Disease detectives

By Uriel Quilinguing

THE process of identifying people who may have come in contact with an infected person and subsequent collection of information from them is known, among public health professionals, as “contact tracing.” This standard procedure for viral epidemics, which is intended to contain an outbreak and break the transmission channels could be painstakingly challenging. Those involved are in a race against time to save human lives.

For Mindanao, the 54-year-old male Covid-19 patient who died in an isolation room at the Northern Mindanao Medical Center in Cagayan de Oro on Friday night, can be considered by epidemiologists as the index case or patient zero, from him the virus transmission trail begins here. This is also where the headache of the contact tracer starts.

Patient 40 was in critical condition when he was admitted to the NMMC in March 8 and confirmed Covid-19 positive three days later. It is no longer possible to extract information from him now but he had two companions who became patients under investigation in the same medical facility.

Vital information on Covid-19 Patient 40:

1. He could have been infected with the novel coronavirus while in Pasig, Metro Manila since he had influenza-like symptoms since Feb. 24;

2. He took a plane from the Ninoy Aquino International Airport, Pasay City to Laguindingan Airport, Misamis Oriental; he was from Lanao del Sur;

3. He was admitted for pneumonia in a hospital in Iligan City March 3 until the day he was referred to the NMMC.

For now, no one from the Department of Health regional office revealed the plane and flight number Patient 40 took in coming over from Pasay, as well as the exact day of his arrival before his March 3 admission at Iligan hospital.  

All those who flew in, regardless of the flight number and the name of the plane, may now think twice and be anxious about his or her health condition though the 14-day window period may have over. But has the plane that brought him here and areas at Laguindingan airport where he might have stayed for 15 minutes or more been sanitized?    

So far, Iligan officials, upon learning that patient spent days in Iligan and a hospital there, ordered the sanitation of identified areas and classrooms as well as the suspension of classes in a bid to rid the city of the contagion.

For now, what is certain is that not all people who have had close contact with Patient 40, have been traced and contacted for infection screening and regular monitoring of symptoms. DOH-10’s March 13 Advisory No. 36 does not indicate a remarkable increase in the number of people under monitoring. The 21 PUMs may have included those in close contacts but these are not all.

Those tasked for contact tracing, who should act as disease detectives, should have already scrutinized the plane passenger manifest, viewed the surveillance tapes, and secured a roster of health professionals who took care of him in Iligan City. Hopefully, Patient 40 had not taken a bus, taxi or a public jeepney since tracing other passengers may even be more challenging if not highly improbable.          

This is the proper time contact tracing be done vigorously since there is an index case before the epidemic spread could outpace the identification of close contacts—with a cluster of cases or second-generation infections outside the chain of transmission that epidemiologists pursue.  

For now, those tasked with health education and promotion functions should be engaged to help convince those who might have been infected to come out into the open, assure them that contact tracing is intended to help them, hence the need for self-quarantine for 14 days, other than preventing the novel virus from spreading further.

(Uriel C. Quilinguing is a former president of the Cagayan de Oro Press Club who had been editor-in-chief of Cagayan de Oro-based newspapers, including this paper. For almost a decade, he led the Media Health Advocates Group in Northern Mindanao. For reactions, email them to uriel.quilinguing@yahoo.com.)