Western Sydney University and the University of Notre Dame Australia, alongside the Western Sydney Local Health District (WSLHD), recently ran an intensive workshop to train medical students and health services staff in case investigation/contact tracing.
Nearly every facet of society was impacted when COVID-19 began spreading across the world – the first cases appearing in Australia in late January. As the number of cases started to rapidly rise in late February, health services had to explore ways to expand the number of trained health professionals capable of managing the volume of case investigations that were needed.
“An important part of the ‘containment phase’ when managing an infectious disease, like COVID-19, is identifying cases and anyone with whom they may have been in contact,” said Professor Lynne Madden, Professor of Population and Planetary Health at Notre Dame.
“Currently every person in NSW who has a positive swab for coronavirus has a very careful detailed history taken to identify the places they have been and the people with whom they have been in recent contact. The people who they identify as contacts are then followed up to check if they are well. Anyone who has symptoms is tested for coronavirus – as you can imagine, this is an essential but hugely time-consuming process.”
In response to the crisis, the Public Health Unit and the Research and Education Network at WSLHD approached the medical schools at Notre Dame and Western Sydney universities to work with them to develop a course to train staff and medical students in case investigation and contact tracing to help meet the anticipated demand. The ambition was to develop a standardised core training that might also be adapted for use across NSW and develop surge capacity in the event of successive waves of COVID-19 or indeed, any other form of communicable disease.
Dr Kate McBride and Dr Brahm Marjadi, from the School of Medicine at Western Sydney University, and Dr Jennifer Davids from the Research & Education Network at Westmead Hospital, were dispatched to the Public Health Unit of WSLHD to observe first-hand how the case investigation (the first step in contact tracing) process was being approached for COVID-19. Their learnings directly informed the course content.
“We were very conscious that the course could not just be theory based. The training would need to prepare them to step into a role in a Public Health Unit, and after observing a couple of investigations, start working straight away – so it needed to be very active and practical,” said Dr McBride.
From their observations of the public health officers, Dr McBride said it was apparent that students and medical professionals needed to quickly become ‘disease detectives’ who are skilled at interviewing.
“There is quite a skill involved in speaking to people over the phone and being able to make them feel comfortable about opening up,” she said.
“Medical students have been taking clinical histories since Year One – but case investigation is much more detailed. You need to ask probing questions. You need to know everything that they have done, and every person that they have had recent contact with. When these people are unwell, they might not be comfortable disclosing their multiple trips to Woolworths – but it’s essential that they do so.”
On 20 April a pilot of a day of training was delivered online to a group of 19 people, including health services staff and final-year medical students. The eight-hour session comprised presentations by expert speakers and practice sessions for communication skills, and was complemented by two days of on-site training at Public Health Units, including the WSLHD Public Health Unit in Sydney.