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GPS SAYS THEY have been “inundated” with calls since early this morning from people who believe they are a close contact of a confirmed case of Covid-19, after the HSE revealed it would be asking those who received a positive test in three periods days to inform your own contacts.
The HSE will ask between 2,000 and 2,500 people who received positive results on Friday, Saturday and Sunday of last week to notify their own contacts because of what it described as “unprecedented pressure” on the contact tracing system.
Those who received positive tests on those days will receive a three-part message explaining what they are expected to do, with a link to detailed information.
This includes tips on what to consider when compiling your list of close contacts, such as home visitors, taxi rides, sports activities, and hair appointments.
“You may not know the names and numbers of all the people you came in contact with. For example, if you were at an event or shared accommodation. In these cases, call the Covid officer or the event or venue manager.
“If you were at work 48 hours before your symptoms started, or 24 hours before your positive Covid-19 test result, call your employer to let them know.”
People are advised to follow up on their text message with a phone call to their close contacts. The HSE has provided guidance on how to handle these “difficult calls,” including acknowledging their concern or discomfort and telling them to call their GP if they have any questions.
People who tested positive from Friday to Sunday will also be sent a message template that they can forward to their close contacts. He says:
“The HSE is asking [person who has tested positive for Covid-19] to transmit this text to your close contacts.
“As a close contact for this person, you should call your GP within 2 days to get a free Covid-19 trial. You must restrict your movements (stay home) for 14 days from the last time you were in contact with [name of positive case]even if you have no symptoms. “
The message also includes a link to more tips for those affected, such as restricting their movements for 14 days from the last time they had contact with the confirmed case.
A man who received this second message, who is a close contact for a confirmed case, said TheJournal.ie the person who tested positive received their result four days ago. The man said he had been restricting his movements for four days because the person who tested positive had already informed him of the result.
“In my opinion, putting this in the hands of the people will not work out,” he said. “It’s okay for responsible people, not so good for lazy, selfless or careless people.”
‘A flurry of calls’
The HSE has come under fire today for not informing the government of the decision over the weekend to take this measure. Taoiseach Micheál Martin told Dáil this afternoon that the HSE did not inform him of the problem and that he found out when someone sent him a notice about it. The Minister of Health also learned about the decision last night.
GPs have said they were likewise left in the dark until last night when they received a notification, not from the HSE, but from the Irish Medical Organization (IMO), which provided information to its members.
Drogheda GP Dr Amy Morgan said TheJournal.ie that she was “shocked” to read the IMO email and said she has not yet received any direct communication from the HSE.
“I wasn’t expecting this at all, I knew that the tracking system, from my own experience in surgery, was obviously under overwhelming pressure, but I didn’t see it coming.
“We had previously been informed that we were not intended to play a contact tracing role. We were told that the IMO notification pre-dated an HSE notification that was coming in today, but I haven’t seen it yet. “
He said this kind of work is time consuming for GPs and is not something they have been trained in.
“Immediately, as soon as we opened the phone lines this morning, there were people who had received the text message and wanted to organize the test, it has been a flurry of calls. It implies that we take some history of the patient over the phone, for example, if it is a family member. People get confused about the difference between close contact and casual contact and also about the timing of exposure. [48 hours]. “
The HSE defines a close contact as:
- spending more than 15 minutes of face-to-face contact within 2 meters of someone who has Covid-19, indoors or outdoors;
- live in the same house or shared accommodation as someone who has Covid-19;
- sitting in 2 seats of someone who has Covid-19 in public transport or on an airplane.
A casual contact can mean:
- spending less than 15 minutes of face-to-face contact within 2 meters of an infected person, indoors or outdoors;
- being in the same room as an infected person for less than 2 hours;
- being in public transportation or on an airplane with an infected person but not sitting near them.
However, the HSE says that spending more than two hours indoors with someone who has Covid-19 “will sometimes count as close or casual contact.”
It could be an office or a classroom.
