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Conspiracy Theories Aside, Here’s What Contact Tracers Really Do

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Conspiracy Theories Aside, Here's What Contact Tracers Really Do

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Contact tracing for the coronavirus is the subject of colorful conspiracy theories. In fact, contact tracing is a straightforward process of notifying people if they’ve been exposed to someone who is sick.

Hannah Norman/KHN


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Hannah Norman/KHN

Contact tracing for the coronavirus is the subject of colorful conspiracy theories. In fact, contact tracing is a straightforward process of notifying people if they’ve been exposed to someone who is sick.

Hannah Norman/KHN

In the midst of the COVID-19 pandemic, contact tracing is downright buzzy, and not always in a good way.

Contact tracing is the public health practice of informing people when they’ve been exposed to a contagious disease. As it has become more widely employed across the U.S., it has also become mired in modern political polarization and conspiracy theories.

Misinformation abounds, from tales that people who talk to contact tracers will be sent to nonexistent “FEMA camps” a rumor so prevalent that health officials in Washington state had to put out a statement in May debunking it to elaborate theories that the efforts are somehow part of a plot by global elites, such as the Clinton Foundation, Bill Gates or George Soros.

At the very least, such misinformation could hinder efforts to contain the coronavirus, and at worst it has sparked threats against tracers, say some observers, including the Institute for Strategic Dialogue, a London-based organization that studies polarization.

The dynamic, ISD notes in a June report, “is being generated both by individual social media users and by key influencers in conspiratorial communities” and plays on fears that Big Brother is watching us.

According to that report, social media posts, mainly videos, have been associated with “widespread sharing of petitions and other efforts to galvanise political action against contact tracing.” The videos, steeped in disinformation and conspiracy think whether alleging that tracers have ties to the deep state or casting them as part of a Democratic effort to interfere in the 2020 election “are receiving more than 300,000 views each on YouTube and are being shared tens of thousands of times across public Facebook pages and groups.”

Of course, the real story behind tracing is nothing like these colorful conspiracy theories. Contact tracing is an age-old infection-control strategy, and it’s a bit tedious, actually.

“We’ve been doing it in public health for decades,” said Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials.

Part old-fashioned shoe-leather detective work, part social work, the goal is to interrupt the spread of the illness by reaching out to people who test positive and the people they have been in close contact with and provide needed support for them to isolate. It has to be done quickly, and it takes a lot of people. Recent case count surges in some parts of the country are making the task more difficult.

So let’s take a look at what it is and isn’t.

What’s the process?

When a person tests positive for a communicable disease, health care providers must report the person’s contact information to public health departments. Contact tracers then try to reach out quickly, generally by phone.

The tracer will ask for the patient’s address. Some social media sites have decried this as nefarious, but it’s not. The tracer does not want to provide private medical information “Mr. Smith, I see you tested positive for COVID-19” to the wrong person. Answering contact tracers’ questions is always optional, and those contacted should also feel free to confirm it really is the public health department calling, experts note, as there have been reports of fraudulent calls.

During the initial call, the tracer makes sure the patient is OK and understands the disease and what to expect. Ideally, the contract tracer builds a relationship with the patient. Some can link the patient with local resources or services, such as food delivery or needed medical supplies, that can make it easier to stay isolated until the patient has recovered from the virus.

What’s a close contact?

Contact tracers ask where the infected person traveled and with whom they came in close contact generally defined as being within 6 feet for 15 minutes or more from about two days before they started showing symptoms until they isolated themselves.

That does not include such things as simply passing people on the street or opening the door to pick up a package dropped off by a FedEx driver.

Providing the information is voluntary, but it is the only way the programs will work. Most patients happily comply, but a few are reluctant, said Plescia.

“That was a little surprising,” he said. “You would think if you might cause another person to become ill, you would have an interest in that person being notified. But some worry they are snitching on other people.”

Tracers do not disclose the name of the infected person to the contacts. Contacts simply “receive a call saying, ‘You have had a significant exposure,’ ” said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security and the co-author of a report on contact tracing.

To assist with tracing, some restaurants, stores, salons and other businesses are keeping daily logs of customers. Some voices on social media have raised concerns about those logs, saying they are intrusive and suggest that Big Brother is watching. Their purpose, though, is to make it easier for health officials to notify other employees and patrons in the event that someone tests positive.

