Dataset Information

Performance of hospital-based contact tracing for COVID-19 during Australia's second wave.

ABSTRACT:

Background

Hospital-based contact tracing aims to limit spread of COVID-19 within healthcare facilities. In large outbreaks, this can stretch resources and workforce due to quarantine of uninfected staff. We analysed the performance of a manual contact tracing system for healthcare workers (HCW) at a multi-site healthcare facility in Melbourne, Australia, from June-September 2020, during an epidemic of COVID-19.

Methods

All HCW close contacts were quarantined for 14 days, and tested around day 11, if not already diagnosed with COVID-19. We examined the prevalence and timing of symptoms in cases detected during quarantine, described this group as proportions of all close contacts and of all cases, and used logistic regression to assess factors associated with infection.

Results

COVID-19 was diagnosed during quarantine in 52 furloughed HCWs, from 483 quarantine episodes (11%), accounting for 19% (52/270) of total HCW cases. In 361 exposures to a clear index case, odds of infection were higher after contact with an infectious patient compared to an infectious HCW (aOR: 4.69, 95% CI: 1.98-12.14). Contact with cases outside the workplace increased odds of infection compared to workplace contact only (aOR: 7.70, 95% CI: 2.63-23.05). We estimated 30%, 78% and 95% of symptomatic cases would develop symptoms by days 3, 7, and 11 of quarantine, respectively.

Conclusion

In our setting, hospital-based contact tracing detected and contained a significant proportion of HCW cases, without excessive quarantine of uninfected staff. Effectiveness of contact tracing is determined by a range of dynamic factors, so system performance should be monitored in real-time.

SUBMITTER: Bailie CR

PROVIDER: S-EPMC8457622 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Objective Contact tracing is one of the key public health response actions to control the outbreak of a novel virus. This paper describes the preparation process, activation and operational experience for contact tracing of individuals in response to confirmed COVID-19 cases in Wales. Study design A descriptive approach has been adopted and lessons learned from our initial public health response to COVID-19 will be used to develop a new operational model for contact tracing in Wales. Methods As part of preparations for the response in Wales, Public Health Wales formed a Contact Tracing Cell (CTC) ready to be mobilised in the event of a confirmed case. Results Trial activation of the CTC during the preparation period helped to resolve some issues before ‘real’ activation. A highly flexible approach was needed due to the constant changes to the guidance that required rapid understanding, updates to pathways and clear communication to contact tracers. Conclusions Our experience and recommendations may benefit future efforts to control the spread of the virus in Wales and elsewhere, particularly in supporting COVID-19 outbreaks in enclosed settings such as care homes or in geographically localised areas. Learning from the initial public health response to COVID-19 will guide the delivery and implementation of a new contact tracing model as we move to a later stage of the pandemic when containment measures become feasible in localised outbreaks. This may include scaling-up the CTC to mobilise contact tracers to local teams and the potential use of digital technologies to support the next operational model of the CTC in Wales. Highlights • Contact tracing is one of the key public health response actions to control the outbreak of a novel virus.• For a CTC to be effective, identification and training of adequate numbers of staff needs to be done as early as possible.• A highly flexible approach was needed due to the logistical complexities of dealing with constant changes to the guidelines.• The mobilisation of non-health protection staff freed up health protection teams to deal with more complex issues.• Learning is needed to enhance future contact tracing activities when containment becomes feasible in localised outbreaks.