Saturday, 19 September, 2020
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OPINION

Effective Contact Tracing Needed



Anup K.C.

Amid growing concerns over the spread of novel coronavirus in the country, health professionals including politicians are urging government to strengthen tracking system of the contacts with confirmed cases.
So far five cases of COVID-19 have been confirmed to date. The government has asked the foreign returnees to maintain their travel history after they were found infected with the deadly virus. It has also called on the State and local governments to keep an eye on them so that they do not transmit it to others.
The government should aggressively deploy health personnel for the contact tracing that is an epidemiological investigation of persons who have or may have come into contact with the pathogen-infected person(s). The persons who got contacted with virus-infected ones or exposed to them should be placed under medical observation for at least 14 days which is equal to the maximum incubation duration of the disease from the day of catching it. However, it is recommended that such persons should be put in observation for as many as 27 days.
Contact tracing indeed is an approach to save the lives of hundreds of vulnerable individuals from the infection. It begins with contact identification in which the people who are in contact with suspected get identified through the activities of the case (alive or dead) and the performance of people with exposure to the case. The exposure happens mostly in family, workplace, social functions, hospitals and travels. The government has already identified family members, relatives and all passengers connected to the second virus-infected person, who had arrived from France via Qatar on March 17. It is yet to produce in-depth details of contacts of other case as well.
Health authorities should categorically mention contacts with cases, level, time and duration of exposure and his/her addresses for the follow-up activities through development of contact listing forms. However, the public seems not be convinced that the authority has gone through such procedure as a part of tracing the possible infected persons. It is feared that the probable contacts are roaming freely in the cities and villages without any public health interventions. It requires informing the contacts about the status of their contact with case and their importance in management and spread of the virus.
There should be continuous follow-up of contacts for at least 14 days from the day they came into contact with the corona patient. Principally, a trained team of health personnel and epidemiologists should jointly monitor the symptoms, thus ensuring an early detection of the disease. The persons without any symptoms should also be kept under quarantine till the incubation period whereas those manifesting symptoms should be put in isolation followed by laboratory test, treatment and regular follow-up.
Any missing or delay in the act of effective contact tracing of even a single contact may cause the spread of the corona virus beyond the control of the government. So it must simultaneously implement prospective contact tracing and retrospective contact tracing to detect contacts of new case.
Effective contact tracing demands precautionary measures, efficient surveillance, socio-psychological counseling, evidence analysing skills in team members and coordination with security forces and local government. Similarly, the government must draft a protocol of contact tracing and provide virtual trainings for workforce to conduct a medical probe on outbreak of any deadly disease in the country. 


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