By Vivienne Clarke
Various GPs have criticised the handling of Ireland’s contact tracing system which has been overwhelmed as daily cases of Covid-19 soar to unprecedented highs.
It has emerged that thousands of close contacts of positive Covid-19 cases will not be contacted by the HSE after the contact tracing system was overwhelmed by cases last weekend.
The HSE has instead asked those with a positive result to call their own contacts as a “one-off temporary measure” that was being implemented in consultation with GPs.
A Monaghan GP has said that the contact tracing issue has been “foisted” on GPs who are already “overloaded”.
Dr Illona Duffy told RTÉ radio 1 that GPs had been predicting for some time that the contact tracing system was being overwhelmed. To then learn of the directive to patients to text their own contacts through the media was very disappointing.
The recommendation that patients phone their GP for advice meant that the situation was going to be impossible for doctors and would mean delays for other patients attempting to contact their GP, Dr Duffy said.
If we didn’t have a reason to lockdown two days ago, we do now.
Patients will feel unnecessary guilt that they have contracted the virus, she said and will be reluctant to report this to their contacts or unable to do so if they do not have details for everyone with whom they have been in contact.
Dr Duffy warned that there will be further delays in testing and tracing and further spread of the disease because of the inadequacies of the contact tracing system.
Dublin GP Maitiu O Tuathail pointed out that contact tracers were professionally trained and to expect patients to alert their contacts themselves undermined the system.
“GPs have been saying for days that the contact tracing system had collapsed,” he said.
There was a huge risk, he said, that large numbers of close contacts would not be informed. “If we didn’t have a reason to lockdown two days ago, we do now.”
If someone was ill with Covid-19, the last thing they wanted to do was to start contacting people. There was already a lot of Covid fatigue, he warned and people were not adhering to the rules: “This is going to lead to more confusion and more problems.”
Dr O Tuathail explained that the term “close contact” meant anyone living in the same house; anyone with whom one has spent more than 15 minutes; anyone with whom one has been in the same room for more than two hours and anyone who sat closer than two seats on public transport. “There are so many nuances,” he said.
Unreasonable ask
Meanwhile, a Donegal GP has said that it would not be feasible for GPs to get involved in the contact tracing system. Dr Denis McCauley was responding to a suggestion on RTÉ radio’s Morning Ireland that general practitioners could assist in the process.
“We’re not contact tracers, we can assist people and set them on their way,” he explained.
GPs already have capacity issues in terms of their daily work, he said, it would not be feasible to ask a worried patient to give their GP a list of 60 contacts and for the GP to then call them.
“We will check back in with them. But we’re not contact tracers, it would be an unreasonable ask of GPs.”
Having patients who have tested positive call their own contacts was not an ideal situation, said Dr McCauley, but it was a temporary safety net. “Will it work? Maybe.”
Asking patients to call their own contacts could be a disincentive, he warned. The most important thing was for anyone contacted to self-isolate for 14 days and to organise a Covid-19 test.
The HSE’s Midwest Director of Public Health, Dr Mai Mannix has said that “ideally” professional contact tracers should be carrying out contact tracing, but that the move to have patients alert their contacts themselves was a temporary measure.
