Who and how should track COVID-19 cases? Should health professionals from the public system or private companies do it? Should apps be generalized on mobile phones or make random calls to the homes of people in quarantine? Each alternative has its advantages and disadvantages, but in the end what it is about is that someone carry out specific tasks – research or collect information – in the most effective way possible and respecting all rights.
Data collection is up to the trackers. This tracking task consists of identifying the people who have been in contact with those who have received a positive diagnosis of the disease. The protocol to be followed in their task includes the formulation of a questionnaire to be able to warn those who may be affected, warn them about the need to adopt precautionary measures (tests included) and thus avoid new infections.
The Profile of Trackers
Epidemiologists stress that trackers must be qualified people, but we do not have a regulation that specifies their professional profile. This lack is not trivial, because the control of the pandemic requires clearing several questions about the status of trackers, the nature of the data collection entrusted to them and the obligation of collaboration of the people with whom they contact.
The public health regulation in force in Spain does not serve to achieve the best organization of the tracking system, as it is sparing in its treatment of elementary questions: what is the scope of the duty of informative collaboration? Data of the contact persons? Would there be sanctioning consequences in these cases? Could other responsibilities be demanded for putting public health at risk? What happens if someone offers inaccurate references?
The General Health Law of 1986, the Public Health Law of 2011 and the Royal Decree on the Epidemiological Surveillance Network of 1995 are not enough to clear up all these issues.
The obligation to collaborate and communicate information about COVID-19 was regulated in an Order of the Ministry of Health of May 11, 2020, designed for de-escalation. The range of this standard has been offset by the validation of Royal Decree-Law 21/2020, of June 9, regarding reporting obligations, but regulatory gaps still persist.
Some people ignore their duty to cooperate
Some people are ignorant of their duty to cooperate, so they do not attend the call for PCR testing. The breach of quarantine is a much more serious breach, so the work of the trackers must also include the periodic verification of the respect of the isolation conditions of the positive diagnoses. A phone call and geolocation would be enough to guarantee traceability.
Other countries have advanced much faster than Spain in automating “tracking” needs. The complementarity between these services and surveillance apps, incipient in Spain (Radar-Covid), also deserves specific regulation: are they interchangeable institutional solutions? Do they complement each other in the control work? What advantages and disadvantages raises the automation of epidemiological surveillance functions as opposed to carrying out the task by people, capable of collecting much more detailed information on how the contacts occur, the origin of the outbreaks and the characteristics of the affected people? Will it be voluntary, or will there be an incentive not to escape public health control?
In short, are we still not very clear about what we should do, at this stage of the pandemic?
Ricardo Rivero Ortega, Rector of the University of Salamanca. Professor of Administrative Law, University of Salamanca
This article was originally published on The Conversation. Read the original.
