Many Americans will not participate in contact tracing for the coronavirus

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Reluctance to share information about coronavirus infections or contacts seems deeply entrenched in the United States – all the way to the White House, where an investigation into the spread of the virus was called off shortly after the outbreak was discovered .

According to survey results released Friday by the Pew Research Center, 41% of adults surveyed said they would be “not at all” or “not too likely” to speak to a public health official by phone or by text message from the coronavirus.

The survey of more than 10,200 adults from the nationally representative U.S. Trends Panel was conducted in mid-July, and its results are consistent with previous findings and anecdotal reports of contact tracers unable to reach or extract information from many people they have tried to contact. .

“We get a variety of responses, from yelling and hangups to those who tell us they’ve already contacted all of their friends and won’t give us those names,” County Health Director Jen Freiheit told Reuters. Kenosha, Wisconsin. summer.

To help reduce the spread of the coronavirus, which can be most contagious in the days leading up to illness, contact tracers are first contacting people who have tested positive to advise them to self-isolate and get the names people they might have been in. close contact with during their infectious period, including the two days before the onset of symptoms. Contact tracers then attempt to reach out to these people to ask them to self-quarantine so that they do not pass the virus on to others in case they have contracted it.

The Pew survey found that people who were more knowledgeable about contact tracing in general said they were more likely to participate. Of those who had heard “a lot” of contact tracing, 63% were “very or somewhat comfortable with or likely to” comply with contact tracing – compared to 29% of those who were “not at all everything” familiar or 35% who had “not heard too much about it”.

Other challenges in getting people to participate in contact tracing are habit-based. Much of this work is currently done over the phone, but 80% of respondents said they would not answer the phone if they received a call from an unknown number. People aged 18-29 were the most likely (25%) to say they would answer a call from an unknown number. This group, however, were also the least likely to say they would speak with a contact tracer, with almost half (49%) saying they were not at all or not too likely to. To do.

Willingness to help with contact tracing also tracked political party affiliation to some extent, Pew found. About two-thirds of Democrats said they would be likely or somewhat likely to speak with a contact tracer by phone or text, but only about half of Republicans said they would.

Why are people in the US so reluctant to help contact tracers, undermining a key strategy to stop the spread of the virus? Many seem to fear that their data will be compromised in some way. About 40% of survey respondents said they were “not at all confident” or “not too confident” that public health organizations could “protect their records.”

A contact tracer interviews Covid-19 patients from his home in San Francisco, California on June 25, 2020.
Paul Chinn/The San Francisco Chronicle via Getty Images

Others don’t know what contact tracing entails or that a public health official asking for their name and date of birth is really who they say they are. And many people of color are rightly suspicious of public health workers and the medical establishment after centuries of entrenched racism and unethical experimentation.

“When a segment of the population is so systematically excluded … it becomes really difficult to reach out and be able to have that coordinated response,” said Kathleen Page, infectious disease specialist at Johns Hopkins University School of Medicine, to Katelyn Esmonde. , a researcher at the Johns Hopkins Berman Institute of Bioethics, in a June article for Vox.

Insufficient staff and mistrust of apps also hamper contact tracing

The difficulties of effective contact tracing, however, do not rest entirely on the shoulders of these filtering calls or hanging up on tracers. Although states have increased the number of contact tracers they have, the country still does not appear to have enough of them overall. A recent survey by the Johns Hopkins Center for Health Security and NPR found that there are now more than 50,000 contact tracers in the United States, but that’s only half the number that experts have suggested we we needed.

And that kind of effort is incredibly laborious, as Jahnavi Curlin, a volunteer contact tracer, wrote for Vox in early October:

“We are not permitted to share privileged health information at any time, but contact tracing requires individuals to be notified of exposure to a confirmed case. It’s almost like playing a reverse game of Clue, where you as the tracer know the time, place, and person, but you’re never allowed to say it directly.

Unlike many other countries, the US has relied on manual contact tracing instead of widespread apps. However, more than a dozen states have now rolled out Apple’s exposure notification system, which uses Bluetooth to detect possible contacts. It was launched, for example, to iPhone and Android users in Colorado last weekend, letting them know they could sign up for the program. The state hopes that even only 15% of people will participate.

At this level, a September pre-print study found that new infections could be reduced by 8% and deaths by 6%. Other research took a closer look at the technology (at least as it worked on a commuter tram) and questioned the effectiveness of Bluetooth distance sensing as a reliable source of contact tracing data. , at least by the standards of some European countries.

And when paired with results on people being suspicious of their data security and 50% of Pew respondents saying they are not at all or not very comfortable sharing location data from their cell phones with a local health official, whether or not these apps end up being a major tool in the fight against the pandemic in the United States remains to be seen.

Some, like Cliff Young, president of US public affairs at public opinion reporting firm Ipsos, point to the general reluctance to contribute to a philosophy of individual control over personal information — even though that information might help prevent others illness or death. He views centralized contact tracing efforts as essentially contrary to the concept of individual freedoms, as he noted in Axios earlier this year.

In the meantime, in an effort to mitigate the latest national surge of the pandemic, now may be the time to add a fourth “W” to the standard list of three: wear a mask, wash your hands, watch your distance – and working with contact tracers.

Katherine Harmon Courage is a freelance science journalist and author of Cultivated and Octopus! Find her on Twitter at @KHCourage.

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