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Europe’s lessons learned in COVID-19 contact tracing

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As we conclude the second year of the COVID-19 pandemic response, WHO/Europe has been collecting and sharing best practices in contact tracing from countries of the WHO European Region. It aims to document a variety of approaches based on several factors, including capacity, methodology, tools, community engagement and culture.

Dr Richard Pebody, who leads the High-threat Pathogen team at WHO/Europe, commented: “We know that contact tracing is an effective public health measure for combatting COVID-19, but experience has highlighted that it can be challenging for countries to establish a well functioning contact-tracing mechanism that can cope when there is widespread community transmission. We have commonly seen small teams of contact tracers having to deal with large numbers of COVID-19 cases and contacts.”

Contact tracing pays off

Contact tracing has never been conducted at such a scale as during the COVID-19 pandemic. Experience and evidence show that when systematically applied, contact tracing can help to break chains of transmission of infection and be a tool for keeping societies open.

Establishing comprehensive contact-tracing systems can be complex and resource-intensive. Yet, if done appropriately, the investment pays off when compared to the potential costs of full or partial lockdowns, the loss of productivity suffered through illness, and the burden to health-care systems.

The case studies collected by WHO/Europe provide a unique learning opportunity for countries and WHO, and will contribute to shaping future guidelines and recommendations.

“These case studies underline some of the strategies countries have used and the importance of having a flexible and well trained contact-tracing workforce, ideally composed of locally recruited contact tracers. We know that high-quality community engagement increases the perception of credibility and trust – both prerequisites for successful contact tracing and for compliance with quarantine requirements,” concluded Dr Pebody.

In-country contact tracing

Initial case studies conducted in Kosovo* and Kyrgyzstan involved interviews with key personnel undertaking contact tracing at national, regional and local levels, as well as with WHO focal points.

In both Kosovo* and Kyrgyzstan, contact tracing has been one of the key strategies employed by national health authorities to interrupt chains of transmission and reduce morbidity and mortality, as recommended by WHO.

Their contact-tracing infrastructure for COVID-19 was built on existing public health experience and expertise, although as case numbers rose rapidly, there was a need to train additional personnel to expand the contact-tracing workforce and scale up operations.

Additional case studies on contact tracing are planned with other countries in the WHO European Region to increase the breadth of the experiences shared and further build this important public health resource.

*All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999).