When the post-mortem into the world’s response to the COVID-19 pandemic is conducted, attention will be focused on the success or failure of the many measures implemented to stop the spread of the virus.
One likely to receive particularly poor marks is contact tracing.
Introduced with much promise in the early days of the pandemic, when numbers were relatively low, contact tracing has, in many places, been a colossal disappointment. A country’s financial capacity has played virtually no role in that outcome. In fact, some of the jurisdictions where it has been most effective have a fraction of the wealth of, say, the United Kingdom or the United States, where the value of contact tracing has been especially limited.
Even in the worst-hit provinces in this country, such as Quebec, Ontario and Alberta, contact tracers have been overwhelmed by the sheer number of cases. While perhaps never altogether pointless, it does become increasingly futile when the number of tracers are mathematically outnumbered by the ever-multiplying volume of people with whom they need to get in touch.
As you’ll recall, as cases soared in the fall, the practice had become so useless that the city of Toronto abandoned it altogether for a while. Health authorities in Alberta started telling people who tested positive to notify close contacts themselves. The province doesn’t know the source of 60 per cent of its cases.
According to reports out of Britain, tracers there don’t make contact with one in eight people who test positive – and that was before the COVID-19 variant took hold, which is spreading at a rate far greater than the original virus. In California right now, one in five people are testing positive for the virus. You would need literally thousands and thousands of people on phones to communicate with even a fraction of those who have tested positive to find out who they may have been in contact with while contagious.
Besides just simply not having enough people to deal with rising case numbers, contact tracers have run into other problems.
Many people simply don’t pick up the phone when tracers try their numbers – up to 25 per cent in the state of Maryland. Positive results often take days to receive. By then, a person’s previous contacts have often been in touch with dozens of others. Many people are against providing any personal information over the phone to someone they don’t know – not a shock, given the degree to which trust in our institutions is plummeting almost worldwide, especially in western democracies. Some people are told but then refuse to self-isolate because they can’t afford to take time off work.
Meanwhile, countries that have been exemplars of the practice include South Korea, Japan, Taiwan and Vietnam. They managed to keep their case numbers low because of strict lockdown measures, which allowed the contact-tracing system not to become swamped. But some also use personal data through mobile phone activity to track the movements of those who had tested positive (or had been in contact with someone who has) to see if they are obeying quarantine rules.
According to a recent article in Nature magazine, South Korea has had huge success with contact tracing in large part because of a law that allows authorities to use data from credit cards, mobile phones and closed-circuit television to track a person’s movements. Meantime, tracers in Vietnam, according to the piece, use data from Facebook and Instagram to check people’s movements.
One reason for the success of contact tracing in Vietnam is the broad net that is cast. As many as 200 contacts for each case are located and tested. Tracers are locating not just the primary contacts of someone who has tested positive, but secondary and tertiary contacts as well. It’s the only way, they feel, they can keep pace with something that moves as fast as the virus.
In Japan, tracers track a new case’s contacts as far back as two weeks before they tested positive. Known as “backwards contact tracing,” this method gives a country a better chance of locating the individual who infected the person in the first place.
It seems unlikely that Canadians would feel comfortable allowing health authorities to use their personal data to track their activities to the degree other countries have. Still, something has to be done to address the woefully inadequate tracing system that has been rolled out in this country.
It’s mostly been a dismal failure and it didn’t have to be. We should have been better prepared and we weren’t.
Editor’s note: (Jan. 8, 2021): An earlier version of this article included incorrect information about COVID-19 rates in California. This version has been corrected.
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