The 'hard to reach': why fear and a lack of trust make contact tracing difficult

Friday, 29 October 2021

Waikato Covid-19 cases are responding with fear and mistrust when faced with contact tracers, a health leader says.

A group of cases in Waikato had been difficult to reach and contact trace, Covid-19 Response minister Chris Hipkins said at Wednesday’s press conference. He would not elaborate or provide specifics.

He said that did not mean they were being uncooperative, just that “it is a more difficult to contact trace group of people”.

Manager of Ngāruawāhia's Ngā Miro Health Clinic Glenda Raumati said it took time for people to dig back into their memories to recall their movements, but it was made slower by fear and mistrust.

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“It’s an issue we realised quite quickly in this Waikato outbreak.”

She said the contact tracers had medical backgrounds, and there was a lack of trust.

First, people received a diagnosis that had the potential to cause catastrophe in their family.

Then they had to look back on their life and try to recall where they had been, and it’s hard.

“We see it with anti-vaxers, people are a bit guarded about where they go and how they live their life.”

She said some people avoided getting a test, because if they did, and it came back positive, they thought everyone would dig into their life.

“They are fearful that with divulging their movements their information might be shared beyond the contact tracers. But that’s not the case.”

“If they were doing something underhand, that won’t be shared. They are not a tip-off agency for the police. This is about keeping communities safe.”

She said the issues didn’t lie with certain parts of society, there was widespread anxiety and mistrust.

“It’s not just because they are from a certain part of society. Some have been cooperative and some haven’t.”

And sometimes, people started off cooperating and then felt victimised and pulled back.

“When they label everyone and say it’s about drug runners and people that live on the fringes it isn’t helpful.”

Raumati said in this outbreak, there had been a move to diversify the Public Health team and there was a unit that supported tracers with cultural advice.

She said the teams were adjusted to the appropriate staff to get the best results, because “you want to be able to build trust”.

Clinical psychologist at Victoria University of Wellington Dr Dougal Sutherland said people were more likely to trust contact tracers if they were from similar communities and backgrounds.

He said it was important as they were not seen as trying to push a particular agenda, like trying to “make” people get vaccinated.

“People who are being contact traced are likely to be feeling anxious, fearful, and possibly physically unwell due to contact or potential contact with Covid-19.”

He said this could add to the suspicion or mistrust of contact tracers.

Taking time to get to know those who were being tracked and traced, understanding their hesitancies, and being familiar with the communities they were working with would help the contract tracers build trust.

However, he acknowledged that might be hard as there was some time pressure to get contact tracing done as soon as possible.

A Waikato District Health Board spokesman said contact tracers had confirmed links for almost all cases to date.

“Contact tracing information has indicated that exposure events have been between individuals in private settings, this has been supported by the data we are seeing from our widespread testing and those cases we have identified.”

He said it took time to establish this information, particularly where people are not easily contacted and/or do not use Covid Tracer app.