Rising COVID-19 tide blinding health department
Overwhelmed staff can no longer engage in detailed investigations or process daily data quickly
There was a time when the public health department knew exactly what the novel coronavirus was doing in Niagara.
Contact tracers knew where COVID-19 was being spread and among which groups of people. They knew how outbreaks started, identified emerging superspreader clusters and had data to support measures aimed at restaurants and bars.
But that was then. Today, faced with rapidly rising cases, expanding outbreaks and nearly 200 deaths, Niagara Region Public Health’s view into the pandemic is increasingly opaque.
There are too many cases, not enough staff and nowhere near the time to do the kind of investigations they did only months ago.
“In the past contact tracing was much more intensive,” said Dr. Mustafa Hirji, Niagara’s acting medical officer of health. “Now if a case is not involved in an outbreak, we are moving on pretty quickly. As a result, we just don’t have the kind of data we used to that helped us understand what was happening.”
The crushing workload has also impacted how the public health department reports data on its website each day. On Monday, the health department reported 471 new cases — eclipsing the previous pandemic record of 196 in a single day. However, 388 of those cases were not new, but rather represent a backlog of case data that has only just been properly processed.
Hirji said every lab report received by the health department must be verified before it is entered into its database. Health department staff have to make sure there are no errors, that a case has not been duplicated or that a retested person is not counted twice, or that a tested person is a Niagara resident.
Until recently, those checks were all done manually. And when the number of cases per day was low, it wasn’t an issue. Now, the health department is receiving hundreds of lab reports each day. At the end of each shift, the number of reports still in need of processing grew, as did the number of new files the next day.
“So we have developed software that automates some of that work for us,” said Hirji. “So that is why you saw so many cases (Monday.)”
Even with the help of algorithms, the daily data posted by the health department is still a little bit behind. As cases continue to rise, Hirji said that will keep happening. And when the vaccination program launches later this week, some staff will be directed to that effort and away from contact tracing.
Aside from slowing down the processing of basic data — such as the total number of new cases — the workload also means it is nearly impossible to know where emerging hot spots are, or from where the recent surge in cases is coming.
Hirji said based on the degree of contact tracing that is possible, it appears Christmas gatherings have played a significant role in the rising tide of COVID-19 infections. Entire families have become infected after large holiday gatherings, he said.
However, he cannot say exactly how much of a role those gatherings are playing in the current situation because he doesn’t have enough data.
Hirji said even if he wanted to use his powers under provincial legislation to impose new restrictions in Niagara, it would be difficult because he no longer has the level of data needed to know where and what kind of restrictions would be helpful.
The province is expected to announce new COVID-19 restrictions Tuesday. Hirji said given the state of the crisis, actions that further limit individual behaviour is necessary.