Fear a barrier for contact tracers
LOS ANGELES — Radhika Kumar goes to work every morning hoping to save lives.
As a contact tracer for Los Angeles County, her job, at least on paper, entails phoning people who have tested positive for the coronavirus, along with others they may have exposed, and providing them with guidance on how to isolate so as not to infect others. If that sounds easy, it is not.
To persuade people to cooperate, she has to get them to trust her. She has to persuade them that they might be infected, even if they have no symptoms.
“Oh, yes,” she’ll say, “I’ve been hearing that a lot.”
She has to let people curse at her and hang up; then she has to call them back the very next day. And if she wants them to heed her advice, she has to listen, really listen, to how scared they are that if they stay home from their jobs, they might not be able to feed their families.
“Sometimes it can really get to you,” Kumar said. “The other day I had one young lady, and she was screaming on the phone, ‘You don’t understand. I have three kids. I have to go to work.’
“I kept calling back and calling back. I’m very relentless like that. I thought about it all night: What am I going to do? I called her again first thing in the morning, and I was so relieved when she picked up.”
Even as officials at the Centers for Disease Control and Prevention continue to tout contact tracing’s effectiveness and state and local health agencies across the nation deploy new armies of tracers, tracking down all the people with the coronavirus is proving to be a Sisyphean task.
One of the key reasons, as Kumar and many other tracers are finding out, is fear.
Lulled by the state’s early success in flattening the curve, officials in California, which now has more confirmed cases than any other state, failed not only to anticipate the outbreak’s more recent trajectory but also people’s reluctance to cooperate with the government’s tracing effort.
Some simply can’t be bothered, but more often people decline to participate because they’re worried about wage loss, deportation or stigmatization.
Those factors have created a snowball effect that has overwhelmed tracers’ ability to reach people before it is too late.
In Los Angeles County, tracers were assigned 13,766 cases over the week ending July 28. But more than one-third of the calls to people who tested positive went unanswered, and more than half of those who did pick up refused to provide at least one close contact.
“People are reluctant because they are scared,” said Kumar, a 55-year-old mother of two. “I’ve even had one person ask, ‘Are you FBI?’ I said no, but they were like, ‘Well, you could be.’ I just kept saying, ‘I could be, but I am not.’ ”
She spends anywhere from 20-45 minutes on a call, acting as an epidemiological investigator, educator and social worker wrapped in one.
Contact tracing isn’t just a matter of reading from a script, though every tracer is given one. It’s not just calculating the number of days a person must self-isolate or learning certain tricks of the trade, like the fact that it is better to call older people earlier in the morning because the younger ones tend to sleep in.
Ultimately, it involves something much harder to teach.
“How do I convey my message and be empathetic when I cannot even see their expression when they cry?” Kumar said she asks herself. “It’s not just an interview. It’s a conversation. I say, ‘I am here to help. Let’s figure this out together.’ ”