Contract Tracing, Key to Reining in the Virus, Falls Flat in the West

LONDON — As the coronavirus stampeded across Europe and the United States this spring, governments made their depleted citizens a tantalizing promise: Soon, legions of disease detectives would hunt down anyone exposed to the virus, confining them to their homes and letting everyone else get on with their lives.

Nearly eight months on, as a web of new infections spreads across Europe and the United States, that promise has nearly evaporated.

Despite repeated vows by Western nations to develop “world-beating” testing and tracing operations, those systems have been undone by a failure of governments to support citizens through onerous quarantines or to draw out intimate details of their whereabouts. That has shattered the hope of pinpoint measures replacing lockdowns and undermined flagging confidence in governments.

Beholden to privacy rules, Western officials largely trusted people to hand over names to contact tracers. But that trust was not repaid, in large part because governments neglected services that were crucial to winning people’s cooperation: a fast and accurate testing system, and guarantees that people would be housed, fed and paid while they isolated.

“Public health leaders fell in love with the idea of contact tracing as an important tactic — and it is — but that’d be like if you’re going into war and were just talking about the tanks,” said Brian Castrucci, president of the de Beaumont Foundation, a public health charity in Maryland.

Just as important, officials overlooked the impact of raging mistrust in government and a thicket of conspiracy theories about the virus’s spread. Fearful of plunging themselves or their friends into a painful period off work, infected patients have handed over a paltry number of contacts and often flouted self-isolation rules. Contact tracers are struggling to reach people who test positive, and being rebuffed once they do.

“The track and trace system is unrealistic and useless,” said Mahmoud Salamon, 27, a recent business school graduate on a visit to Brighton, on England’s south coast, where a testing center at a stadium was recently closed for the start of soccer season. He said he distrusted restaurants or stores with his personal information.

In Taiwan, an infected person names more than 15 contacts on average, and tracers often interview patients in person, trying to extract details about secret jobs or marital affairs. But the picture in Europe is far different, and the low level of cooperation has startled public health experts.

“You need to have the trust of people for this to work, and trust comes by whether you’re going to take care of me,” said Dr. Jason Wang, a Stanford University professor of health policy who has studied Taiwan’s coronavirus response. “If I’m sick, are you going to help me, or just quarantine me? Are you going to get me tested on time?”

With tests results lagging in many countries, contact tracers cannot get ahead of the virus. In Paris, people wait up to a week to get testing appointments and results. England recently recorded a backlog of nearly 200,000 untested lab samples, making it impossible to track the virus through newly reopened schools.

Danielle Lennon, who lives in hard-hit northeastern England, sat in a mile-long line of idling cars for almost an hour to get her 7-year-old daughter tested, only for someone to announce that the testing center was closed.

“The government has kind of lost the general public on this, through incompetence,” she said.

Some elected leaders have blamed recalcitrant citizens for undermining contact tracing. Prime Minister Boris Johnson recently said the problem was that Britain was “a freedom-loving country.”

But the evidence for such claims is thin. Some countries have successfully tracked the virus, despite people’s resistance, in large part by investing in chronically underfunded health departments, epidemiologists said.

In Germany, people said they would refuse to hand over names to contact tracers at double the rate of Britons, according to a poll by Imperial College London. Even so, the country has largely kept a small uptick in new infections under control.

Beyond Germany’s strong testing program, said Ralf Reintjes, a professor of epidemiology at Hamburg University of Applied Sciences, the country also responded to the pandemic by pouring money into its roughly 400 local public health offices, which had long conducted contact tracing for communicable diseases.

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