Contact tracing in the Canadian Armed Forces during the COVID-19 pandemic

August 6, 2020 – Defence Stories

Lt(N) Kristian Cunningham, Health Care Administration Officer and Contact Tracing Coordinator
Canadian Forces Health Services Group

CF Health Services Group (CF H Svcs Gp) is expanding its contact tracing capability in support of widespread public health efforts to ensure a safe work environment for all, in preparation for the Department of National Defence/Canadian Armed Forces (DND/CAF) phased return to the workplace in the upcoming weeks. Besides reengineering the workplace and work processes, considerable effort has been focussed toward directing and containing the spread of COVID-19 cases within the CAF.

Contact tracing is an essential measure to interrupt ongoing transmission and reduce the spread of COVID-19.  It is used in combination with other interventions such as practicing proper hygiene, wearing non-medical masks and physical distancing. When contacts of cases are quickly identified and instructed to self-quarantine (if asymptomatic) or self-isolate (if sick), community spread is reduced and more knowledge is acquired about the epidemiology of the disease. Contact tracing measures are effective and are employed daily around the world to prevent transmission of diseases such as measles, tuberculosis, HIV, and Ebola – including the 2014 outbreak in West Africa.

As the CAF and the Department of National Defence resume more activities and prepare for a phased return to the workplace, CF H Svcs Gp has increased its contact tracing capabilities including the number of Health Services personnel who can perform contact tracing within the CAF.  Contract tracing for civilian members of the Defence Team who test positive for COVID-19 remains the responsibility of the provincial or territorial public health unit where they live, and no contact tracing or testing of civilians will occur without Minister of National Defence authority.

Cases and contacts are not the same

An important first step is determining the list of contacts from a case. This interview with the COVID-19 case enables the contact tracer to generate this list of potential contacts.

A “case” is someone with a confirmed diagnosis of COVID-19 – a positive test. A “probable case” is someone who develops symptoms suggestive of COVID-19, but their test results are pending. A “contact” is someone who had contact with a case while the case was infectious: two days before the case’s symptoms began and until the case is isolated. Individuals are most likely to spread the disease, however, during the first few days after they develop symptoms.

Contact Risk Levels

Contacts will be identified as high, medium, or low risk. High risk contacts are those persons who have been in close contact with a COVID-19 case: within two metres for periods greater than 15 minutes cumulatively, direct care without appropriate Personal Protective Equipment (PPE), or direct contact with bodily fluids. These contacts undergo 14 days of quarantine/self-isolation. Medium risk contacts are those persons who have been in non-close contact (outside two metres) or have provided direct care to a case while employing appropriate PPE. These contacts require 14 days of self-monitoring. Low risk contacts are those people who have had transient interaction with a COVID-19 case; they should continue with existing control measures. If a member is contacted by a contact tracer, more detailed information will be provided and the contact tracer will arrange for daily follow up calls, if necessary.

Contact tracing is a proven public health tool

While this may seem a little bit daunting, remember that resources are available. Being contacted by a contact tracer should not cause any stress. Contact tracing is a common and proven public health measure. Quarantine/self-isolation for high risk contacts effectively prevents the spread of communicable diseases: restricting the movement of people to separate those at a high risk of being infected with a disease from the rest of the uninfected community, during the period where disease can spread, is often the most effective way to prevent spread of the virus and the development of further cases. Isolation and quarantine was an important tool in 2003 in forestalling the Severe Acute Respiratory Syndrome (SARS) from developing into a more severe epidemic. These measures were also employed to control the spread of Middle Eastern Respiratory Syndrome (MERS) in 2012.

Moving forward together into a post COVID-19 workplace

Should you be identified as someone who was in contact with a confirmed case, you will receive a call from a contact tracer. Contact tracers will work with you to confirm your risk level, and if appropriate, will provide daily follow up calls for up to 14 days. To prevent the spread of COVID-19 within communities and across the country, Canadians are advised to follow the public health recommendations within their jurisdictions.

Contact tracing – the identification and follow up with contacts – and quarantine/self-isolation where warranted, is part of total Force Health Protection.

If you have symptoms of COVID-19, even mild symptoms, it is important to isolate yourself to prevent spreading the virus to others and visit a health care professional or call your local public health authority for information on getting tested. Call ahead to tell them your symptoms and follow their instructions."

Should you have any outstanding concerns, please submit your question through the Ask anything: COVID-19 form.