Reluctance to share information about coronavirus infections or contacts seems to run deep in the United States – right down to the White House, where an investigation into the spread of the virus was halted shortly after the outbreak was discovered.
According to a poll released Friday by the Pew Research Center, 41 percent of adults surveyed said they would "not at all" or "not too likely" to talk to a public health officer about the coronavirus by phone or text message.
The survey of more than 10,200 adults on the nationally representative American Trends Panel was conducted in mid-July. The results are consistent with previous results and individual reports from contact tracers who were unable to reach or extract information from many people they tried to contact.
"We get a variety of responses, from yelling and hanging up, to telling us that you've already contacted all of your friends and won't tell us those names," said Jen Freiheit, health director for Kenosha County, Wisconsin , opposite Reuters Summer.
To help reduce the spread of the coronavirus, which can be most contagious in the days leading up to feeling sick, contact tracers first turn to people who test positive to advise them to isolate the names of people they may have been on and identify close contact with during their period of infection, including the two days before they began to feel symptoms. Contact tracers then try to reach out to these people to place them in quarantine so that they don't spread the virus to others if they become infected.
The Pew survey found that people who were more familiar with contact tracing in general said they were more likely to participate. Of those who heard “a lot” about contact tracing, 63 percent were “very or somewhat comfortable or likely” to follow contact tracing – compared to 29 percent of those who were “not at all” familiar with it or 35 percent who had "not too much" heard of it.
Other challenges to getting people to participate in contact tracing are habitual. Much of this work is currently done over the phone, but 80 percent of respondents said they won't answer the phone if they get a call from an unknown number. The 18 to 29 year olds said they were most likely (25 percent) to receive a call from an unknown number. However, this group was also the least likely to say they would speak to a contact tracer. Almost half of them (49 percent) said they would not do this at all or not too likely.
Willingness to help trace contacts also followed, to some extent, membership of a political party, Pew noted. About two-thirds of Democrats said they were likely or likely to speak to a contact tracer over the phone or text, but only about half of Republicans said they would.
Why are people in the US so reluctant to contact tracers, undermining a key strategy to stop the virus from spreading? Many seem concerned that their data will be compromised somehow. About 40 percent of respondents said they were "not at all confident" or "not too confident" that public health organizations could "keep their records safe".
A contact tracer interviews Covid-19 patients from their home in San Francisco, California on June 25, 2020. Paul Chinn / The San Francisco Chronicle via Getty Images
Others aren't sure what contact tracing means or that a public health officer who asks for their name and date of birth is really who they say they are. And many people of color, after centuries of embedded racism and unethical experimentation, are rightly suspicious of public health workers and the medical establishment.
"When a segment of the population is excluded so systematically … it becomes really difficult to achieve and maintain that coordinated response," Kathleen Page, an infectious disease specialist at Johns Hopkins University Medical School, told Katelyn Esmonde, a researcher at the Johns Hopkins Berman Institute for Bioethics, in a June piece for Vox.
Inadequate staff and distrust of apps also hamper contact tracking
However, the difficulties of effectively tracking contacts aren't entirely on the shoulders of those screening calls or hanging up tracers. Although states have increased the number of contact tracers they employ, the country as a whole still does not seem to have enough. A recent survey by the Johns Hopkins Center for Health Safety and NPR found that there are now more than 50,000 contact tracers in the U.S., but that's only half the number experts believe is necessary.
And that kind of effort is incredibly labor-intensive, as Jahnavi Curlin, a volunteer contact tracer, wrote for Vox in early October:
“At no point are we allowed to share privileged health information. However, contact tracing requires that individuals be informed of exposure to a confirmed case. It's almost like playing a reverse clue game where, as the tracer, you know the time, place, and person, but you must never say it directly. "
Unlike many other countries, the US relies on manual contact tracing instead of widely used apps. However, now more than a dozen states have introduced Apple's Exposure Notification System, which uses Bluetooth to identify potential contacts. For example, it was rolled out last weekend for iPhone and Android users in Colorado to let them know they could sign up for the program. The state hopes that only 15 percent of the people will take part.
At this level, a September preprint study found that new infections could be reduced by 8 percent and deaths by 6 percent. Other research has delved deeper into the technology (at least how it works in a commuter car) and has cast doubts about the effectiveness of Bluetooth distance sensing as a reliable source of contact tracing data, at least by the standards of some European countries.
Coupled with results on people who suspect the security of their data and 50 percent of Pew respondents who say they are reluctant or completely reluctant to share location data from their cellphones with a local health officer, regardless of whether those apps end up being Are Available Or Not An important tool in tackling the pandemic in the US remains to be seen.
Some, like the president of the US public affairs reporting firm Cliff Young, report a general reluctance to contribute to an ethos of individual control over personal information – even if that information could help prevent further illness or death. He sees centralized contact tracing efforts as essentially contradicting the concept of individual freedoms, as he noted in Axios earlier this year.
In the meantime, adding a fourth “W” to the standard list of three could be an excellent time to steal some fuel from the recent nationwide pandemic flare-up: wear a mask, wash your hands, watch your distance – and work with contact tracers.
Katherine Harmon Courage is a freelance science writer and author of Cultured and Octopus! Find her on Twitter @KHCourage.
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