the Russian language has no exact word that would describe the work of these people. In English they are called contact tracers, literally — people who trace contacts. Now, according to many scientists, these people will help, if not to stop completely the spread of coronavirus, or at least prevent the second wave.
In theory, agree officials of most European countries. In practice, some systems just don’t work.
Despite the steady growth in the number of cases, Germany, unlike the US or the UK, even during the peak of the pandemic did not stop the process of contact tracing (contact tracing) is a calculation of people with whom contact was infected.
the volunteers were yesterday medical students, firefighters and even the military. It is believed that in particular through the work of these people, Germany managed better than other European countries to cope with the epidemic.
Berlin is the most affected by the coronavirus city in Germany. In each of the 12 districts of the capital has a dedicated team that tracks contacts infected with a coronavirus.
Information about the cases usually provide the lab, and initially they indicate only the name, gender, date of birth of the patient and only sometimes — it contacts. The rest is done by the people whose job it is to find this patient and the maximum number of those with whom he came in contact.
the Municipal authorities — and in Germany are engaged they find the patient contacts and inform them about the diagnosis. At this stage, experts say, employees of local health departments and volunteers often have to be psychologists on this information, people react different, they have a lot of questions: what to do, how to isolate, how to tell the chief how to be with children who go to school who help to buy products, do I need to call the doctor or go to hospital?
“These people should help you come up with a plan of action, — says an expert on infectious diseases from Johns Hopkins University in the United States Emily Gurley, who developed training for people who need to track the contacts of cases. They must answer the question: what to do with your grandmother, who you took the food, now if you can’t leave the house?”.
“When you find out that you have an infectious disease or there is a danger that you have been infected, the natural reaction is fear, says epidemiologist Christine Coyle, who herself once worked in this field. — I found it very hard to do contact tracing. I tried to cope with the different reactions of people, but all the situations were so different. (…) Good volunteers should be patient, cultural, Chu��Kimi and flexible. They are real extroverts, who get energy and pleasure from interaction with others.”
the Second step is to convince the person to remember and call the names of all those with whom patients had most recently communicated. To do this it is sometimes not easy: people don’t want to be “informers”, sent to isolation from his family and friends. And sometimes you just forget — so that with one call volunteers are not limited.
the Ultimate goal in the process of contact tracing is to identify all people who could be exposed to the pathogen, to convince them to get tested and treatment and thus to stop the epidemic. Christina Coyle says: in the case of Covid-19, from which there is no effective treatment, the goal is to encourage people to get tested and to take precautions that will reduce risk of transmission — in this case we are talking about isolation.
If in Germany for contact tracing of cases of responsibility of the local authorities in the UK this is regulated at the state level.
Prime Minister Boris Johnson has promised that the British system will be the most efficient in the world. According to the experts, on which the government relies, in order to stop the epidemic, it is necessary to trace up to 80% of the contacts of infected people.
During the first week of operation of the system in the database was a little over 8 thousand people, but only 5.4 million provided information about his contacts for the last time. They called the names of 31.7 thousand people, of which only 26.9 thousand agreed to isolate themselves when they get through the volunteers.
Former chief scientific adviser to the government David king stated that in its current form, the British system will not cope with its task, and the opposition MP Ben Bradshaw, who was quoted by the New York Times, called the system a “complete mess”.
British Sara Penn, involved in the government programme, passed the training at the end of may, but since then has not made a single call.
“My training lasted eight hours on the Internet. There was General information about the NHS [the national health service of great Britain — Bi-bi-si], the coronavirus, why keep track of contacts. And the scenario in which we need to communicate with people, plus information on how to answer difficult questions. And a few scenarios: how to talk with a person if he somebody died how to tell if it is about the children,” says Penn.
However, there is no communication with professionals during these trainings was not to ask questions there was nobody eight hours Sara Penn, just looking at the slides and videos. Immediately after, she might choose the working days and start calling people.
the First working day failed due technical problems with entrance��m system:
Commenting on bi-Bi-si another similar case, the British Department of health said that such stories do not reflect “the tremendous work being done”. The new system of contact tracing “is working and will help to save lives”, say in the Department.
Like, for example, in the United States, involved in a program of NHS volunteers get for their money — a little more than the minimum possible in the country of the salary.
But in the UK there are those who lead their own programs: for example, in Sheffield a group of doctors, already retired, has created the country’s first system of contact tracing coronavirus patients, and without help from the state.
contact Tracing has demonstrated its effectiveness in countries that successfully cope with the pandemic in South Korea and New Zealand. Doctors in Sheffield are confident that now that the quarantine restrictions are gradually removed, without an operating system, it is impossible to prevent a second wave and to deal with possible new outbreaks of the disease.
