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April 09, 2020 00:00:00 | Dr.UmarNazir  (M.D)                                                        

Covid-19: Contact tracing, testing and facility based quarantine

In public health, contact tracing is the process of identification of persons who may have come into contact with an infected person (“contacts”) and subsequent collection of further information of these contacts.

By tracing the contacts of infected individuals, testing them for infection, treating the infected and tracing their contacts in turn, public health aims to reduce infection in the population. The goal of contact tracing are:

  • To interrupt ongoing transmission and reduce spread of an infection
  • To alert contacts to the possibility of infection and offer preventive counselling, screening, treatment or prophylactic care
  • To offer diagnosis, counselling and treatment to already infected individuals
  • If the infection is treatable, to help prevent re-infection of the originally infected patients
  • To learn about the epidemiology of a disease in a particular population.

Contact tracing has been a pillar of communicable disease control in public health for decades. The eradication of smallpox, for example, was not achieved by only universal immunization but by exhaustive contact tracing to find all infected persons.

Now about novel disease which started in Wuhan China and so far has infected more than 1 million people and has claimed more than 56000 lives across the globe till date. In India as of now we have 2567 laboratory confirmed cases of Covid 19 infection and 72 deaths has been reported which estimates to CASE FATALITY RATE (CRF) of 2.8% till now.

As the deadly virus from China spread with ferocity across U.S, large scale testing of people who might been infected didn’t happen-because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels.

The result is in front of us as U.S has now 245442 cases of this novel virus and has claimed 6099 lives in the world’s richest country-armed with some of the most highly trained and infectious disease specialists-squandered its best chance of containing the virus’ spread by delaying the lockdown and tracing, testing and treating the cases which led to the loss of 10 million jobs in their country. Americans were left largely blind to the scale of a looming public health catastrophe.

Many developed countries in the world earlier had taken measures to treat the new coronavirus infections having mild symptoms at home and their close contacts who were asymptomatic for the disease were put on home quarantine.

It was later observed by these countries that these measures were counterproductive as they were not able to contain the disease in their regions, though having the best healthcare delivery system.

Experts in China, as it was the first epicenter and later Italy when the epicenter shifted to their region have pointed out the danger, that home quarantine of mild disease/asymptomatic contacts will transfer the virus to family members and spread the infection to the community without realizing the dangers it can pose to the state/country.

These experts in China said that it was wrong about Wuhan’s early approach to isolating mild cases at home and keeping other family members at higher risk of contracting the disease. In Italy also there are around more than 115000 cases and 2000 to 4000 cases are being added every day from last few days, with more than 13000 deaths to date.

Leading Microbiologist of Italy Andrea Cristani, University of Padau commented that many of the new cases were infections from families were mild cases who were home isolated and asymptomatic carriers who were never tested for COVID 19 which was one the reasons of such a huge number of cases in their country. Despite taking all the measures why was the no. of cases growing in their country? He was of the opinion that these infections are coming from home. 

Similar claims have been asserted by a group of Chinese experts. Liang Zong’An, Chief of Respiratory department at Sichuan University pointed out the method used early in containing the spread of the new coronavirus in Wuhan was incorrect. Chinese Physicians have said earlier that ‘we should isolate patients with mild symptoms at home to reduce the burden on Wuhan’s healthcare delivery system, ‘but that was a big mistake.

In the early days of the outbreak, there was a poor understanding of what the virus would look like and what it do in asymptomatic contacts, but now the virus can spread to the family and household, even with mild symptoms or asymptomatic contacts, we know it well.

So my dear fellow doctors while after identifying the person who is positive (lab. Confirmed) for Covid 19, his family members, friend with close contacts and nearby neighbors with whom they are close with should be quarantined in the Facility Based Quarantine which our UT administration has already acquired and are in use while combating this war with this enemy for which they deserve their share of appreciation. But without doing testing in these asymptomatic contacts we are putting our community at higher risk of contracting the novel disease and may backfire our efforts in this crucial juncture of pandemic.

As  we all are aware that elderly people, pregnant women, children and persons with co-morbidities like hypertension, diabetes, chronic renal disease, COPD within the household are at higher risk of not only contracting the disease but their chances of recovering from the infection are also bleak.

So keeping these vulnerable group at home quarantine would be a big risk for them as well as for community which we can’t afford to take, keeping in view of our limited resources and limitations in our healthcare delivery system.

Lessons must be learnt fast from our neighboring countries like China who have placed all the contacts of COVID 19 positive patients in Facility based Quarantines and testing them all which has helped them to reduce the risk of transmission to the minimum.

So with these lines I want to conclude and advise the people who are at the helm of affairs in the administration to take cognize of the danger and start tracing, testing, treating and trusting our Health Experts from Community Medicine on fast track basis. As two unknown cases have a potential to spread the virus to 800 people if we are not tracing, testing and Quarantine them.

