Contact tracing stirs emotions

Critical communication and public health strategy entices different levels of responses

The scenario: You get a call from an unidentified local number and when you answer, the person on the other end of the line tells you that you’ve had close contact with someone who’s tested positive for COVID-19. They ask you who you might have spent 15 minutes in close contact to.

It’s part of a process called contact tracing. Someone tests positive for the disease and a public health nurse investigates, asking them who they’ve been in close contact with.

Then, the nurse contacts those people to let them know to quarantine for two weeks and asks if they’ve developed symptoms.

Some people share their information. Others respond differently.

Last month, Marcus Cheatum, health officer for Mid-michigan District Health Department, told Gratiot County Chairman George Bailey that one of his nursesmaking these calls received so much abuse from the public that she asked to get shifted to other duties.

Angry responses are not uncommon, said Jonathan Warsh, chief of staff for themichigandepartment of Health and Human Services. He said he can understand it.

The nurses making the call is sharing sensitive, difficult information, he said. Due to privacy concerns, they also can’t answer the biggest question people have ... who infected them?

“People are upset about that,” he said, later in the conversation adding, “These are stressful jobs, making stressful calls.”

When it comes to school outbreaks, it’s even more difficult, Cheatum said. School outbreaks involve disease, but they also create disruptions for everyone in

volved.

The children need to learn and it’s hard for a lot of parents to juggle caring for a potentially sick child with the need to work, he said. And, the school needs to remain open to fulfill its function.

“That’s just awful for the community,” he said.

Cheatum said he’s engaged in outreach with officials in a variety of government functions — from elected officials to education leaders — and asked them to express support for their work. The public health department is part of government, there to support other units of government and to try to protect the public.

“We’re doing what we need to be doing,” he said. He said the response has been positive. It can also help health departments contain outbreaks.

When students returned to Central Michigan University in mid- August, some of them brought COVID-19 with them. Transmission at off- campus parties caused cases to explode in numbers. Students weren’t as forthcoming as they might have been with information.

“CMU students have been great recently,” said Steve Hall, CMDHD health officer. “There were some bumps in the road initially, however CMU has been a great partner with us. If we have any issues, we are able to work with their Student Affairs office to get them taken care of.”

CMDHD issued an order further limiting gatherings. The number of new cases started to rapidly decline, and as health departments servicing Michigan State University and Grand Valley State University took more drastic action, the back-to- campus outbreak had slowed dramatically.

While there is some animosity everywhere, it is especially high in communities with broken trust with government, Warsh said. These aren’t just political lyconservative areas, but also communities that have experienced years of poor treatment at the hands of government.

It’s hard to quantify how much more difficult an uncooperative public is in contact tracing efforts, Warsh said. Still, he said, its the “only way to stop the chains of transmission.”