SARS-CoV-2 contact tracing among disadvantaged populations during epidemic intervals should be a priority strategy: results from a pilot experiment in Barcelona

2021 
Abstract Objectives The aim of this study was to trace contacts of COVID-19 hospitalised patients and determine the risk factors of infection in urban areas. Study design Longitudinal analysis of contacts identified from index cases. Methods A contact tracing study was carried out in the Northern Metropolitan area of Barcelona, Spain, during the inter-epidemic lapse of May to July 2020, a period of low SARS-CoV-2 incidence. Index cases were notified from the referral hospital. Contacts were traced and followed-up for 14 days. Reverse transcription polymerase chain reaction (RT-PCR) was performed at day 0 and day 14 for contacts. Results In total, 368 contacts were identified from 81 index cases (median of 7 contacts per index case), from which 308 were traced successfully. The median age of contacts was of 28 years old, 62% (223 of 368) were males and 28 were non-nationals (34.1%). During the follow-up period, 100 contacts tested positive for COVID-19 (32.5% [95% confidence interval {CI} = 27.3–38.0]), with a secondary infection rate of 48.3% (95% CI = 40.8–55.9) among housemates. Clusters of index and respective contacts tended to aggregate within disadvantaged neighbourhoods (p Conclusions Disadvantaged communities experience a disproportionate burden of COVID-19 and may act as infection reservoirs. Contact tracing with a cross-cutting approach among these communities is required, especially during inter-epidemic periods.
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