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Contact tracers are key to stopping the spread of COVID-19. ArtistGNDphotography/Getty Images
  • Many people have declined contact tracers’ calls.
  • There are several reasons as to why someone would block a contact tracer’s call, but it often comes down to concerns about privacy, politics, or not wanting to answer an unknown number.
  • Experts say local health officials need to earn the public’s trust and be transparent about their goals and intent of contact tracing.

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Contact tracing has long been an effective public health tool used to slow the transmission of infectious diseases.

In the past, contact tracing has helped public health experts swiftly identify who may have been exposed to diseases — like HIV, sexually transmitted infections, and tuberculosis — and encourages them to take the proper precautions to avoid exposing others.

But in order to have a strong contact tracing program, people need to participate. And in many parts of the country, that’s not happening with COVID-19.

Many people have declined contact tracers’ calls.

Some refuse to engage, concerned the program may compromise their privacy. In certain corners of the country, the pandemic has become so politicized that some citizens may not see the value.

“It is a difficult time, and this can be a challenging process, but participating fully and remembering that contact tracing protects communities — our families, friends, and loved ones — will contribute enormously to getting us all back to normal,” said Dr. Linda Niccolai, a professor in the department of epidemiology of microbial diseases at Yale School of Public Health.

A survey from Pew Research Center found that 41 percent of adults would not likely engage with a contact tracer either by phone or text.

New Jersey Governor Phil Murphy also tweeted that nearly 70 percent of people contacted by a contact tracer in New Jersey refuse to cooperate.

Health officials in other states, including North Dakota, Texas, and Pennsylvania, have shared similar experiences.

There are a number of reasons a person may refuse to work with contact tracers, but most commonly, people are concerned that talking to a contact tracer could compromise their privacy.

“Even before COVID, I think there’s been a degradation over time in the level of trust people have in giving out information about themselves even to government agencies aiming to help residents and help the community,” said Dr. Lorna Thorpe, a New York University professor in the department of population health.

Over the last 10 to 15 years, response rates in surveys have significantly declined, according to Thorpe, and trust in the government has eroded.

Meanwhile, many facets of the pandemic have also become highly politicized.

In some parts of the country, participating in high-risk activities can be shamed, while in other parts of the country, simply believing that COVID-19 exists could lead to stigma.

It’s reasonable to assume that people who refuse to wear masks or believe the virus is a hoax may also be less likely to work with contact tracers.

Niccolai said some people may not want to acknowledge that they could have exposed others by not adhering to preventive methods like social distancing.

They may also not want to cause their friends to need to quarantine for 2 weeks, Niccolai added.

Sometimes the reason is as simple as where the call comes from. If an unknown number is listed, people may assume the caller is a telemarketer and send the call to voicemail.

“People may not answer their phones as routine practice if they don’t know the caller, or they may not remember who their contacts were during their infectious period. Index cases may also be distraught by their diagnosis, making it difficult to remember with clarity who they may have been around during their infectious period,” said Niccolai.

According to Thorpe, a strong contact tracing program is able to quickly reach people who have just tested positive, and then identify and reach people they may have been in contact with. Those contacts can then isolate and avoid transmitting the virus further.

“When that happens swiftly, tremendous reduction in COVID cases can occur,” said Thorpe.

Countries like Taiwan, Australia, South Korea, Germany, and Ireland have successfully used contact tracing to reduce transmission dramatically, said Thorpe.

Without widespread public participation, the contact tracing system won’t be able to get ahead of an outbreak and block off transmission.

“The number one thing that ensures the success of a contact tracing program is compliance of both index cases to report all of their contacts as requested, and for contacts to follow quarantine guidance,” said Niccolai.

According to the global public health organization Resolve to Save Lives, public communication about the purpose of contact tracing is crucial.

The public needs to understand how their participation can help “suppress the epidemic, protect the health of people in the community, and reopen society,” Resolve to Save Lives’ contact tracing playbook states.

Thorpe said public health officials need to be transparent about the goals and intent of contact tracing.

“Transparency is key for building trust,” Thorpe said.

The public health messaging behind contact tracing must also be consistent. Thorpe said we haven’t had that level of consistency around the country.

Thorpe added that health departments should partner with trusted community leaders — such as leaders of faith-based institutions, community organizations, and local politicians — to convey these messages.

The more embedded contact tracers are in the community, the greater the likelihood people will respond to their calls.

“Having a contact tracing staff that is familiar with the needs and desires of the community they are serving is critical,” said Niccolai.

Lastly, it’s crucial to safeguard people’s confidential information, and convey those standards to the public.

Failing to do so can quickly lose the public’s trust.

“Public health departments have decades of experience, and confidentiality is always maintained,” said Niccolai.

Public health surveys and contact tracing data has found that a significant portion of the population has refused to engage with contact tracers.

There are several reasons why someone would block a contact tracer’s call, but it often comes down to concerns about privacy, politics, or not wanting to answer an unknown number.

For a contact tracing program to be effective and reduce transmission, local health officials need to earn the public’s trust and be transparent about their goals and intent of contact tracing.