Although the United States has started vaccinating minors, the students in this elementary school were too young to be eligible.

The infections happened despite the students’ desks being six feet apart, despite the classroom doors and windows being kept open, and despite an air filter installed in the room. The virulence was not surprising: the infections involved the Delta variant.

The outbreak was reported in the latest issue of the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report and which has been used for an infographic showing the classroom’s seating arrangement and which seats were affected. Also in the infographic was a reiteration of COVID-19 prevention measures: vaccination, masks, staying home if you have symptoms, and periodic testing.

This was only one of many examples of real contact tracing that goes beyond cold statistics and ends up being used for public information and education that is more effective because people get to see what the real-world situation is, instead of just faceless numbers and reproductive rates.

Information campaigns are tricky in the States with Americans who still don’t believe COVID-19 is a serious threat, or that masks and vaccines work, opposing any rules or laws supposedly because they violate an individual’s freedom.

China, on the other hand, is pursuing a zero-tolerance policy that seeks to eradicate every outbreak as quickly as possible.

Its latest outbreak began late in July, when an incoming Russian passenger landed in Nanjing with an infection. Nine cleaners who went into the plane right after passengers disembarked were infected, who then passed on the infection to fellow cleaners. A total of 60 cleaners were tested positive but by then they had spread the infection to other people in Nanjing, including visitors who then brought the infections to 50 cities in 17 provinces, a total of 235 cases. As quickly as the outbreak started, new infections dropped to zero before the month was over.

The key to the quick eradication of the outbreak was massive testing, followed by quarantine in affected areas (and not entire cities), as well as a government order issued Aug. 9 naming airports, seaports, and several other public places where masks were to be required. Also included were mahjong parlors and the reason was simple: cases were reported, too, in these parlors.

Here, we see how contact tracing is implemented efficiently, and then translated immediately into public policy to safeguard public health.

With the Philippines planning to stop large-scale lockdowns and go granular, meaning smaller geographical areas, we will need better contact tracing in the way it’s done, analyzed, and then translated into public policies.

We seemed to have been doing better in the early months of the pandemic last year. I remember reading Department of Health reports of clusters of infections associated with such diverse activities or events as birthday parties (no, not the one of the general), cockfighting, construction workers stranded in their work sites, and even one oath-taking ceremony.

These outbreaks need to be publicized (with data privacy), together with lessons learned. A case in point was the outbreak in December 2020 in the Philippine Military Academy, where officials thought the students were safe in a bubble because they were confined to the campus, but the Academy’s officials forgot about the staff who lived outside.

It’s not easy doing contact tracing. I finished an American online course (Coursera) on that topic last year and it included long sessions on how to get people to cooperate and give useful answers, besides figuring out incubation periods, convincing people to stay home or in quarantine.

Then, there’s the reporting system, which requires well-designed apps and software … a problem in the Philippines given our penchant to have different uncoordinated systems.

Unless we work out a good system for contact tracing and connect it to our public information systems, especially for government officials and COVID managers, we will continue to resort to useless lockdowns and confusing rules and regulations, including ECQs of the eternal kind and economic ruin.

mtan@inquirer.com.ph