Voluntary contact tracers within the COVID-19 Public Health Response Team are facing abuse and threats, swearing and shouting when calling contacts of positive cases and instructing them to quarantine as the surge in numbers continues.

Some are hanging up and not volunteering information about the friends they were with, refusing to tell them to stay home, said Tanya Melillo, who leads the response team’s case management, which is also dealing with its own hurdles when gathering contacts of positive cases and looking for the source.

“People are not realising that they are not protecting their friends and colleagues by not sharing their contacts, but only doing them a disservice and making the situation worse,” she said of the tedious process.

“Case managers can have trouble getting contacts and we often have to call two to three times; sometimes, we are told we will be given a list of contacts, but it never comes.”

Melillo, who also heads the Infectious Disease Prevention and Control Unit, voiced her frustration at the public’s resistance, lack of cooperation and sense of responsibility as the COVID-19 situation has “exploded in our faces”.

Some people who have undergone swabbing simply do not believe they have tested positive even though they would have done this on their own initiative, meaning they should know there is a chance they could have contracted the virus, she said.

Volunteers within the response team have been warned by some people they contacted that they would speak to their lawyers, to ministers, or even decide the call is a prank, take it as a joke, and waste even more time because they refuse to listen.

Pre-empting calls to be told to quarantine and wanting to avoid it, some are not even answering the phone, and police have to be sent to their doors, lengthening the process.

“No one wants to go into quarantine in summer and we do not get any enjoyment out of this. We are just doing our job to stop the spread of the virus and prevent deaths,” Melillo said, pointing out that her staff were working round the clock.

“The first wave was managed well, and we coped, but now, it has exploded in our faces. We are so inundated that, with the same resources – 10 doctors, we now have a backlog in case management and contact tracing takes longer.

Volunteers warned by some people they contacted that they would speak to their lawyers, to ministers or even decide the call is a prank

The workload of case managers is “enormous” because the numbers are now “huge”, said Melillo.

“Today, when you ask infected people where they have been and what they have done, unlike in winter, they have all been out and about and done loads of activities.

“Every person could easily have been in contact with 30 to 50 people: at least 30 socially, excluding family members and work, if you go back a few days. These figures would need to be multiplied by 60 positive cases a day, for example,” she calculated.

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Last week saw around 300 positive cases of infection. If the case managers traced a minimum and conservative figure of 10, it would already mean 3,000 contacts.

This also implied that for every infected person, between 30 and 50 are going into quarantine – and that is not including people living in their same household.

The coronavirus is “spreading like fire”, Melillo warned.

“We have seen sporadic cases of elderly who are hardly going anywhere and are still contracting COVID-19.”

Wait it out

People need to understand they must wait at home after they take a test and until the results come out – and they cannot go to work and meet friends.

This could take 24 hours and another day could pass before a risk assessment is then carried out to try to find and stop the source.

Melillo appealed for patience, saying results should be in hand within 48 hours, while acknowledging there has been the occasional lost test.

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Addressing any flack received for not providing timely information about clusters and the source of outbreaks, Melillo explained that the first step is to contact any positive people immediately, assess whether they need to be hospitalised and put their family in quarantine.

But a day can pass until their medical history is obtained and the case managers start looking for the source of infection and the contacts.

“By that time, they would have informed their place of work and everyone would have already started talking before we would have even begun assessing the situation and contact tracing.”

Melillo said it was not the job of employers to decide their staff should quarantine if one of them tested positive.

“Give us a chance to do the proper scientifically-based risk assessment on who was exposed before you send everyone home as only some would need to be quarantined,” she appealed.

“Instead, they are going on autopilot and facing more panic at the workplace.”

It can be especially hard to track down foreigners who tested positive, Melillo continued about the ripple effect of big numbers on the job.

“We keep looking for them, but some, we then discover, would have left the island,” she said.

“We have to try to find their flights to see which passengers would have been exposed.”

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