The new pandemic reality: Limited testing and do-it-yourself contact tracing

“The public isn’t trained in navigating these types of conversations. Even we in health care find it challenging."

Jacquie Miller, Elizabeth Payne 5 minute read December 21, 2021

COVID-19 testing. Luke Hendry / POSTMEDIA

When Paul Peters’ 11-year-old son became suddenly ill on the weekend with a high fever and extreme fatigue, he immediately suspected it was COVID-19.

His suspicion was quickly confirmed when the boy tested positive with one of the rapid antigen tests provided to Ontario school children to use during the holiday break.

So began a scramble that continues three days later for the Ottawa family amid exponential spread of the Omicron variant and rapidly shifting public health advice.

The family’s experience illustrates the worsening situation in Ottawa as COVID-19 testing facilities and contact tracing teams become overwhelmed by an explosion of new cases, leaving people waiting for — or unable to get — testing and having to notify contacts on their own. Fewer people are expected to qualify for PCR testing in the coming days as essential workers and high-risk populations are prioritized.

Twenty-one months into the COVID-19 pandemic, “We are in uncharted territory here,” uOttawa epidemiologist Raywat Deonandan said of the way the Omicron variant is hampering the ability of public health officials to respond.

Peters said his son started feeling unwell on Friday night and by Saturday had whole-body aches, a headache, a throat so sore he could barely speak and a temperature of 105 degrees Fahrenheit.

“I’ve never seen him with such low energy, have never seen him that sick. We had to help him out of the bath, that kind of thing.”

Paul Peters. jpg

Peters and his wife tried to book a PCR test for their son at the children’s COVID-19 assessment centre at Brewer Park, but no appointments were available until Wednesday, Dec. 22. Peters went down to the Brewer clinic in person, thinking he might be able to get a drop-in appointment or a take-home PCR test kit, but no luck there, either.

Peters said he wanted to warn anyone his son had been in contact with before crucial days passed.

Ottawa Public Health protocol now says if you have tested positive for COVID-19 on a PCR test that you should notify anyone you have been in contact with yourself, as the contact tracing system is overburdened. But the family was unable to get a timely PCR test for their son to confirm his positive rapid test and had no guidance about what they should do.

Peters decided it was necessary to act immediately. What if it took a week to book a PCR test and get the results?

“We wanted all the other parents to know, and we wanted the school to know.”

He notified teachers, parents of children in his son’s class at Hopewell Avenue Public School for whom he had contact information and also asked a friend with a Facebook account to post a notice on a neighbourhood group to alert parents.

Peters soon received information by email and Facebook that several other children in his son’s class had tested positive on either PCR or rapid tests or otherwise had symptoms.

He also called Ottawa Public Health — they don’t answer the phone on the weekend, he says — and 311 in an attempt to notify the authorities about the situation.

“I wanted it to get into the system so public health was notified as soon as possible so the other parents would get a letter.”

There seems to be a gap in the system, Peters said. There was no instruction from public health on whether to notify close contacts if you have a suspected case of COVID-19 or one that has been confirmed only on a rapid test.

That will likely change as Ottawa Public Health continues to deal with more cases than it can handle. But there will inevitably be gaps, experts say, as more of the burden of managing the pandemic shifts to individuals.

On Monday, OPH tweeted that testing sites were experiencing an unprecedented surge “and can’t keep up with demand.” Public health advised people to isolate if they had symptoms, had tested positive or had been in close contact with a positive case.

Ottawa’s COVID-19 testing task force says testing will shift in coming days to prioritize essential workers and vulnerable populations.

The situation is leaving more of the management of the pandemic up to individuals. And that is creating difficulties, especially at a time when pandemic fatigue has never been higher.

Do-it-yourself contact tracing, for example, is considered a strategy of last resort to manage the COVID-19 pandemic, but it is increasingly being relied on in Ottawa and elsewhere in the face of the explosive growth of the Omicron variant.

That places an added emotional toll on people already dealing with COVID-19. Uncertainty about advice adds to that burden. People who have had to call contacts report they sometimes face anger and pushback in addition to questions they can’t answer.

“The public isn’t trained in navigating these types of conversations. Even we in health care find it challenging,” said Fatima Tokhmafshan, a bioethicist and science communicator who is studying medicine. She said she had made some calls on behalf of friends and found it difficult.

And, with pandemic fatigue running high and some cases of the Omicron variant mild, it could get increasingly difficult to convince people to isolate, especially if testing and contact tracing is not widely available, Deonandan said.

Deonandan said the goal must be to continue to slow down the transmission of the virus until more people are vaccinated in order to blunt its effect and to protect young children who are still not vaccinated.

There will likely be gaps in the system as cases continue to rise, he said, but, if enough people with symptoms stay home and other policy tools such as capacity limits are in place, it should make a difference.

Peters and his family, meanwhile, have had a first-hand experience with the new reality of the pandemic.

“If this is the Omicron strain, it seems to be so infectious,” he said. His son was following all the pandemic protocols at school. “I’m sure he was wearing a mask and they were following all the rules.”

Peters says his son is now feeling better. He, his wife and his other two children are all isolating at home.


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