oa Challenges faced during COVID-19 outbreak investigation in Qatar: From the investigators’ perspective

Background: Case investigation and surveillance is a key step in managing any epidemic. This report aimed to identify the main challenges faced by COVID-19 case investigators in Qatar and to suggest possible solutions to improve the case investigation process in managing future pandemics. Methods: Purposive sampling was used to select 40 COVID-19 case investigators posted at the Ministry of Public Health, Qatar. Interviewees were from diverse educational and cultural backgrounds and had been investigating COVID-19 cases for more than 6 months, at the time of interview. Face-to-face semi-structured interviews were done to collect data which was anonymized before analyzing for the purpose of this qualitative study. Results: The most common concern faced in conducting case investigations was language barrier, given the multinational and diverse diasporas Qatar is host to. Authenticity of the investigation was a matter of suspicion for many patients; whereas the majority of the investigators opined that multiple calls received from different healthcare departments asking for information overwhelmed many patients. Laborers/migrant workers often did not divulge information due to fear of repercussions from their supervisors. Social stigma associated with COVID-19¹ caused reluctance to reveal the index case and close contacts. Information regarding social gatherings attended and public places visited was often concealed (Figure 1). Cultural differences as well hindered smooth investigation in a few cases. Rising case load at times put restraints on improved coordination between different health departments² and structured guidance for investigators³ about the pandemic response system, which could help to deliver appropriate health services more efficiently. Comprehensive orientation in using the Electronic Surveillance database could also improve the efficacy of epidemiological analysis for improved public health outcomes. Conclusion: Addressing these challenges will help the public health team in Qatar to increase preparedness and efficiency in managing potential future outbreaks, especially in view of upcoming mass gathering events such as the FIFA 2022 World Cup.