Aug. 24, 2020 -- COVID-19 contact tracing is important to slow the spread of the pandemic, public health officials know. In one modeling study, contact tracing, along with isolating people who are infected and placing everyone in their household in quarantine, decreased virus transmission by 64%.
But some people are refusing to help tracers notify close contacts of an infected person that they’ve been exposed to the virus.
In New Jersey, more than half of the people in the state called by contact tracers refused to cooperate. "Take the damn call,” Gov. Phil Murphy pleaded.
In Rockland County, NY, officials issued subpoenas and threatened fines of $2,000 a day to guests at a party who refused to cooperate with contact tracers after the host had tested positive for COVID-19. Ultimately, the guests complied and provided information.
Contributing to the problem are scammers are posing as contact tracers.
Ignoring the legitimate calls is bad for everyone's health. "Contact tracers are giving you valuable information, that you might be at risk [of infection], that you might have exposed others," says Amesh Adalja, MD, senior scholar at the Johns Hopkins University Center for Health Security. And, he says, "the scam artists are making it much harder for public health officials to do their job."
How Contact Tracing Works; What to Expect
When someone tests positive for COVID-19, the public health department is notified, and the contact tracer, usually working for the department, notifies the person. Mary Urtecho-Garcia, a contact tracer for the Pasadena, CA, Public Health Department, says she identifies herself by name and where she is calling from and asks the person to verify their identity. She can't assume they have received or looked at the results, so she asks that first. "Once they say yes, I ask how they are feeling," she says. And she offers resources.
She then asks the infected person about recent contacts to find potential exposures and help slow community spread. The CDC defines a close contact as anyone who was within 6 feet for at least 15 minutes of a person with confirmed or probable COVID-19. The contact had to occur anywhere from 2 days before the person became sick (or, for people without symptoms, 2 days before a positive specimen collection) until the time the person is isolated.
"We go back 2 weeks from the onset date [of symptoms], because that is the incubation period of the virus," Urtecho-Garcia says.
If someone declines to help, she says, they get marked down as “lost to followup,” and written information about isolation and quarantine is sent to their home.
The contact tracer then takes the list of contacts and calls, texts, or emails those people to tell them about the exposure. For COVID-19, contact tracers are always racing against the clock. To slow the spread, they must reach people quickly. Under contact tracing practices issued by the CDC, a close contact to a confirmed or probable COVID-19 patient should be notified as soon as possible, hopefully within 24 hours. The person who tested positive for COVID-19 may also notify close contacts before the contact tracer does.
When contact tracers call the people who were exposed to notify them, they should identify themselves by name, where they work, and why they are calling you, says Georges Benjamin, MD, executive director of the American Public Health Association. "They ought to be able to tell you where and under what circumstances [you were exposed]," he says.
Will the tracer tell you the patient's name?
"We only tell exposed people [the name of the infected person] with the permission of the positive person that gave us their information," Urtecho-Garcia says. "If the positive person is not comfortable, then we just let the exposed person know they were exposed and should get tested."
Not once in the 6 months she’s been doing this has Urtecho-Garcia given the name of the infected person to someone else.
She says she leaves up to three voicemails for the infected person, always asking for a callback. If there is no reply, she sends a letter to explain the need to isolate themselves. She leaves at least two voicemails over a couple of days, or sometimes the same day for those who have been exposed, and then sends a letter about the need to isolate. "Depending on when they were exposed, we suggest they get tested."
Urtecho-Garcia says she does up to five interviews a day, as she has other duties with the Health Department. "Each interview plus reporting takes about an hour." And the job isn't always easy. "I've had people hang up on me," she says, "and then won't answer the next time I call." But most people cooperate, she says, "and they are very grateful to us for calling and checking on them."
Stopping the Scammers
The rise in scam callers claiming to be contact tracers has triggered alerts from the Federal Trade Commission and state attorneys general, among other agencies. The scammers may email, text, or call, according to an alert issued by California Attorney General Xavier Becerra in June. Scammers ask for much more information than a legitimate contact tracer, says another alert posted by the Montana Attorney General's Office. Here are some things scammers may ask for:
- Payment for contact tracing
- Social security number
- Bank account information
- Immigration status
- Health insurance information
Legitimate tracers will not ask for any of these.
If you answer a call from a number that is not familiar, Benjamin suggests asking for the person's name and who they work for. "Do a little research and call them back," he says. You can easily confirm that the number really is your local health department, for instance.