As Omicron emerges in Ontario, DIY contact tracing could soon be the norm

In response to the Omicron surges, contact tracing is shifting across the province to classify high-risk cases, meaning most people will likely need to take a DIY approach if they test positive, contacting your own friends and family rather than waiting for a call from the public. health that may never come.

According to the guide of the Ministry of Health published on Friday, all positive COVID cases will now be handled first by a provincial workforce brought in earlier in the pandemic to help with contact tracing, and will only go to local public health units for follow-up if they are in high-risk settings such as hospitals, long-term care homes, or schools.

Already at least two health units, Ottawa and Kingston, are telling people to call their own contacts, as they are overwhelmed with the Omicron cases. Peel is implementing this “high-magnification guidance,” spokeswoman Ashleigh Hawkins said in an email, and Toronto Public Health is also prioritizing high-risk cases, a spokesperson confirmed.

“Contact tracing is done,” said Colin Furness, an infection control epidemiologist at the University of Toronto. “Partly because (Omicron) moves faster, but partly because the numbers are so high.”

Ontario reported 3,784 new cases on Monday, when third doses of COVID vaccines were opened for everyone 18 years of age and older. (There were many reports of difficulties getting real dates.)

The province’s polymerase chain reaction (PCR) laboratory testing network is also beginning to show signs of strain, under pressure from Omicron, which is about four times more contagious than the Delta variant.

Contact tracing – reaching out to people who test positive to ask who they’ve been with to stop transmission – is an age-old tool that has been used to control many past outbreaks of infectious diseases, from smallpox to syphilis.

But Furness added that it is “hugely optimistic” to think that even high-risk Omicron cases can now be traced, as it is difficult to know who is high-risk before a full investigation.

Under the new provincial leadership, individuals will receive self-isolation and testing instructions to pass on to “members of their household and other high-risk contacts.” Calls after this initial contact “are at the discretion of the public health unit.”

Furness does not want to “vilify” public health units for not having the resources to follow up on each case, and said they should focus their efforts on vaccination.

But in the meantime, it’s up to people to reach out to people they’ve been in contact with if they test positive, and not wait for a PCR test to confirm a rapid test at home, he said.

“Call everyone, tell them to isolate themselves, tell them to get a rapid test, tell them to get a PCR test if they feel symptomatic,” he said. “That is the right thing to do and it underscores the importance of rapid tests. Rapid tests are the new contact tracing; They do not do the same but they will fulfill the same function in terms of trying to break chains of transmission ”.

Furness recommends looking back for about five days, but it depends on whether you know when and when you may have been exposed.

That’s what 29-year-old Alexandra Floyd did last week after she suddenly felt “very sore” and tested positive for a rapid test last Tuesday.

He immediately isolated himself and told everyone he had seen in the last few days, long before he received a call from Toronto Public Health on Friday night, to inform him that he had tested positive on a subsequent PCR test, despite be twice vaccinated.

The contact tracker told him to isolate himself for 10 days, but did not ask for his contacts. Fortunately, she had already told the contact herself.

“You really have to take control yourself,” he said. “Just go back, use your phone and text, that’s all you can do.”

Contact tracing was more important when cases were low and when we didn’t have rapid tests at home, U of T’s Furness said.

“And I think it is a big seismic change, when we have thousands and thousands of cases that we cannot control.”

Instead, he thinks people should be able to run quick tests and tell them to call their own contacts, like Floyd did.

What would be feasible, Furness added, is for public health units to try to “passively collect” data on where people think they were exposed, to better understand where Omicron is spreading.

It’s something the Peterborough Public Health unit is already doing, asking people to fill out a short survey if they have a positive rapid test result.

“The data will be used for surveillance purposes and will not be used for our formal counts of reported cases,” spokeswoman Sarah Gill said in an emailed statement.

“We anticipate that with the increase in cases due to the Omicron variant, our ability to trace and test contacts will be limited. We hope that residents will use this confidential survey to help us understand the spread of COVID-19 in our region. “

Test sites at Ottawa Public Health are experiencing “an unprecedented increase and cannot keep up with demand,” according to a statement from the health unit. official Twitter account posted on Monday, and high-risk contacts won’t get a call from the unit, says their website.

It’s a similar situation in Kingston where residents are told, “Don’t wait for a phone call from KFL & A Public Health,” on the website of the health unit. “Notify your close contacts and encourage them to isolate themselves for 10 days of their last exposure to you and get tested.”

It can be a bit overwhelming to do this, Floyd said. But most of the people she contacted appreciated knowing she had COVID, “especially now since everyone is going home and seeing their families.”

Fortunately, no one tested positive except for her partner and they are both fine, their pain quickly turning into cold-like symptoms, although they canceled plans to see family in Thunder Bay and are spending the isolated vacation together.

For now, they are just happy to feel good, even if Christmas looks very different than they had imagined.

“It is what it is, and as long as we’re healthy, that’s all that matters,” he said.

“To be honest, it will come for all of us.”

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