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Over the weekend, South Korea closed recently reopened bars and clubs after a new group of Covid-19 cases emerged from the Itaewon nightlife area, according to reports, after a person who visited several nightclubs there. tested positive.
With up to 1,500 potential contacts and more than two dozen cases linked to nightclubs, the Seoul case shows how quickly the virus can spread without social distancing.
Controlling that spread, both in the state and in South Korea, requires systems to intercept the virus and break the chains of transmission through which a case becomes a cluster, and then an uncontrolled outbreak. This is done through testing and contact tracing, and the most important element is speed.
“The five-stage process: sampling, testing, reporting to a positive case, contact tracing, and contact quarantine all must be done in a 72 hour period,” says Dr. Tomás Ryan, assistant professor at the school of biochemistry. from Trinity College Dublin. and immunology.
But how does the process work, and how well does it work, in the Republic?
Some 1,700 contact trackers have been trained. So far, the demand for contact tracking has been relatively subdued. At any time, a fraction of these tracers has been needed. In the week ending May 2, an average of 70 were working. On its busiest day, which saw 1,400 new cases, the HSE says 292 people made 5,000 calls.
Multiple problems
Those on the front line have seen multiple problems. In some tracking centers, technical problems delayed the start of work; By the time the work began, the tracers were working on cases where samples were taken approximately two weeks earlier, although this situation has improved. According to documents seen by The Irish Times, some officials who were nominally reassigned to this area in mid-March have yet to follow up on any contacts, and have been told that there is no definitive timetable for the reassignment. One tracker said the promised training materials have not materialized, while another said the shift numbers have been reduced because the volume of calls being made is very low.
The HSE says that once a positive test is identified, its details are uploaded to the contact tracking system within 90 minutes, but those involved in the system have concerns. Mary Codd, professor of epidemiology and associate dean of public health at UCD, participated in the creation and management of a testing center at the university.
“To get to the point of being able to contact someone in a timely manner, there is still work to be done. It is not yet timely enough, “she says. Currently, it takes too long to get samples from the sampling centers to the labs, and also the gap between the results from the labs and the availability for contact tracing is too wide, she says. “Considerable attention must be paid to that interval,” he adds. The process, which is executed by HSE, is “too long.” It often has to significantly reduce the number of contact trackers at its center due to lack of of cases. “Often based on the information and data available, we have to re-scale up to 20 people or even 10 people.”
“Central chaos”
Some senior doctors and experts are also concerned about how the system works. A doctor relates the story of a colleague who was contacted by five different people to communicate his diagnosis and ask about contact tracing, a situation the doctor describes as “central to chaos.”
On Sunday, HSE CEO Paul Reid said the average time to get a test result is 2.4 days. Currently, the HSE claims that the average time for contact tracing in what it calls a “non-complex case” is within 36 hours.
The above suggests that a relatively simple case can optimistically expect to complete the entire process in approximately 3.5 days. It appears that complex cases may take longer, but the HSE did not provide figures on exactly how long. With a virus that spreads slowly and invisibly, experts are concerned.
“If it’s two or four days for testing and another two or three days for tracking, that won’t be effective,” says Dr. Ryan. “Research has shown that once you go from five to six days, you have a negligible impact on virus transmission.”
Smartphone application
A smartphone app, designed to aid in the process of locating contacts, was initially seen as “a key element” and “a vital part” of the Irish response. However, the emphasis on that aspect has been reduced as the timeline for the application has slipped from the beginning of April to the beginning of May, until the end of this month, not to mention that concerns about privacy and its effectiveness They have increased. On Sunday, Reid casually said that “it plays a role, not an important role.” The final role, and importance, of the app that was once flaunted now seems to be an open question.
On Sunday, Reid said that in the coming months and weeks, testing and tracing will shift from “a kind of wartime model” to “a future model of operation,” a scoping report to be launched this week. .
Much depends on your success.
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