The number of Saskatchewan people with COVID-19 is likely three or four times higher than current daily case numbers suggest as contact tracing becomes “almost impossible” without public health measures, according to one expert.
Cory Neudorf, interim senior medical health officer for the Saskatchewan Health Authority (SHA) and an associate professor of community health and epidemiology at the University of Saskatchewan, said high test positivity rates suggest there are many cases going undiagnosed.
“With these kinds of rates of test positivity, we’re thinking there could be at least three or four undiagnosed cases for every case that we’re actually finding right now,” he said in an interview Wednesday.
These cases are likely people who have mild symptoms and do not go for testing or people who are asymptomatic. It’s these groups, said Neudorf, that are helping drive the fourth wave.
Scott Livingstone, SHA CEO, told reporters during a Wednesday news conference he believes there is a “high number” of people who are unaware they have COVID-19.
“One of the reasons we believe it’s high is because a very high percentage of patients coming into hospital are getting their first COVID test and being positive,” he said.
“We do know that there’s lots of cases out there and that’s one of the indications of widespread, uncontrolled COVID activity, and that’s the situation we’re facing.”
But contact tracing difficulties across the province are also contributing to the number of people who are unaware they have COVID-19.
The provincial government cut back on contact tracing staff over the summer months when cases were low and Saskatchewan ended its state of emergency. Now, as the fourth wave ravages the province, health care workers are once again being redeployed to do contact tracing — including staff in pediatric therapies and treatments, resulting in cancelled children’s therapies and surgeries.
NDP Leader Ryan Meili urged Premier Scott Moe to ask the federal government for help, saying he was “baffled” why the request had not already been made. Meili said those federal supports could help with contact tracing and allow pediatric workers to get back to their regular jobs.
Even with the extra SHA staff currently being pulled in, Neudorf said contact tracing resources are not what they were during the third wave, and with few public health measures in place the job has only become more complicated.
Now when people are informed they are a close contact and asked to provide a list of their own close contacts, those lists are long and often include large public events.
“That number of contacts is much larger because we’re far more open than we were then … so that contact tracing just becomes a lot more difficult, more incomplete, and that means that more spread can happen before you can get on top of the next cases,” Neudorf said.
“Contact tracing becomes much, much more difficult, almost impossible, when we’re operating close to normal in society,” he added.
Marlo Pritchard, president of the Saskatchewan Public Safety Agency, which is now leading the province’s pandemic emergency management response, told reporters the Provincial Emergency Operations Centre is going to contribute resources to help with contact tracing in the hopes of freeing up some SHA staff currently in those roles.
But without more public health measures, Neudorf considers throwing more resources at contact tracing a losing battle. Without events or businesses being required to take down contact information for every person, it’s impossible to know who has potentially been exposed to a COVID-19 case.
The biggest challenge, however, is the lack of gathering restrictions.
Neudorf said private gatherings continue to be one of the main drivers of new cases and reimposing gathering limits would give contact tracers a fighting chance of getting in touch with a smaller number of close contacts in a timely fashion.
“It’s more an issue of trying to get in more restrictions … until we can get it down to a manageable level again,” Neudorf said.
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