ONE YEAR ON | Biggest Covid-19 headaches revealed as tracing teams talk about their challenges

Covid-19 track and tracing teams' biggest headaches over the past year included patients giving the wrong contact details and team members falling ill themselves, provincial officials told TimesLIVE.

This led to many positive cases not being traced, and an uncountable number of people getting infected after coming in contact with those not knowing they had the virus.

This transpired from interviews with provincial officials looking back over the past year since SA experienced its first Covid-19 case.

In the Western Cape, between 10% and 40% of positive Covid-19 cases could have been missed or were untraceable due to patients giving the wrong contact telephone numbers.

“We often encountered incorrect phone numbers of positive cases. This has remained a challenge throughout,” said Western Cape health spokesperson Nomawethu Sbukwana.

“Wrong numbers remain between 10-40%. This means that the positive case will not receive their results and is unlikely to isolate. This results in the infection being spread further.”

Sbukwana said another challenge faced by the Western Cape contact tracing teams was asymptomatic people often unknowingly infecting older people in the household, who then become ill.

She also highlighted that positive cases who lived in informal settlements struggled to isolate themselves as they shared bathrooms and water points with other households, and could not buy food in bulk for their 10-day isolation period.

“This limited the ability of case and contact tracing [teams] from stemming infection.”

Western Cape public health specialist Dr Virginia Zweigenthal said the track and tracing work took people out of their usual roles.

Zweigenthal said the province's biggest win was the co-operation with private sector doctors.

“We contacted patients who in ‘private’ tested positive, informing them what they need to do about isolating, funerals, and gave certificates where necessary. Conversely GP groups alerted us to possible super-spreader events and we were able to galvanise volunteer teams to do contact tracing and limit further infection spread,” she said.

Dr Katy Murie, who attended to the first Covid-19 case in the Western Cape, says she still remembers the uneasy silence that settled over the room when they were told the first Covid-19 case had been diagnosed in the Western Cape.

“Knowing very little about Covid-19 myself — only what little I'd read about it, I made the first case call. I needed to check up on his physical wellbeing and advise him on how to isolate as well as what to expect from the illness, though it was all new to me too,” Murie explained.

Eastern Cape health spokesperson Sizwe Kupelo says their biggest achievement was designing  a community-based programme that managed to reach everyone in the province.

“There was no urban-rural divide. As long as one was positive, the teams were able to reach them,” Kupelo said.

However, Kupelo said the biggest challenges in the Eastern Cape were at the beginning when people did not understand the value of quarantine and isolation.

He said the rural nature and vastness of the province resulted in some people not getting tested in time.

“Shortage of test kits, clogging in the laboratories delayed results during the peak of the pandemic.”

Gauteng health spokesperson Kwara Kekana says their biggest accomplishment was the ability to track and trace most of the primary cases and their close contacts in the province, especially during the second wave.

However, Kekana said they were given wrong physical addresses and wrong phone numbers — knowingly or inadvertently — by primary case patients.

“It obviously made contact tracing very difficult.”

Kekana said they had to deal with patients refusing to answer their phones or being rude to callers.

Mpumalanga health spokesperson Dumisani Malamule told Sunday Times Daily that some members of the province's tracking team got infected, affecting their ability to trace and track patients.

“A number of team members got infected which had an impact on the human resource available for contact tracing. Most team members got exhausted from the sustained marathon. For those infected, the general exhaustion that is brought about by Covid-19 also had an impact on their performance,” Malamule said.

He said the province is still on high alert for a possible third wave.

KwaZulu-Natal health spokesperson Agiza Hlongwane said stigma was their biggest problem as people were reluctant to share their full details and contacts.