“I am sure to react to the nidus of infection, it is necessary to involve the municipal authorities. first, we’re not in China where you can just order people not to leave the house. That is why it is important that you told people that you understand. But we are here and we can support, to help, for example, delivery of products — after all we ask of a person to be isolated at 14 days, says Bing Jones, the founder of the group. — Initially, we had problems — could not get through. But since we do live here, we can just walk a few streets and knock on the door.”
According to the estimates of Jones, 20% of people in the city who test positive for coronavirus have not lifted the handset, but responded to the letters that the volunteers just left them in mailboxes.
“although we have no authority, we cannot say that we’re from the government, for example, so you have to listen to us. But we can say that we live a few blocks from you and we think that’s important. We are here to help,” explains Jones.
When the group started talking about volunteers in the city, many local General practitioners agreed to cooperate and began to provide information on the cases.
“One of the main problems in Britain is that the whole process is controlled by the government and too centralized. And local authorities and General practitioners do not have delegated powers,” — said Jones.
contact Tracing — not fiction coronavirus-time experts in the field of healthcare in many countries have used this tool in the case of HIV, tuberculosis and hepatitis.
“So over the years we have realized that the most important thing is training the people who say sick. These people must be extraordinary skill of the interviewer to establish contact with patients. Of course, there are different apps that can give people similar info and even track. But the app is an additional resource, and I don’t think it can replace the human factor,” says David Holtgrave, an expert on health from the University at Albany, USA. The so-called digital keep track of your contacts — using applications, or through mobile operators — used in many countries, together with the work of volunteers and professionals or is it, as, for example, are going to do in Russia.
When Bing Jones and his colleagues call the people of Sheffield, they always ask the question: are you ready to take part in this project? “If somebody says no, we have to end the conversation. But such happens infrequently. Many people are at least giving the primary consent for participation,” says Jones.
the Most common problem that the volunteers in Sheffield related to the law on personal data protection. It often happens that people are asked to list employees with whom patients had contact at work:
In Berlin, where the doctor Lucas Muraya, a team of volunteers and health workers fear the removal of quarantine restrictions.
“People in Berlin have started to think that the situation is improving, it’s just a little cases, but for us in a situation when schools are opening one or two infected in the class — it’s a whole week of work. You need to contact the family of each child, with teachers,” he says.
the Muraya believes that now, perhaps, even increased. He says that about a month ago, the team worked with about a hundred new cases a day. Each of the hundred was an average of about five contacts. Now — about five cases per day, but each of these five can be hundreds of contacts.
“So for us not much has changed, especially when we are talking about schools, hospitals or nursing homes. Sometimes a person can be up to 300 contacts and for us it is a snowball, which a bunch of potentially infected people, which we should call to find out about their health, send for testing, to isolate”.
the Robert Koch Institute prepares special volunteers, which in Germany is referred to as scouts — these people are trained, after which they are sent to the regions in which there is something problems — for example, the lack of staff. Scouts get paid, but for the region, their help is free. For example, the Federal government sent in Baden-württemberg 65 scouts who will work in the region six months — mostly medical students.
a Special program is in the United States: a specialist in infectious diseases from Johns Hopkins University Emily Gurley and her team developed a special training for people who want to help keep track of contacts. The training lasts six hours and passes online.
“Now, in different States, hire people who need to keep track of contacts, but many do not have any knowledge about infectious diseases, so our course gives people a General idea of what they are dealing with. This is only the first step,” says Gurley.
According to her, such people must be both detectives and social workers, and psychologists, but most importantly to be able to communicate. But in most cases you have to rely on the honesty of the interlocutors.
“none of the initiatives will not work if people have no confidence in the health system. It’s like a vaccination — it protects us all, so we accept it and do the vaccination.”
Often said that the main objective of contact tracing is to prevent a second wave of infections. Lucas Muraya does not believe that this is possible: “I still think the second wave will come. We just wish she didn’t cover us in the spring. But I think it will happen in the fall. So our task is to break the chain of cases are reported”.
Berlin is considered acceptable if one patient infects another person, but the third and fourth infection is already a problem. The system is to cope — mostly thanks to a sufficient number of tests, allowing you as soon as possible to confirm the diagnosis and isolate the person.
“Our goal is to limit the ability of the virus, says David Holtgrave, an expert on health from the University at Albany. — If you are infected, but with no one to contact, you anyone and does not infect. Accordingly, our task is to establish contact before an infection”.
the Problem is that many States and many countries, including European ones, are just starting to establish a system. Is it too late? “Yes, later. It should have been done much earlier. But does this mean that we should fold and not try to stop the spread? I think we should try,” says Emily Gurley from Johns Hopkins University.
Epidemiologist Christine Coyle is confident that it can stop tracking the contact, when the experts will see that the rate of R0 (basic reproduction rate, also known as “an indicator of infectivity”) of the coronavirus fell below 1.0: “This means that each infected person on average infects less than one healthy person. When R0 becomes less than unity, we can say that flash is coming to an end.”
