Contact tracing is the process of gathering information about the people a known case of COVID-19 might have been in contact with, and the places they have been. Australia now has a well established COVID contact tracing system.
I believe contact tracing can serve as a reminder as to what good evaluation is about. And this is timely as we move through 2021 with the need to evaluate COVID-19 response initiatives across a number of industries.
According to experts, the there are five key features of good COVID contact tracing.
Detection and investigation
To find coronavirus cases, you must be able to firstly detect, then fully investigate them. Contact tracers don’t settle on the first piece of evidence they find. They cross-check their findings to be sure they have reliable and consistent information.
Sound evaluation involves being confident your data is a true portrayal of the views or experiences of your population of interest. To achieve this you need to keep researching a topic until you know you have the full and true picture of what is going on. ‘Triangulation’ is involved, which is about drawing on multiple sources of information, or interviewing a number of people from different perspectives about the same topic to ensure you have the full picture. I discuss triangulation in a previous blog post here. http://nsfconsulting.com.au/triangulation/
Ideally, a contact tracer needs to get in touch with the positive cases they’re trying to nail down within 24 hours of their diagnosis. If this doesn’t occur, the confirmed case could potentially infect others and the task takes on the form of a runaway train.
Rapid evaluation (RE) is an intensive, team-based program-focused investigation that uses multiple methods of data collection (including triangulation) to quickly develop a holistic understanding of a program. When used appropriately, RE can dramatically shorten the research time frame from months to weeks without sacrificing data accuracy.
Number of tracers
It is important to have enough contact tracers to keep up with the case load when positive case numbers are high. If contact tracers cannot get through all of the people, they are chasing yesterday’s cases and will be constantly behind the clock.
Similarly, large evaluation projects require larger teams to conduct more extensive fieldwork and collect more extensive data. They need to be planned and budgeted for accordingly.
Time spent working with cases
The amount of time contact tracers have to work with individual cases is crucial. It takes quite some time, given you’re talking to someone who’s just had a very unpleasant experience of a potentially series infection. You need to ask them a whole lot of questions, asking them to think back to who they’ve come into contact with, and they’ve got to think back sometimes up to 14 days.
Most of my evaluations are predominantly qualitative in nature. I conduct many in-depth interviews as part of my evaluation projects. It is important to budget for this fieldwork time when planning sound evaluations.
Building trust and empathy
Although confirmed cases are given questionnaires, some questions require contact tracers to work through the questionnaire step by step. Contact tracers need to demonstrate great tact and empathy when gathering relevant information, as people won’t readily share information if they think they’re being judged.
Through my work in the disaster recovery and human services sectors, I am often interviewing people about difficult and personal issues and experiences. I have learned ways in which to build trust with my interviewees by giving them time to tell their stories without judgement. This is crucial for gathering honest and meaningful information.
A range of programs and initiatives were rolled out in 2020 to support particularly hard-hit industries such as the arts, culture and human services sectors. There have been resilience funds, response packages and other support initiatives to support individuals and industry sectors, including those rolled out by the Australia Council for the Arts. As we start to evaluate these responses to the pandemic, I believe if we think like good contact tracers we will be sure to gather information that is timely, reliable and sound.
* University of New South Wales Professors and infectious disease specialists Mary-Louise McLaws and Raina MacIntyre
Image credit: www.healthaffairs.org