Background Contact tracing aims to prevent onward transmission of infectious diseases
and data obtained during tracing provide unique information on transmission characteristics.
A key performance indicator that has been proposed to evaluate contact tracing
is the proportion of cases arising from known contacts. However, few empirical studies
have investigated the effectiveness of contact tracing.
Methods Using data collected between September 2020 and December 2021 in Belgium,
we investigated the impact of contact tracing on SARS-CoV-2 transmission. We compared
confirmed cases that were previously identified as a close contact to those that were
not yet known, in terms of their traced contacts and secondary cases as well as the serial
interval. In addition, we established contact and transmission patterns by age.
Findings Previously traced, hence 'known', cases comprised 20% of all cases and they
were linked to relatively fewer close contacts as well as fewer secondary cases and a lower
secondary attack rate compared to cases that were not already known. In addition we
observed a shorter serial interval for 'known' cases. There was a relative increase in
transmission from children to adults during circulation of the Delta and Omicron variants,
without an increase in the extent of contact between these age groups.
Interpretation These results suggest that contact tracing in Belgium has been effective
in reducing onward transmission and that individuals aware of their exposure to SARSCoV-
2 seemed more reserved in their social contact behaviour. Data from a reference
period or region are needed to measure the impact of contact tracing in terms of the
number of cases and deaths averted.