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Problems with contact tracing: Public health office in the Rhein-Sieg district hits its limit

Problems with contact tracing : Public health office in the Rhein-Sieg district hits its limit

An internal paper from the Covid department of the Rhein-Sieg-Kreis suggests that not all contacts of infected persons have been reached for weeks. Now infected people are asked to inform their contacts themselves.

Is the virus already out of control in the Rhein-Sieg district? It looks like it. In an internal paper from the Covid department, which was sent to the crisis management teams of the 19 towns and communities in the district and has been submitted to the editorial team, it is stated that "with the current infection development of incidence values well over 100, individual contact person identification can no longer be guaranteed to the same depth of investigation that has been customary up to now". In recent weeks it has no longer been possible to reach all direct contact persons of infected persons, i.e. so-called KP1, "if at all“ - promptly.

The procedure: Positive findings from the laboratories are still forwarded by the public health department to the Robert Koch Institute and the Landeszentrum Gesundheit (LZG) via the epidemiological reporting system SurvNet. The data is then entered into the in-house recording tool "Sormas" and transmitted to the local public order offices.

They issue the order to commence quarantine. At the same time, the infected persons receive a list in which they enter the contact persons with the request to inform them about the data transfer to the Health Office (GA) and to isolate themselves at home. The infected persons must also send these KP1 lists to the Health Office, which enters them manually in Sormas and forwards them again to the public order offices. From there the quarantine order goes out.

Change of strategy: The fact that the public order offices are now more accountable is a "change of strategy" for some in the municipalities. The head of the Covid unit, Ralf Thomas, speaks of a "temporary, situation-related adjustment of working methods". After all, "as a matter of urgency, every effort must now be made to withdraw additional contact opportunities from KP1, which could infect more people, in order to slow down the current increase rate in the number of infected persons.

As soon as the rate of infection subsides again, the investigation work will gradually resume", the paper says. When asked, district spokeswoman Rita Lorenz explained that "depending on the level of infection, different contact tracing strategies are used. Due to the increasing numbers, we are now moving from an individualised procedure to a generalised procedure.

This means that the contact persons reported by the group of positively tested persons will no longer be contacted by telephone before an administrative order is issued. "Instead, the public health department checks the conclusiveness of the report on the basis of the file and passes on the names of the contact persons identified to the regulatory authorities, which in turn - as before - issue a regulatory order," says Lorenz.

"For the protection of the community, the individual procedure must therefore be discontinued if the occurrence of infection so requires. If it should subsequently transpire that a contact person has been unjustly quarantined, the administrative order will of course be revoked. The ultimate goal is to quickly interrupt the chain of infection. Lorenz: "The outbreak management facilities will continue to be carried out intensively and closely monitored by the health authority to protect the particularly vulnerable groups; here, as before, employees can of course be reached at the weekend.

Personnel situation: The fact that, in view of the situation, no reinforcements from the local authorities have been requested is surprising to many in the crisis teams between Rheinbach and Windeck. However, Lorenz refers to a decision made by the district in the summer "that staff will be provided from their own ranks".

In addition, the provision of soldiers has now been requested who will be deployed in the Rhein-Sieg district from Thursday. "In addition, personnel amounting to 27 full-time equivalent persons, who will be financed by the state of NRW for a limited period of six months, will be recruited. The deployment of municipal staff has been dispensed with, as the pandemic has also greatly increased local tasks in the field of public order", she said.

The municipalities: "The change in strategy of the district means less involvement of the public order offices, but much more personal responsibility of those affected," said Carolin Trost, spokeswoman of the town of Sankt Augustin. Infected or sick people are now to become proactive and report their contact persons to the responsible health office. "What effects will the change of strategy have for Sankt Augustin remains to be seen in the future". The staffing situation at the health office will be the subject of the mayors' conference this Tuesday, she said.

For the town of Bornheim, the fact remains that the Rhein-Sieg district alone is responsible for contact tracing. Whether this remains in the district is not a matter for the local authorities, said city spokesman Christoph Lüttgen. He could only say that the delivery of the quarantine orders, which is part of the duties of the municipal public order offices, is working in Bornheim.

Although the procedure at the public health department has now changed, the city's public order office still has to deliver the quarantine notices, reports Marion Lübbehüsen, press spokeswoman for the city of Meckenheim. The number of quarantine notifications varies from day to day - at weekends there are none, and the number rises rapidly in the event of smaller outbreaks. In Meckenheim, the follow-up is guaranteed in any case.

The field staff of the public order office delivered each quarantine order personally. "In this way, we can check whether those who have already been informed by telephone are complying with the orders," says Lübbehüsen. Field and office staff are in "permanently high workload". Because of the many tasks, the public order office has been expanded with administrative staff from other departments.

The same applies to Bad Honnef. According to first deputy Holger Heuser, the public order service has been strengthened by employees from other departments. Eight or nine colleagues are on the road seven days a week, as required, to deliver the administrative orders; the peak value was 100 orders per day. Heuser is very understanding and states, "in the current situation it can very quickly reach the limits". For Bad Honnef: "We are well positioned", and there is still room for improvement - if necessary we can also support the district.

Original text: Dylan Cem Akalin, Claudia Sülzen and Katharina Weber. Translation: Mareike Graepel