As the nation ramps up efforts to implement contact tracing to slow the spread of the novel coronavirus, physicians can do more than report as they would for diseases such as tuberculosis, measles and HIV.
Doctors can use their trusted role with patients diagnosed with COVID-19 to encourage them to talk directly to the people they have been in contact with while contagious and urge them to ask those contacts to quarantine. This could be a useful way to augment and support the role and efforts of public health contact tracers.
“Contact tracers have very strict privacy rules, so we don’t tell people, ‘You were exposed to so-and-so.’ We just say there has been a case and you have been exposed. It’s once removed and people may not be very convinced by that,” said Marcus Plescia, MD, MPH, the chief medical officer of the Association of State and Territorial Health Officials (ASTHO).
“It may be more compelling and people may be likely to take it more seriously if the person they know says, ‘Hey, I’ve just been diagnosed with COVID, and you and I spent a lot of time together three days ago. You will probably be hearing from a health department contact-tracing staff, and you really should consider quarantining,’” Dr. Plescia added.
Dr. Plescia recently spoke about why contact tracing—one of the four signposts for safely reopening America that the AMA has laid out for proper reopening—is vital to slowing the coronavirus from spreading during a recent AMA COVID-19 daily video update.
You can stay up to speed on the fast-moving pandemic with the AMA's COVID-19 resource center, which offers a library of the most up-to-date resources from JAMA NetworkTM, the Centers for Disease Control and Prevention, and the World Health Organization.
Physicians can help slow spread
Dr. Plescia said physicians can help contact tracers and slow COVID-19’s spread by stressing to patients diagnosed with the disease the importance that they stay home and limit contact with others in their household.
“It’s a really important message and physicians need to think about how to communicate that to their patients who test positive,” he said. “People listen to their physicians. They trust them.”
Physicians can also help by being leaders in community settings, whether it is with local elected officials, an opinion piece in a local publication or in a faith community to which they belong.
“I think we forget we have that very trusted, respected and earned status in society,” he said. “Use your authority and expertise to talk about how serious this is. Some people think this is nothing. We need people to say, ‘This is not nothing. This is dangerous and we want people to be safe.”
Technology’s contact-tracing role
ASTHO and the Hopkins Center for Health Security issued a report in April, “A National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the U.S.,” that recommended ramping up contact tracers to 100,000. Now there are calls for 100,000 to 300,000 contact tracers.
A handful of states are where they need to be, but all states have started scaling up and bringing on more contact tracers, Dr. Plescia said in the daily video update.
“If we can get to 100,000 by the summer, that'd be fantastic. We'd be just so much better positioned to take care of this epidemic,” he said.
Dr. Plescia said he and his ASTHO colleagues are telling states to ramp up the workforce assuming that technology won’t play a big role in helping in the trace contacting. While technology could extremely helpful and make the process more efficient, he said, it requires mapping and following people’s movements.
“Some people aren't going to be comfortable with that,” Dr. Plescia said. “We've seen it be used very, very well in other societies, like some of the ones in Asia, but we need to tailor this to the United States. And I think we need to be cautious and get a better sense of how accepting people are of technology for this.”
A Washington Post-University of Maryland poll found that a majority expressed doubts about whether big tech companies would protect the privacy of their health data. And as Google and Apple work with public health authorities on an infection-alert system using smartphone apps, nearly 60% of Americans tells pollsters they are either cannot or will not use such a system.
Read more about why COVID-19 tracking will flounder without privacy protections.
The AMA plans to actively engage the administration, Congress and industry stakeholders in discussions on the future direction of regulatory guardrails needed to restore public confidence in data-privacy protections. The recently released AMA privacy principles support an individual’s right to control, access and delete personal data collected about them.
