Why Sask. contact tracing efforts were reduced by hundreds of workers early in the 4th wave

Saskatchewan has a greatly-reduced team of contact tracers on hand as it faces the fourth wave of the COVID-19 pandemic, though efforts are underway to change that, the Saskatchewan Health Authority says.

In March and April of 2021, at the peak of the third wave, there were over 1,000 full-time-equivalent positions dedicated to notifying people they had COVID-19 and guiding them on what to do next, including the then-mandatory step of isolation, according to newly-disclosed figures from the SHA.

Besides redeployed health care workers, the team included staff from organizations such as the Public Service Commission and Statistics Canada, plus medical and nursing students.

Now — as Saskatchewan averages hundreds of new cases of COVID-19 every day, self-isolation is no longer mandatory and health officials call on the provincial government to bring back some public health measures to relieve the pressure on overloaded emergency rooms — the SHA has 330 full-time-equivalent contact tracers and has begun asking some people to do their own contact tracing. 

"Having less staff available to help with contact tracing does have a significant impact on the capacity of our communicable disease teams," the SHA said in an emailed statement on Thursday. 

Those capacity issues were compounded by the rise of fourth-wave cases and the absence of public health orders to assist with the mitigation of COVID-19 spread, according to the health authority. 

"Many positive cases now have a larger number of contacts as restrictions on private and public gatherings have been lifted." 

Agreement to supply team expired in August

The formerly robust complement of contact tracers was made possible in part by a letter of understanding (LOU) between the SHA and five unions: the Saskatchewan Union of Nurses (SUN), Service Employees International Union (SEIU)-West, Canadian Union of Public Employees (CUPE) Local 5430, Saskatchewan Government Employees Union (SGEU) and Health Sciences Association Of Saskatchewan (HSAS). 

That, combined with service slowdowns in other parts of Saskatchewan's health system, "achieved the ability to ensure that we have the people where and when we need them," the health authority said.

The LOU expired on Aug. 8 — about a month after Saskatchewan rescinded its public health orders when COVID-19 case numbers were low — and staff returned to their home departments. 

"Presently there is not an agreement in place with the unions that will allow the SHA to redeploy staff to the extent that we were able to under the expired LOU," the health authority said. 

Work is underway with health care unions to establish staffing strategies to enable movement of staff to meet urgent and emergent COVID staffing needs, including contact tracing, the health authority added. 

SHA abused floating agreement, union says

Tracy Zambory, the president of the Saskatchewan Union of Nurses, said the union believes in the importance of beefing up contract tracing efforts right now. 

But the union is not interested in another LOU because under that arrangement, employees were redeployed to different areas of the health care system for longer than they could bear, she said.

"That letter of understanding did not work in favour of the employee to be able to get themselves out of a stressful situation and back to their home job," Zambory said. 

That, in turn, "has led to a lot of the depression, the anxiety, the burnout," she said. 

The union is open to "floating" members under the terms of their collective agreement with the SHA, which better protects workers, Zambory said. 

'A huge social contribution'

The current operating context is different than earlier in the pandemic when communicable disease processes were significantly scaled up, the health authority said. 

There were no vaccines in wide distribution until early 2020. Also, the reduction of other health services created a pool of available workers to assist in the "non-contact aspects of public health work."

"This did make a huge social contribution," the health authority said. 

Zambory said contact tracers are typically faced with one of two reactions when informing people they have COVID-19.

"You either get someone who is very angry, a non-believer [who] is quite abusive and you don't get anywhere with them," she said. "Or you get someone who it really shocks them. They're very frightened and you have to talk them through what to do next."

"Think about that scenario now," she continued. "That person, the ball's in their court to try to do any contact tracing....The fear is that that person is going to become paralyzed with fear. Nothing is going to happen. Nobody will know what businesses they went to. Did they actually travel to different communities? Were they in large group settings?

"All of that is lost right now."