Close contacts are urged to quarantine for 14 days, check their temperature regularly and avoid contact with other household members, if possible.

For each infected patient, tracers need to contact an average of 10 other people, said Watson noting, however, that the number could be far higher. “If contact tracing is done in a place where there’s a big epidemic and no one is under social distancing restrictions, you’ll have to contact more,” she said.

Speed is of the essence in finding close contacts. Infected people start showing symptoms within two to seven days of exposure although it can take up to 14 and they may be contagious before symptoms appear.

Who is asking these questions?

In the early days of the COVID-19 pandemic in the U.S., tracing was limited because testing for the virus was also limited. The two really go together. That meant the nation used the other tool at its disposal, the blunt instrument of stay-at-home orders. Now, with testing more available and with many states in the fits and starts of reopening, the more targeted effort of contact tracing becomes important.

Used effectively, it can sharply slow outbreaks, as seen in countries that have employed comprehensive tracing programs, such Japan, New Zealand and China.

So far, though, the U.S. has had a more limited effort, and it varies state by state.

An estimated 37,000 contact tracers are now employed by public health departments nationwide, triple the number just a few weeks ago, according to an NPR state survey and tracking effort. Still, those numbers are far below estimates of what many say is necessary. Indeed, Watson and other Hopkins researchers say the U.S. needs to add a minimum of 100,000 contract tracers.

Can they force me into quarantine?

Although health officials do have authority to isolate people who pose a danger to others, that power is almost never used.

“Mandatory quarantine hasn’t really been used since the days of smallpox in this country, although the president used it in the beginning of the pandemic for some people repatriating back to the county,” said Watson.

Public health officials avoid such aggressive tactics because they don’t want to discourage people from getting tested. As for hauling people away from their homes by force, that also doesn’t happen here, although it does in some authoritarian countries. Instead, a number of cities and regions have set up special hotels or other facilities where infected or exposed people who live in homes where they can’t isolate themselves from other family members can voluntarily spend their convalescence.

Is contact tracing working?

It has certainly worked in other countries, said Howard Koh, professor at the Harvard T.H. Chan School of Public Health and former assistant secretary for health in the Obama administration.

“Italy, Spain, China, Taiwan, Hong Kong and New Zealand have all gotten to the other side of the curve,” said Koh. “When they have outbreaks, they are relatively small, and they jump on them right away.”

One difference, he said, is those places have a national strategy.

“In our country, we have a 50-state strategy, a patchwork response including contact tracing, with some states having embraced it and some have barely started.”

Massachusetts and New York have reported success with tracing, said Watson.

But there are many areas of the country, especially the Sun Belt, where cases are spiking, complicating efforts to control the virus. With more demand for testing, the turnaround time for results grows. And large numbers of new cases mean contact tracers have far more people to track down, making it challenging to do so in the short time frame needed to be effective.

“I’m discouraged that a lot of the states where we are seeing a big surge right now have not put a lot of effort into developing their contact tracing workforce,” Watson said, echoing Koh’s call for a national plan. “We need an initiative by the federal government focused on contract tracing.”

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation and is not affiliated with Kaiser Permanente.

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Sanders and Schumer call on McConnell to hold hearings to fight election conspiracy theories – KTVZ

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Sanders and Schumer call on McConnell to hold hearings to fight election conspiracy theories - KTVZ

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Sen. Bernie Sanders of Vermont and Senate Democratic Leader Chuck Schumer of New York are calling on Majority Leader Mitch McConnell to create a new bipartisan committee focused on election integrity and schedule hearings to reassure Americans over a process President Donald Trump has repeatedly sought to undermine.

There is growing anxiety among Democrats, and some Republicans, that Trump will not only continue to sow doubt over the legitimacy of the coming election but throw the subsequent count into chaos by declaring victory before all the votes can be tallied, including the millions that will arrive by mail.

In a letter to McConnell, Sanders and Schumer quote back the Kentucky senator’s own words, in which he attested to the reliability of mail-in voting by citing its successes in Oregon, Washington and Colorado, which have been using the system for years.

