Georgia contact tracers’ first obstacle? Gaining public trust

Misinformation, privacy concerns, distrust of government add to challenge
Dr. Kathleen Toomey, commissioner of Georgia Department of Public Health, speaks during a COVID-19 press briefing at the Georgia State Capitol on May 7, 2020. (Hyosub Shin /

Dr. Kathleen Toomey, commissioner of Georgia Department of Public Health, speaks during a COVID-19 press briefing at the Georgia State Capitol on May 7, 2020. (Hyosub Shin /

A viral Facebook post falsely claiming new federal legislation would allow the government to forcibly remove people from their homes is an example of one of the many messaging challenges facing Georgia’s growing team of contact tracers.

The state Department of Public Health wants to quadruple the number of tracers it employs in the weeks ahead, to upwards of 1,000, as it looks to contain the spread of COVID-19. It's now embarking on a mini public relations campaign to explain to Georgians what contact tracing is — and clear up a bevy of misconceptions about the kind of information the state is collecting.

Winning the buy-in of the public is critical. Tracers’ jobs depend on people who test positive for COVID-19 to disclose sensitive information: their close contacts. The tracers then reach out to those contacts, urge them to isolate for 14 days and report their symptoms, which are fed into the state’s communicable disease tracking system.

The task isn't easy. Tracers must work quickly to keep up with the virus, which infects upwards of 600 Georgians a day and has killed roughly 1,700 people in the state. They must find ways to gain the trust of strangers over the phone, including those wary of the government.

The potential for a communication breakdown is a concern of Kathleen Toomey, the state’s top public health official. She oversaw HIV contact tracing work for the Centers for Disease Control and Prevention earlier in her career.

“For this to be successful, people have to feel comfortable cooperating with us, accepting that phone or text message that comes from the health department,” Toomey said in a recent interview.

‘I’m from the government’

Already, Georgia’s tracers face some skepticism.

Conspiracy theories spreading rapidly across social media amplify myths about the government removing people from their homes — including children — so they can be forcibly quarantined.

One recent post rated "false" by the fact-checking site PolitiFact contends that a $100 billion contact tracing bill introduced in the U.S. House of Representatives is about "controlling/tracking (the) population, not about coronavirus."

The legislation, authored by Illinois Democrat Bobby Rush, would authorize the CDC to award grants to health centers, nonprofits and other groups performing contact tracing in coronavirus hot spots and medically underserved communities.

Dr. Lawton Davis, director of the state’s Coastal Health District, oversees a team of more than a dozen contact tracers. He said most of the people his staff has reached out to have been cooperative but that a smaller number have been “a little bit suspicious,” he said.

“It’s the old ‘hey, I’m from the government and I’m here to help,’” he said. “Some people are just generally uncomfortable of sharing names and contact information and so it feels like an invasion of privacy.”

A growing part of Davis’ and Toomey’s jobs is explaining to anyone who will listen — the public, local elected officials, the news media — what contact tracers do and don’t do.

“We’re not trying to identify illegal aliens and have you transported elsewhere. We’re not obtaining your financial information,” said Davis. “We just want to identify those people who may be at risk and try to slow the spread of the virus and save lives.”

Privacy concerns

One area that's required some extra explaining: the application the state recently purchased to aid its tracing efforts.

The online platform is designed to save the state’s tracers time. People who have been exposed to the virus log their symptoms into the program from their smartphones.

It’s separate from an an app being developed jointly by Apple and Google that uses Bluetooth technology to ping people when they’ve been near someone who reports testing positive for the virus. Still, it has led to some public confusion. A recent survey from The Washington Post and the University of Maryland found that nearly three in five Americans are either unwilling to use the upcoming Apple-Google system or don’t own a smartphone.

Toomey has recently emphasized that Georgia’s new tracing platform doesn’t use Bluetooth.

“Our app is not one that monitors your every move,” she said. “What our app is designed to do is to allow our staff to monitor people without them having to call.”

Still, members of both political parties say special safeguards are needed since the state will be handling sensitive health information.

State Rep. Sheri Gilligan, R-Cumming, wants tracers to be trained to “understand patient confidentiality” and for new restrictions to be put in place so that data is anonymous, encrypted and deleted from all servers “no longer than 21 days after data collection.”

U.S. Rep. Hank Johnson, D-Lithonia, recently introduced two bills in the House that would force app makers to disclose their data collection practices and allow users to access their personal data, correct any inaccuracies and stop brokers from sharing or selling it. The legislation is focused on the private sector, but Johnson said there needs to be separate guidelines for the government's collection and use of personal data.

“I’m not ready to say that I’m going to be in favor of such data collection,” said Johnson.

Building bridges

Cellphone data collection may be new for epidemiologists, who have used contact tracing for decades to track infectious diseases such as tuberculosis and HIV. A longtime challenge that will be just as critical now is reaching vulnerable communities, they say.

Recent evidence suggests African Americans are being disproportionately hit by COVID-19 in Georgia, and undocumented immigrants and low-wage workers are also particularly vulnerable since many work frontline jobs that put them into close contact with the public.

Some people interviewed by Davis’ tracers have been concerned that cooperating could get them in trouble with immigration officials or their bosses if the coronavirus forces them to miss work, he said.

Charles Stephens, founder of the Counter Narrative Project, an Atlanta-based group that seeks to amplify the voices of black gay men, said many in the African American and the LGBTQ communities “haven’t had the best experiences navigating health care institutions.”

Norma Hernandez, head of the Northeast Georgia Latino Chamber of Commerce who is coordinating a COVID-19 task force in Gainesville, a recent coronavirus hot spot, said the local Latino community is close-knit and often distrustful of outsiders.

“The government can’t just show up and say ‘hey, this is what’s going on.’ Nobody’s going to listen,” Hernandez said. “But if the government finds somebody in town and asks to pass the message (along), then that is going to go very far.”

Toomey said DPH is developing educational videos in English and Spanish, seeking out bilingual tracers and reaching out to community, faith and business groups. She’s also seeking out celebrities and other leaders who can act as emissaries.

“We’re looking at every opportunity we can,” she said.

Contact tracing has been a widespread public health practice for decades. Authorities use it to help contain infectious diseases by tracking its spread through communities. They urge people who may have been exposed to isolate in order to halt its spread.

How it works:

Tracers ask people who have tested positive for COVID-19 recall who they’ve been in close contact with while they may have been infectious. Close contacts are people they were within six feet of for at least 15 minutes while they were experiencing symptoms and the 48 hours prior.

The tracers then reach out to those close contacts via phone or text message, urge them to quarantine for 14 days and track their symptoms in a state database. They do not disclose the identity of the person who exposed those contacts to the virus.

What contact tracers ask about:

-Your name

-Your contact info

-Your date of birth

-Your symptoms

-Your close contacts

What they don’t ask about:

-Your citizenship or immigration status

-Your financial information

-Whether they can visit your home to clean or perform a test

They may:

-Direct you to a free testing site

-Offer resources to help you isolate if you’re unable to do so or require assistance such as child care