The work of the Ministry of Health’s Communicable Disease Surveillance Unit is key to the fight against the coronavirus, which causes COVID-19 illness, Minister of Health Dr. the Hon. Duane Sands stated. “The hardworking staff members of this unit are important frontline workers in keeping all of us safe,” Dr. Sands said during a COVID-19 Update press conference at the Ministry of Health, Thursday, April 23, 2020. He explained that the unit is responsible for collecting and evaluating health information to control the spread of communicable diseases in the country.
Dr. Sands said the unit responds:
· to disease outbreaks;
· gives healthcare facilities a description of communicable disease symptoms and protocols to follow;
· informs healthcare providers and the public of infectious diseases that could affect or are currently circulating in the country;
· and works with private and public clinics and other stakeholders to identify cases.
He added that the unit leads the contact tracing efforts.
“Contact tracing is a fundamental public health tool that can break the chain of transmission and decrease the spread of an infectious disease.
“On average there can be 10 to 20 contacts from one infected person.
The Health Minister stated that the Surveillance Unit uses the following three-step process to find these potentially exposed people.
Step 1: Contact identification. During this process, once Case A is confirmed positive for COVID-19, staff members talk intimately with the person to determine what activities he or she was involved in, and the people he or she came in contact with around the time sickness begun. The contacts given for Case A usually are:
c. Friends; or
d. Healthcare providers.
Step 2: Contact Listing. During this process all contacts noted are listed with information on how to reach them. These people are informed they were exposed to the coronavirus. They are provided with information about the necessary steps to take to avoid potentially exposing others, such as quarantine.
Step 3: Contact Follow-up. This process requires following up with the contacts once to twice a day to monitor for symptoms and potentially test for infection.
He said contacts are monitored for up to 14 days to determine if there are signs of illness developing such as fever, a dry cough or shortness of breath. “Once symptoms develop that meet the case definition these persons are immediately tested for COVID-19. “If they are found to be positive, then they are also questioned about their contacts and the cycle on contact tracing begins again.” Dr. Sands stressed that people who have been exposed to the virus are required by health officials to limit their contact with others to prevent its spread. This can be done by quarantine or isolation. “Quarantine is used to separate and restrict movement of people who are well, but may have been exposed to the coronavirus.
“Quarantine is usually for a period of 14 days from the exposure to a confirmed COVID-19 case. During this time the person is monitored to see if he or she experiences flu-like symptoms.” He said people may be required to self-quarantine if they visited an area or country where community infection is present, or if they were in close contact with a COVID-19 patient. Dr. Sands explained self-quarantine takes place at home and usually lasts for 14 days. “If a person starts to feel sick during self-quarantine, that individual should contact his or her healthcare provider or the COVID-19 hotline.”
He stated that those in mandatory quarantine are placed in a designated quarantine facility and are monitored daily by a healthcare provider. “This allows for monitoring for the development of symptoms and early detection of a case. This too is usually for a period of 14 days.” Dr. Sands explained that isolation differs from quarantine because now a person who is ill or infected needs to be separated from others to prevent the further spread of infection. “For people with mild flu-like symptoms such as low-grade fever, dry cough, fatigue, runny nose, and sore throat, they may isolate at home. They must remain in a separate room away from the rest of the household.
“If more moderate to severe symptoms develop, such as shortness of breath or difficulty breathing, then hospitalization in an isolated room at the South Beach Centre or the Doctor’s Hospital West facility in New Providence or a facility in Grand Bahama will be required.” He said those who have received recommendations to quarantine or isolate are strongly advised to remain at home until the prescribed time has ended. Dr. Sands stated, “Since you as a quarantined or isolated contact have been exposed, you have the potential to shed the virus, infect others and accelerate the spread of the disease.”