Covirus 19 coronavirus: compliance checks to isolate close contacts that now occur daily

Close contacts of people infected with Covid are now monitored daily to ensure compliance and to see if they have developed any symptoms, says Health Minister David Clark.

But an app to supplement contact tracking work was still being worked on, and it hasn’t been released for voluntary registration yet.

Clark released an update on contact tracking improvements today, a crucial element in containing any Covid-19 outbreak, particularly when the country is at a less restrictive alert level.

Contact tracing has been considered an area that has needed significant improvement; The cabinet statement revealed yesterday that the system could only track 10 active cases in mid-March at a time when there were 13 cases in New Zealand.

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Last month, the Ministry of Health asked Dr. Ayesha Verrall, a doctor in infectious diseases at the University of Otago, to audit the contact tracking regimen, and she made several recommendations after discovering that regional public health units (PHU) were overflowing.

Verrall was invited again to report on progress last week, and today Clark released her update and a response from Director General of Health Ashley Bloomfield.

Clark said five of the eight recommendations in Verrall’s audit had been completed or were now “working as usual,” including increasing the capacity of the PBUs and daily quarantined contact to verify compliance and symptoms.

The ministry was still working on some recommendations that would provide a clearer picture of the success of contact tracing.

They include a record of the number of close contacts who have been infected at the time they are contacted, reflecting the timeliness and proportion of contacts who became infected, which measures secondary transmission.

The last measurement is only possible at this time for those PBUs that have adopted the national information system.

That was still progressing, Bloomfield said.

“The initial focus will be on those PHUs that do not have or have limited information technology tools to support contact tracking work,” he said in his response letter.

“We believe the value of having this end-to-end national vision available to everyone involved in contact tracking will quickly become apparent to those who use the system.”

Verrall had recommended the ability to trace contacts of 1000 cases a day, and believes it was necessary to get there before moving on to level 2.

But Bloomfield has questioned the basis of this number.

The current capacity of PBUs is to track 185 cases per day, and capacity is being built to handle up to 300 cases per day.

This week, the Ministry of Health released performance metrics for the first time.

From April 18 to 20, it took 10 days to isolate 80 percent of close contacts from the first onset of symptoms from the source of a Covid-19 chain (the index case).

That has been cut in half to five days, and Bloomfield said the ministry wanted to do it four days in line with Verrall’s benchmark audit performance.

The latest data published by the Ministry of Health shows:

• 80 percent of close contacts are being isolated within two days of a positive lab result.
• 70 percent of people undergo testing within 48 hours of their first symptom.
• 70 percent of test results are returned within 24 hours of a swab.

These measures are for 270 contacts for 75 cases in the last two weeks of level 4 block: April 13-27.

An independent contact monitoring assurance committee, chaired by Sir Brian Roche, was appointed last week to oversee the best way to implement the recommendations.

“Great progress has been made to date and we will seek to strengthen what is necessary, recognizing that the issues at stake are broader than just health: they impact how we all ensure the safety and personal well-being of others,” Roche said. it’s a statement. statement.

“Dr. Verrall has said that we need to contact more people, more quickly. That is why we have already added more staff to PHUs and NCCS. That is why we are also making progress with a tracking application.”

The app is expected to be released for voluntary registration soon.

Prime Minister Jacinda Ardern has said the app does not need to be operational before the country can go to Alert Level 2.

The cabinet will make a decision on moving alert levels on Monday.