Using the simple tools of a telephone, paper and pen, contact tracers across Canada are handling some of the most important work in the fight against COVID-19.
In Alberta, a team of 200 has made thousands of phone calls since the first case was detected in that province two months ago.
“We’re working two shifts each day, seven days a week,” said Dr. David Strong, the medical health officer for Alberta Health Services’ provincial communicable disease program. “We redeployed staff and we also recruited a significant number of medical students coming out of Calgary and Edmonton.”
Strong says Alberta Health Services is looking to hire additional contact tracers as the province prepares for the next wave of COVID-19 cases.
A new smartphone app was also rolled out last week. If successful, the ABTrace Together app could help contact tracers identify people who have been exposed to COVID-19.
“It can augment our contact tracing [but] it won’t replace what we do,” Strong says. “We’ll still rely on people’s memories, but this will allow [us] to identify some that the case didn’t remember being in contact with.”
The Alberta app is based on an open-source software protocol from Singapore called BlueTrace. It uses Bluetooth technology and creates a record anytime an app-enabled phone comes into contact with another (within two metres for a cumulative 15 minutes). Those records remain on the phone for 21 days. If a user tests positive, they can consent to uploading that record to public heath officials for followup.
Problems with the app have been identified. The iOS version only works when the phone is on — screen unlocked — and the app is running in the foreground.
“Right now, on iOS, you need to have the app in the foreground,” says Jia Hu, a medical officer of health for Alberta Health Services. “You don’t need that for Android phones. You have it on in the background. We recognize this is a major issue.”
As of May 6, the Alberta government says more than 135, 462 people have downloaded the app but research out of the University of Oxford suggests that millions more will need to sign up in order for the technology to be effective.
“The University of Oxford study details it pretty well — we need 50 to 60 per cent adoption in order for these apps to be effective,” says Zamyla Morgan Chan, a postdoctoral research fellow at the Vector Institute for Artificial Intelligence at the University of Toronto.
Morgan Chan’s team recently developed a different kind of contact tracing app based on Safe Paths, another open-source software protocol from the Massachusetts Institute of Technology.
The app uses GPS to keep a record of where a person has travelled during a period of time. If that user later tests positive for COVID-19, they have the option to consent to that GPS information being uploaded to public health for contact-tracing purposes.
Alberta is currently the only Canadian jurisdiction to have a contact-tracing app available to download but several other provinces, including Ontario, B.C. and New Brunswick, have said they are investigating this technology.
“Everybody and their dog has an app,” Dr. Bonnie Henry, B.C.’s chief medical health officer, said during her daily COVID-19 briefing on Tuesday. “We have been trialing some apps… we’ve been looking into this a lot.
“You know, we need to find the right IT support for the work that we’re doing, [one] that doesn’t create more problems than it solves, and so we have not yet found one that we feel meets the needs that we have in British Columbia.”
On Monday, Ontario Premier Doug Ford called for a national strategy on contact tracing.
“Right now, it’s each individual province doing it, but we need a national plan [to] work with the federal government and all the provinces,” he said.
Canada’s chief public health officer says discussions around a possible national strategy are ongoing, particularly around new smartphone app technology
“I think that’s the area where people are interested in looking at – is there some sort of additional layer of solution that we can look at across the board?” Dr. Theresa Tam said Wednesday.
“Because if people use all different kind of tools, then it would be more difficult and some contacts may go between provinces – so I think that’s an important area of discussion.”
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