COVID-19 Diary – Day 239

Contact Tracing Struggling in BC

Contact tracing (followed by isolation) has been a tried and true method of fighting disease transmission since well before the days of COVID-19, and some even consider it to be “the most important public health intervention we have” in our fight against the current pandemic. Many areas of the world have used it with great success, including notable locations like New Zealand and South Korea, and indeed our home province of BC. Unfortunately, as case counts increase it becomes more and more difficult to successfully trace all the potential exposure contacts of test-positive individuals, especially if people are not keeping their contact numbers low.

The way contact tracing works in BC, according to the BC CDC, is as follows:

1. When a person tests positive for COVID-19, they become a “case”. 
2. A public health nurse interviews the case to identify people they’ve spent time with.  These people are “contacts.”
3. Public health gets in touch with the contacts and asks them about symptoms of COVID-19. 
4. Not every contact needs to be identified: only those who could have been exposed to the case’s respiratory droplets from coughing, sneezing or speaking. 
5. Public health maintains the case’s privacy. A case can choose to tell others about their diagnosis but should not do their own contact tracing. 
6. Contacts with symptoms are sent for testing.
7. If they test positive, they become a ‘case’ and the process repeats.
8. Contacts with no symptoms are asked to self-isolate and monitor for symptoms for 14 days after their last contact with the case.
9. Contact tracing helps people get diagnosed earlier and reduces the chance of spreading the virus.

Step 8 is very important because it is what helps keep potential asymptomatic cases from spreading the virus to others. We do not test asymptomatic people in BC because of the drain on resources it causes, combined with the increased likelihood of false-positive/negative results, and the extremely low true test-positive rate that comes from such efforts.

Unfortunately, we are now seeing increased delays in the time it takes public health to contact exposed parties to let them know they need to self isolate and monitor for symptoms. Studies have shown that delays of even 1-2 days can have a dramatic impact on the effectiveness of contact tracing and isolation efforts. While there have been no official statements on the Fraser Health Authority’s current average contact tracing response time, there is increasing anecdotal evidence that delays are becoming significant and that the quality of contact tracing may be declining as well.

One such anecdotal report comes from a school exposure case in October, where a parent received the notice to isolate and monitor their child for symptoms for 14 days, with just 3 days left in the isolation window.

Another anecdotal report, and one that is gaining a lot of recent attention, is that of the super-spreader event that took place at the Capella Dance Academy in Chilliwack. In this situation, the owner received her positive test results 3 days after being tested and was not contacted by public health about contact tracing until an additional 4 days after that. In this case, the owner had already shut down her business and contacted her students about testing positive. According to the studio owner, after another 4 days, she was again contacted by public health and asked to send an email to her students asking them all to self-isolate for 14 days. A full rundown of the experience can be found here. So far 38 individuals have tested positive in relation to this outbreak, and 13 different schools have been affected as well.

While these 2 anecdotal reports may not represent the average contact tracing experience people have with BC Public Health, we do know from public statements that our contact tracing teams are being stretched thin with the rapid increase of new cases. In fact, it has led to at least one public questioning on if Fraser Health might abandon widespread contact tracing similar to how Alberta announced they would be earlier today. At least for the moment, Dr. Brodkin, the acting vice president of BC’s Fraser Health Authority says that so far, the health authority has not reached a breaking point. 

RCMP to Have Ongoing Presence on Ferries

The BC RCMP announced today that they would soon have an ongoing presence on ferries to assist in educating and enforcing Transport Canada safety rules and regulations. The announcement focuses on their plans for patroling lower decks to ensure all passengers exit their vehicles and stay within designated passenger areas during their trip. Previously there was a special dispensation from the requirement earlier on in the pandemic, but since the end of September, the rule has been back in enforcement.

This move also comes just days after a woman was removed by police after refusing to wear a mask on the ferry, despite having a doctor’s note providing a medical exemption. It also comes only a few weeks after about a dozen anti-mask protestors were banned from BC Ferries after causing a disturbance and verbally assaulting passengers.

Conspiracy Theorist Leader Arrested

Back in April Delta police were frustrated by their lack of ability to enforce health orders, or do anything significant to prevent Makhan Singh Parhar from using his yoga studio to host large unsafe gatherings of conspiracy theorists and anti-science pandemic deniers, as well as organize local protests against lockdowns and mandatory mask requirements (neither of which have happened in BC).

It looks like Makhan Singh Parhar’s luck has run out now, however, as he was arrested yesterday for allegedly failing to comply with the quarantine act, after returning to Canada having recently attended a flat-earth conference that took place in the USA. Parhar posted videos of himself on youtube discussing breaking his quarantine and discussing his recent trip to the USA.

That’s all for now, stay safe everyone!