Simcoe Muskoka health unit unable to keep up with contact management due to increasing COVID-19 caseload

Unless it is a particularly high risk situation for transmission, cases will be asked to alert their contacts

The Simcoe Muskoka District Health Unit is facing challenges on several fronts as new COVID-19 cases in September reached levels not seen since April and May during the peak of the first wave.

There were 185 cases of the virus in Simcoe Muskoka last month.

Medical Officer of Health Dr. Charles Gardner told a media briefing Tuesday the health unit is challenged with the ability to keep up with contact follow-up.

“We have such a large volume and a rapidly increasing volume of not only cases but the number of contacts, we are unable to keep up with all of the contacts.”

Gardner cited Toronto Public Health last week that issued a declaration that they were unable to keep up with the contacts and they needed to refocus their resources to manage those situations that were highest risk.

This is the path the health unit in Simcoe Muskoka will now take.

“We’re following up with the cases. We are following up with contacts that we deem to be of particularly high-risk situations for transmission, such as outbreaks,” said Gardner. “Otherwise, we are going to be asking cases to follow up with their own contacts if they are willing and able to do this, and advise their own contact they need to be in isolation for a 14-day period and advising they follow up for testing.”

He said anybody who has questions after receiving such information from a contact can reach out to the health unit.

Gardner said if there are cases that cannot or are unwilling to do that kind of follow up, the health unit will do the follow up with the contacts.

What makes contact tracing more challenging now compared to the spring, according to Gardner, is the first wave was essentially the shutdown of the economy

“That greatly reduced the amount of movement that people particpated in, and there was a great shutdown in public gatherings and public venues, therefore the number of contacts per case is much less than it is now.”

He pointed out the health unit this time is dealing with the opening up of the economy and people going back to work and school.

“With the school cases in particular, you can have 30 or more contacts per case because it’s an entire class or more, and each contact is a significant amount of work. If you have a vastly increased number of contacts it becomes unsustainable for us to be able to follow up with them all with the staff that we have.”

The health unit said schools and school boards already do email and telephone communication with contacts of cases. Gardner said they’ll be relying on that as a means of a communication rather than directly from the health unit.

A service from Public Health Ontario will also be used to do some of the outreach.

Gardner said it will be quite awhile before they will be able to back away from this type of approach.

The health unit has hired more nurses and will continue to do so, but Gardner said it is still insufficient and they will have to embark on the alternative approach.

The increasing case count is also challenging the health unit’s ability to provide certain programs.

The spring Grade seven vaccination program was not completed because schools were closed and staff was redirected. The health unit intends to catch up with those vaccinations in the fall, either by clinic appointments at health unit offices or other locations.

Students currently in Grade seven normally would be receiving their first doses of the vaccine in the fall and that will be postponed until late 2021, when they will be in Grade eight, and will be done at the same time as the new Grade seven students, so the health unit will be doing two years in a year to catch up.