Every positive case leads to contact tracing and study
Peterborough letter: Health officials should offer more details about cases, May 14, 2020
Thank you to Ms. Hansford for her letter and this opportunity to clarify for readers the rationale for sharing details of infectious disease cases. Whenever Peterborough Public Health receives a positive result, the first thing we do is contact the case immediately and begin our investigation.
Our public health nurses conduct contact tracing and determine everyone who could have been exposed to the case while they were contagious. Then we identify which of those are close contacts and follow up with those people directly. If our public health nurses determine that a case was in a public space, event or working during the infectious period, we conduct a risk assessment of that setting.
This risk assessment considers the nature of the setting and how the virus is transmitted. If we believe there is a high- er risk to the general public, that would potentially lead to more people requiring to self-monitor or self-isolate, we would issue a public alert to give residents the information they need to stay safe and stop the spread.
To use another infectious disease as an example, if a case of hepatitis A was discovered in a worker who made sandwiches for the public, we would issue a public notice to customers who ate there during the infectious period to get tested.
COVID-19 is spread by droplet, and is usually spread in the community long before we find out. Someone who develops symptoms could have been exposed up to 14 days earlier, so it’s not always directly connected to a specific setting.
As people encounter more rumours about positive cases associated with specific stores, workplaces or communities, I would urge us all to keep in mind that it’s not helpful to focus on specific locations because the coronavirus could be anywhere. My own advice: It’s best to assume the virus is everywhere. There is absolutely no reason to think that you won’t encounter the virus — in fact, a false sense of security could put us at higher risk. We all need to keep up our guard.
As a health information custodian, under provincial privacy legislation, I have a professional responsibility to protect individual privacy rights, so there must be a strong enough public health reason to disclose information that could potentially identify a positive case.
We are required to disclose outbreaks in long-term care homes, food premises, infection prevention and control lapses, and other settings that we inspect — these are always available on our website by clicking on the “inspections” link at the top of the page. That practice continues, even during COVID-19.
Dr. Rosana Salvaterra, medical officer of health