In its guide to close vs. casual contact, the HSE says it will depend on the size of the room and other factors.
It also says that “public health physicians or contact trackers will inform you if you are at risk during contact tracing and public health risk assessments.” However, in this case, this work is left to those who tested positive and to the GPs of their close contacts.
Dr. Morgan said she is concerned that confusion over the definition and 48 hour period for contact tracing could lead those who test positive to tell more people than they need that they are close contacts and this is something in what GPs will have to work on. when those people call.
“It’s creating confusion and stress and we are a generally pragmatic group of people as a profession, we want to help people, but this all feels rushed and like we are in a damage control space right now.”
‘Everything is thrown at us’
Dr Illona Duffy, a GP from Monaghan, said TheJournal.ie that he had also not “heard anything” from the HSE and relied on the guidance issued by IMO last night.
She said that because of the way the information got out, through the media for the most part, her surgery had been getting calls from anyone who considered themselves a close contact.
“They are only supposed to be those who received a positive result from Friday to Sunday, but that message has not been clearly communicated and we are answering calls from close contacts or perceived close contacts and full stop. People who say ‘I know so and so they have it and I had a coffee with them or I work with them’.
Dr. Duffy said she is concerned that her office will be “inundated” with calls before the holiday weekend.
“The HSE has now put this function on an already overloaded acute service, we are the only front line available now because people can’t just go to the Emergency Department,” he said.
“We have to be able to talk to our patients, we are very busy with really sick patients. Our referral rate to the hospital has increased, not massively, but we have sicker patients who need to talk and possibly see us.
“If our phone line is blocked by people who are well and should isolate themselves, it will be a big problem. Why is this reaching GPs?
“I am quite angry about that, it is again this lack of respect for the GPs and the lack of understanding of what we do and how hard we are working. Everything is on us, including the launch of the flu vaccine for children, which many of us are doing in clinics outside of our regular hours and on weekends. “
Tallaght GP and co-founder of GPBuddy.ie, Dr. Darach Ó Ciardha, also expressed concern about the burden placed on people who have been diagnosed with Covid-19, a disease that can make people seriously ill.
“It is an extraordinary demand for people and not one that we would dream of under normal circumstances,” he said.
“The diagnosis can be a shock for people, it can be really upsetting, particularly if they are in a vulnerable group, if they are older or have an underlying condition.
It’s really important that these connections are made, but people are naturally reticent, they may feel embarrassed, and they may also not be sure exactly who their contacts are. If they were sitting outside a cafe or store, for example, it can be difficult to be precise and that’s where contact tracing teams come in. They can contact facilities that might have a slightly better record of who was there.
He said asking people to do their own contact tracing eliminates the possibility of anonymity and also asks people to engage in “the really difficult human interaction of having to report to someone else.”
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“That middle function of contact tracing is so important. It is a great burden for people, but it seems we have no other option for now, ”he said.
Hiring contact trackers
The HSE has been hiring staff to strengthen its contact tracing system. In late September, the HSE said it had 280 trackers in eight contact tracing centers and was building capacity for 500 trackers.
The HSE has said that there are now more than 400 employees working in these contact tracing centers.
However, there is confusion about the recruitment figures.
In today’s Dáil, the Taoiseach said that the first 700 people are through the interview process, the HSE said today that this number is 600.
Micheál Martin said that 20 new employees have already started; the HSE said 135 have started, including 70 last week.
At the beginning of the crisis, public service workers were transferred to contact tracing centers to help with the workload and these individuals must return to their duties when the recruitment drive is complete.
At the government level, there is concern that the return of these workers to their old jobs could leave the contact tracing system understaffed, even with new hires.
In a statement, HSE said it expects to continue adding 60-70 new employees to the service each week for the next period.
“The HSE plans to recruit up to 800 initial trackers and then review the additional recruitment requirement.”
The statement went on to say that there is a plan to increase the number of community Spanish speakers to 1,000.
– With reporting by Christina Finn.
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