Workplaces to undertake contact tracing if COVID infection hits

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Workplaces to undertake contact tracing if COVID infection hits

By Henrietta Cook and Aisha Dow

Any Victorian workplace with a confirmed coronavirus case will be required to conduct its own contact tracing under a government plan which has worried infection-control experts.

A Health Department presentation to business groups detailing the plan says “we will also ask you to undertake contact tracing”.

Businesses will have to do their own contact tracing.

Businesses will have to do their own contact tracing.Credit: Jason South

But as businesses including retail and hospitality gear up for Sunday’s expected announcement of a mass reopening, infection-control experts warn many workplaces lack the expertise to properly trace contacts, saying it could pose a risk.

While interviewing close contacts of infected people is still the department’s responsibility, workplaces are now required to identify close contacts among staff and visitors, collect their details and tell them that they are close contacts.

The Department of Health and Human Services presentation says: “Workplaces have access to rosters, understand their workers' roles and movements, and have ‘insider knowledge’ of the business, making you often the best judge of close contacts.

"In outbreaks, we may determine entire shifts or workplaces to be close contacts due to the risk of spread within the workplace. In these situations, we will work with you to try to minimise the impact on your business."

One coronavirus case will mean a lot of paperwork.

One coronavirus case will mean a lot of paperwork.

La Trobe University epidemiologist Associate Professor Hassan Vally said there was a risk in handing over aspects of contact tracing to workplaces.

“It is a skilled public-health task,” he said.

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“I don't think that can be completely done by people who don't have the right training. It requires experience, understanding of public health ... as well as building rapport, critical thinking.

"There is a risk involved in outsourcing some of what is usually done by the public health unit. You are relying on workplaces to do the right thing.”

But Associate Professor Hassan Vally said it was important the DHHS worked closely with workplaces because they understood workers and had access to documents that assisted contact tracing.

Victoria’s head of contact tracing, Professor Euan Wallace, said the arrangement was brought in a few months ago under changes to emergency powers that made it a legal requirement for employers to collect records of all workers and visitors and notify DHHS of positive coronavirus cases.

He said workplaces were best placed to identify close contacts, swiftly get in touch with them and tell them to quarantine.

Professor Wallace said the changes were introduced after the department's contact-tracing team was expanded to 2100 workers and had nothing to do with a lack of capacity.

Professor Euan Wallace.

Professor Euan Wallace.

“It is much more rapid,” he said. “We get information much faster and the quality of information is much higher. We ask you to undertake contact tracing but it is not the full contact tracing.”

He said the department would also contact any close contacts identified by workplaces.

Training is being provided to industries including abattoirs, hairdressers, distribution centres, taxi companies and hospitality to ensure they understood the changes, Professor Wallace said.

“It is a huge change but it's allowed many of these places to stay open ... We recognise it is a burden but it is a small trade-off to the alternative which is you have to close the plant down.”

A number of organisations have already been conducting their own detailed contact tracing throughout the pandemic, including schools, universities and hospitals.

One school contact tracer, who did not want to be named because he did not have approval from the Education Department, said he sketched family tree-like maps on a whiteboard in his office to establish links of transmission between families. The school has also developed a contact-tracing script which it runs through with students and parents.

“We can make decisions very quickly based on prior knowledge,” he said.

“We know the families who are estranged and have little contact as opposed to those who are in closer contact.”

He said schools were well placed to conduct the work of disease detectives because families trusted them.

“DHHS only call from a private number and our families don't answer private numbers. That’s the government calling.”

Victorian Chamber of Commerce and Industry chief executive Paul Guerra said he supported the move to request businesses to notify close contacts after a positive case was detected, saying businesses “will do everything they can to open up and remain open”.

Burnet Institute epidemiologist Professor Mike Toole said he did not see any issue with workplaces being asked to identify close contacts, as long as the information was integrated with the department’s contact-tracing efforts.

With so few new cases now being reported daily, including one on Friday, he said the response to new cases affecting workplaces should be sweeping: those linked to the workplace should go into isolation and be tested, even if they didn’t have symptoms.

Australian Principals Federation president Julie Podbury said it “made enormous sense” for schools to conduct their own contact tracing.

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“They understand the culture and context of their own communities and they understand the links,” she said.

Dr Clare White, the leading geriatrician at Western Health, said she recently learnt that aged-care facilities were expected to do their own contact tracing and provide that information to the public health unit.

“That is really concerning to me and a lot of other people,” she said. “Facility managers are now having to do short courses in contact tracing … but it’s an exceptionally detailed and difficult thing to get right.”

An experienced nurse at a major Melbourne institution, who was sent contact-tracing spreadsheets by the department in July as her team managed multiple outbreaks, said she was concerned that people without infection-control expertise would be asked to determine the infectious period of cases and direct people to isolate.

“They are asking employers to start the process and email their spreadsheet, which is what they were doing to us in July,” said the woman, who was not authorised to speak publicly.

“You have to know what incubation periods are, you have to know when people are infectious … that’s not going to come easy for a lot of people.”

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