Contact Tracing: What Developing Countries Have Shown

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SEATTLE, Washington — With COVID-19 sweeping the world, every country is scrambling to determine the best ways to contain the disease. One common solution has been to trace contact, which is the process of keeping track of individuals and who they come in contact with so that researchers can monitor the spread of disease. With the information that contact tracers gather, people can find out if anyone with whom they have come in recent contact has tested positive for the virus. Contact tracing is effective because it slows the spread of the disease and allows individuals to self-isolate if they have come into contact with another diseased person.

Using Contact Tracing to Slow the Spread of Disease

This method has already shown to be effective in other countries. In South Korea, it was able to slow the spread of coronavirus, significantly reducing the number of cases as early as April. The country used technology and tracing to contain the virus without having to enforce drastic, country-wide shutdowns. Contact tracing has also worked in the past, controlling the spreads of syphilis in the United States in the 1930s, and the Ebola epidemic in Africa in 2014. During COVID-19, several companies have launched apps to enable digital tracing.

The United States did attempt to implement digital contact tracing, mostly with tracing apps. However, these are voluntary downloads and there aren’t unified standard apps for the entire country. Therefore, they have not had the same effect as they have had in other countries. Also, there is widespread reluctance within the American population to download these apps for privacy concerns and data security. In one study of 2,000 Americans, only 27% of people would even hypothetically download a contacttracing app. So, what does the U.S. need to do in order to effectively contact trace? Well, it turns out that the answer may lie within impoverished countries.

Communities Are Key

There is often the conception that contact tracing is an invasive procedure, interrupting the livelihoods of individuals with the large amounts of data-mining that goes into tracing. However, not all of that technology is needed to trace effectively. As impoverished countries have shown, the only thing needed is a workforce and a trusting community. In India, where contact tracers are working to control the spread of Tuberculosis, they are also helping sick patients keep track of medicine and making sure they’re living healthy lifestyles.

This was also the case during the Ebola outbreak in Africa where governments used contact tracing to stop the spread of the disease. In Liberia, where this kind of tracing was studied, contact tracers were hired “from within the community.” These tracers visited each of their contacts twice a day, checking temperatures and determining if anyone had symptoms of the virus. They weren’t teams of medical experts. The tracers were just workers who reported to medical authorities throughout the day.

This kind of contact tracing was “crucial” to bring the number of Ebola cases in Liberia down to zero, experts said. That’s the key to effective tracing: hiring local, trusted tracers. It’s one thing to get a phone call from a stranger asking where someone has been and with whom they have had contact, and it’s another to get a call from a neighbor gathering information as a means of keeping the community safe. When contact tracers come from the community, there is trust. Tracers can help to fill in information gaps because they know the members within their community.

Overcoming Distrust

The solution isn’t as easy as creating an app or data-mining for information. To stop the spread of coronavirus in the U.S., local governments will need to hire tracers to operate within their communities. It worked in Liberia during the Ebola outbreak. Furthermore, it’s currently working in India to control the spread of Tuberculosis. This level of contact tracing would also require a large number of employees. This could aid with the current unemployment crisis in the United States. It turns out that high tech, big-data software isn’t the only way to stop the spread of coronavirus. Impoverished countries have shown that tracing can start in local communities.

Hannah Daniel
Photo: Flickr

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