Thread by @vukosi

Given the Minister and his wife's COVID-19 positive test as well as the quick communication to their contacts to self-isolate (seems to be direct contact). Let's talk about contact tracing just a bit.

What the minister's family did would be termed active tracking and tracing.

What is active tracing? You can identify the risk level of recent contacts of the index case (here the minister and their spouse). The contacts need to be traced and asked self-quarantine. and/or tested as well. How does this contact listing, tracing and monitoring happen?

It can be active in that a health care worker gets the contact list from the index case. In summary (you can read fuller guidance here afro.who.int/publications/t…), the HCW or tracing team will physically or telephonically get in contact with the contacts to inform them and ...

explain how they should self-quarantine and guidelines to reduce their risk of spread. There should be monitoring of the contacts as they are on this 10-14 day quarantine.

Example from WHO guidance. Why am I bringing this up?

For the moment, we are in a time where we have relaxed restrictions. We have more movement of people in South Africa than in the last few months. We have many large gatherings and some of them are not adhering to guidelines to have events or people.

Contact tracing is now key.

Do we, understand what is supposed to be done at establishments with high risk to make sure that if there is a positive case they can easily trace/track contacts? Do we know how well our tracing efforts are going? Measured as % contacts traced in 24 hours from index case?

Have we switched from passive tracing (notifying contacts by SMS/Whatsapp/etc.) to active tracing (having HCW physically or telephonically track contacts)?

Have we had other big breakouts like the "Tin Roof" incident in Cape Town? What is their frequency?

How did tracing work to reduce further spread?

All of these are important questions as the numbers of new confirmed cases may not tell us the full story of what spread is like now, but we need to be vigilant and reduce spread when we have high-risk scenarios. Contact Tracing 🔑

So yes, we might have relatively low numbers now, but it does not mean we are not having transmission. Contact tracing is one of the pillars that can assist in keeping spread low and reduce risk. But we need to understand the current performance of Environmental Health in SA.