The value of manual backward contact tracing to control COVID-19 in practice, the Netherlands, February to March 2021: a pilot study

Background: Contact tracing has been a key component of COVID-19 outbreak control. Backward contact tracing (BCT) aims to trace the source that infected the index case and, thereafter, the cases infected by the source. Modelling studies have suggested BCT will substantially reduce SARS-CoV-2 transmission in addition to forward contact tracing. Aim: To assess the feasibility and impact of adding BCT in practice. Methods: We identified COVID-19 cases who were already registered in the electronic database between 19 February and 10 March 2021 for routine contact tracing at the Public Health Service (PHS) of Rotterdam-Rijnmond, the Netherlands (pop. 1.3 million). We investigated if, through a structured questionnaire by dedicated contact tracers, we could trace additional sources and cases infected by these sources. Potential sources identified by the index were approached to trace the source's contacts. We evaluated the number of source contacts that could be additionally quarantined. Results: Of 7,448 COVID-19 cases interviewed in the study period, 47% (n = 3,497) indicated a source that was already registered as a case in the PHS electronic database. A potential, not yet registered source was traced in 13% (n = 979). Backward contact tracing was possible in 62 of 979 cases, from whom an additional 133 potential sources were traced, and four were eligible for tracing of source contacts. Two additional contacts traced had to stay in quarantine for 1 day. No new COVID-19 cases were confirmed. Conclusions: The addition of manual BCT to control the COVID-19 pandemic did not provide added value in our study setting.

Automated summary

A study conducted in the Netherlands found that the addition of manual backward contact tracing (BCT) did not provide added value in controlling the COVID-19 pandemic. Out of 7,448 cases surveyed, it was found that some sources were already registered in the electronic database of the public health service, and 13% of potential sources were not yet registered. However, through BCT, only a small number of additional source contacts were traced, and no new COVID-19 cases were identified.