The WHO’s benchmark for a successful COVID-19 contact-tracing operation is to trace and quarantine 80% of close contacts within 3 days of a case being confirmed — a goal few countries achieve.
But even that’s not quick enough, says Christophe Fraser, a mathematical biologist at the University of Oxford, UK. Transmission is too rapid and the virus can spread before symptoms emerge, he points out. Modelling by Fraser and his team suggests that even if all cases isolate and all contacts are found and quarantined within three days, the epidemic will continue to grow. He says that in a single day, 70% of cases need to isolate and 70% of contacts need to be traced and quarantined for the outbreak to slow (defined as each infected person passing the virus to fewer than one other, on average)6.
At the beginning of the pandemic, overstretched contact-tracers in the United States, Australia and the United Kingdom faced the extra burden of antiquated health-care systems. In Australia, as well as in US states such as Hawaii and Washington, health departments are often notified of new cases by fax or phone.
Dyani LewisIt’s somewhat embarrassing, says Plescia, butwe never invested in the systems to allow them to do it differently. Entering names and other details into a database from faxed notifications causes big delays, he says, so that the window during which contact-tracing might make a difference vanishes.
Interesting analysis that goes through several reasons for the low effectiveness of contact tracing in many countries. Paradoxically, while the lack of modern digital technology can hinder contact tracing efforts, advanced technological solutions, such as the decentralized contact tracing protocol introduced early in the pandemic by Apple and Google, have also failed to live up to expectations. Low adoption aside, a decentralized system relies on individual initiative by entering positive test results in the app and isolating – a high ask for many people, as we have all discovered – but even worse it withholds data from health authorities, who cannot make proper projections and estimations of the extent of infection.