Hamilton can’t keep up with contact tracing after surge of COVID cases

Hamilton's strained public health unit is getting reinforcements from the province to help speed up contact tracing as COVID cases soar.

Staff provided by the Ministry of Health started working Wednesday to notify those who have been exposed to the virus by a Hamilton case. The extra help is on top of resources already provided for contact tracing by Public Health Ontario.

We've been holding our own until a day or so ago," said Dr. Elizabeth Richardson, Hamilton's medical officer of health. Our numbers are dropping in terms of our ability to follow up within 48 hours."

Hamilton has seen a surge of 219 new COVID infections in four days from Saturday to Tuesday. The city reported a record 367 active cases Tuesday. All of those exposed have to be notified and contacts can be extensive considering the rapid rise in cases is being blamed on people not following public health measures.

Delay is significant because the longer it takes to contact trace, the higher the chances the person transmits the virus to others before being notified of their exposure and isolating.

We're certainly glad for the help," said Richardson, noting it made a big difference for hot spots like Ottawa, Peel and Toronto.

Richardson said contact tracing struggles won't postpone public health nurses currently returning to Hamilton's schools.

They're still going back because COVID is not the only thing that is going on," said Richardson. Mental health is particularly a concern especially among our young people."

Hamilton's public, Catholic and French elementary and secondary schools are already working with 21 full-time equivalent public health nurses hired specifically for the pandemic to help schools with infection control and contact tracing. They also answer questions from school staff and parents who can contact them for support at 905-974-9848, option five, from Monday to Friday 8:30 a.m. to 4:30 p.m.

We recognize the stress some parents felt in their initial decisions about their children attending school in person," said Chris Pickersgill, manager of the COVID school health program. And we further appreciate how positive case numbers has exacerbated that stress."

Unlike other regions, Hamilton has recruited all of the COVID public health nurses it was allotted by the province.

In addition, roughly 20 full-time equivalent public health nurses who normally work in schools but had been redeployed will return with a focus on issues exacerbated by the pandemic such as mental health, addictions and social-emotional growth and development.

We're just in the process of ... understanding the landscape now as it pertains to COVID-19 and helping to identify ... any other gaps that we're noticing that we need to address," said public health's chief nursing officer Jen Vickers-Manzin.

Each public health nurse works with roughly eight schools but teams are available to help with individual cases or outbreaks.

This enables us to flex up resources," said Vickers-Manzin. I will flag that as case volumes increase ... this can create pressures. We continue to work to access other supports ... as well we problem solve the best ways to reach families quickly."

At the start, COVID nurses focused on infection prevention and control to stop the virus from spreading once it gets into a school.

We had the opportunity to have our nurses go out and be in schools," said Pickersgill.

Their efforts have been successful so far as there have been few school outbreaks in Hamilton despite numerous individual cases.

The school nursing role is really ... getting us to a quick response when we're starting to identify issues," said Vickers-Manzin. They are an essential boots on the ground resource in the moment that we're hearing has been really, really helpful."

Now, the nurses primarily oversee contact tracing, which can be a big job particularly if the student takes a bus or is part of a before- or after-school program. The number of contacts can range from a few to 50 or more.

It's very difficult work," said Vicki McKenna, president of the Ontario Nurses' Association. The kids can be very social not only in the school ... but these kids go home to families of varying sizes ... there's some organized sports ... we have kids who go to morning daycare or after-school care because parents are working ... some of the kids have many, many contacts."

She says public health staff fear gaps left by programs put on hold during the pandemic. Hamilton public health has 232 of its staff working on COVID-19 and the magnitude of the second wave has made it impossible to downsize the pandemic response.

The public health nurses are stretched to the max," said McKenna. They're tired and they're worried about what's happening coming into the second wave ... The nurses are feeling sometimes pretty weighted down."

Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com