Trump has repeatedly questioned the validity of mail-in voting, promoted conspiracy theories questioning election security, called on supporters to act as unsanctioned “poll watchers,” and suggested that the absence of a clear result by the evening of November 3 would in some way cast doubt on the eventual outcome. Key allies in powerful positions, like Attorney General Bill Barr, have followed suit. Barr has persisted in puffing up a debunked claim that ballots received by mail would somehow strip the sender of their privacy — ignoring well-established safeguards.

By escalating the matter now, Sanders and Schumer are responding to growing concern, in partisan and nonpartisan spaces, that Americans are not adequately prepared for the potential of a longer-than-usual wait for results or Trump’s willingness to short-circuit the democratic process if he smells defeat.

“Democrats and Republicans in Congress must come together to ensure that we have a free and fair election where every vote is cast and counted without intimidation,” Sanders told CNN, “where no one has to put his or her health in danger to cast a ballot, and where we have full confidence in the results.”

The proposed hearings would invite a cross-section of election officials from across the country to testify to the security and reliability of mail-in, early- and in-person voting — subjects on which Sanders and Schumer, again, referenced McConnell’s own words.

“Despite the clear security of our vote-by-mail system, some have continued to undermine it with unsubstantiated claims of voter fraud,” they wrote. “As you have correctly said, people ‘can vote early, you can vote on Election Day, or you can drop it in the mail,’ and that voters should ‘not worry about your vote not counting.’”

The minority leader and Sanders, an independent who caucuses with the Democrats, also want more detailed discussion about the fraught hours, or days, after the polls close and a real-time watch of the election horse race potentially swings from one candidate to another.

“We know a number of states may well be counting ballots for a period of time after Election Day, and that those votes may be determinative in this election,” the senators wrote to McConnell. “To avoid disinformation, conspiracy theories, and suspicion about results, we must understand the likely timeline for this process.”

The letter goes on to reference the recent war games-style preparations conducted by a group called the Transition Integrity Project, a bipartisan gathering of operatives and academics that made headlines when some of the outcomes of their exercises — including “both street-level violence and political impasse” — were reported on in late July.

“A bipartisan group of experts and officials have studied multiple scenarios where the outcome of the election was not immediately known. Some of these scenarios resulted in unrest and even violence,” Sanders and Schumer wrote, suggesting the Senate should elevate similar discussions and familiarize the public with the uncertainties ahead. “We would like to hear from the most knowledgeable people in the country as to how we can do everything possible to make sure that the election and the period afterward is secure and peaceful.”

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HHS official sorry for conspiracy theory video

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HHS official sorry for conspiracy theory video

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HHS supported Caputo, with a statement that called him a critical, integral part of the presidents coronavirus response, leading on public messaging as Americans need public health information to defeat the COVID-19 pandemic.

There was no immediate statement from the White House.

Attempts to reach Caputo were unsuccessful.

On Capitol Hill, Sen. Patty Murray, D-Wash., called on Azar to fire Caputo, accusing the spokesman of trying to interfere with CDC reports to the medical and scientific community, as well as the public at large. And Senate Minority leader Chuck Schumer, D-N.Y., called on Azar himself to resign, citing interference with the CDC as one example of what he termed the administration’s failures.

Officials at CDC have privately complained of recent efforts by political appointees at main HHS to try to edit or press for changes in the agency’s weekly MMWR publications, a go-to resource for public health professionals.

MMWR articles are technical, but they reveal telling details. One published earlier this year noted that while Trump’s travel restrictions dramatically reduced travel from China in February, nothing was being done at that time to restrict travel from Italy and Europe, where the coronavirus was spreading widely and rapidly. Analysis of virus samples from hard-hit New York in March suggested it was introduced there from Europe and other parts of the U.S., the CDC article reported.

Caputo is an unswerving Trump loyalist. His recent book, The Ukraine Hoax, claims the presidents phony impeachment was rooted in a vast conspiracy.

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unwinona:This is exactly what conspiracy theorists and anti-vaxxers have done with their HIV/AIDS…

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unwinona:This is exactly what conspiracy theorists and anti-vaxxers have done with their HIV/AIDS...

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My RSS Feedunwinona:

This is exactly what conspiracy theorists and anti-vaxxers have done with their HIV/AIDS and Polio narrative (among others), only we’re seeing it escalated to weeks and months instead of years or decades.

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