 

 

Author is working as Demonstrator in Department of Community Medicine, GMC Srinagar. The views expressed are personal and has nothing to do with the organization.

drumarnazir111@gmail.com

 

Archive
April 09, 2020 00:00:00 | Dr.UmarNazir  (M.D)                                                        

Covid-19: Contact tracing, testing and facility based quarantine

              

In public health, contact tracing is the process of identification of persons who may have come into contact with an infected person (“contacts”) and subsequent collection of further information of these contacts.

By tracing the contacts of infected individuals, testing them for infection, treating the infected and tracing their contacts in turn, public health aims to reduce infection in the population. The goal of contact tracing are:

Contact tracing has been a pillar of communicable disease control in public health for decades. The eradication of smallpox, for example, was not achieved by only universal immunization but by exhaustive contact tracing to find all infected persons.

Now about novel disease which started in Wuhan China and so far has infected more than 1 million people and has claimed more than 56000 lives across the globe till date. In India as of now we have 2567 laboratory confirmed cases of Covid 19 infection and 72 deaths has been reported which estimates to CASE FATALITY RATE (CRF) of 2.8% till now.

As the deadly virus from China spread with ferocity across U.S, large scale testing of people who might been infected didn’t happen-because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels.

The result is in front of us as U.S has now 245442 cases of this novel virus and has claimed 6099 lives in the world’s richest country-armed with some of the most highly trained and infectious disease specialists-squandered its best chance of containing the virus’ spread by delaying the lockdown and tracing, testing and treating the cases which led to the loss of 10 million jobs in their country. Americans were left largely blind to the scale of a looming public health catastrophe.

Many developed countries in the world earlier had taken measures to treat the new coronavirus infections having mild symptoms at home and their close contacts who were asymptomatic for the disease were put on home quarantine.

It was later observed by these countries that these measures were counterproductive as they were not able to contain the disease in their regions, though having the best healthcare delivery system.

Experts in China, as it was the first epicenter and later Italy when the epicenter shifted to their region have pointed out the danger, that home quarantine of mild disease/asymptomatic contacts will transfer the virus to family members and spread the infection to the community without realizing the dangers it can pose to the state/country.

These experts in China said that it was wrong about Wuhan’s early approach to isolating mild cases at home and keeping other family members at higher risk of contracting the disease. In Italy also there are around more than 115000 cases and 2000 to 4000 cases are being added every day from last few days, with more than 13000 deaths to date.

Leading Microbiologist of Italy Andrea Cristani, University of Padau commented that many of the new cases were infections from families were mild cases who were home isolated and asymptomatic carriers who were never tested for COVID 19 which was one the reasons of such a huge number of cases in their country. Despite taking all the measures why was the no. of cases growing in their country? He was of the opinion that these infections are coming from home. 

Similar claims have been asserted by a group of Chinese experts. Liang Zong’An, Chief of Respiratory department at Sichuan University pointed out the method used early in containing the spread of the new coronavirus in Wuhan was incorrect. Chinese Physicians have said earlier that ‘we should isolate patients with mild symptoms at home to reduce the burden on Wuhan’s healthcare delivery system, ‘but that was a big mistake.

In the early days of the outbreak, there was a poor understanding of what the virus would look like and what it do in asymptomatic contacts, but now the virus can spread to the family and household, even with mild symptoms or asymptomatic contacts, we know it well.

So my dear fellow doctors while after identifying the person who is positive (lab. Confirmed) for Covid 19, his family members, friend with close contacts and nearby neighbors with whom they are close with should be quarantined in the Facility Based Quarantine which our UT administration has already acquired and are in use while combating this war with this enemy for which they deserve their share of appreciation. But without doing testing in these asymptomatic contacts we are putting our community at higher risk of contracting the novel disease and may backfire our efforts in this crucial juncture of pandemic.

As  we all are aware that elderly people, pregnant women, children and persons with co-morbidities like hypertension, diabetes, chronic renal disease, COPD within the household are at higher risk of not only contracting the disease but their chances of recovering from the infection are also bleak.

So keeping these vulnerable group at home quarantine would be a big risk for them as well as for community which we can’t afford to take, keeping in view of our limited resources and limitations in our healthcare delivery system.

Lessons must be learnt fast from our neighboring countries like China who have placed all the contacts of COVID 19 positive patients in Facility based Quarantines and testing them all which has helped them to reduce the risk of transmission to the minimum.

So with these lines I want to conclude and advise the people who are at the helm of affairs in the administration to take cognize of the danger and start tracing, testing, treating and trusting our Health Experts from Community Medicine on fast track basis. As two unknown cases have a potential to spread the virus to 800 people if we are not tracing, testing and Quarantine them.

 

 

Author is working as Demonstrator in Department of Community Medicine, GMC Srinagar. The views expressed are personal and has nothing to do with the organization.

drumarnazir111@gmail.com

 

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