By Tara Gibson - September 9, 2020
Contact tracing is one of the most effective ways to prevent community transmission of COVID-19. However, some states are reporting the effectiveness of their efforts is being handicapped by not being able to communicate with non-English communities. While some jurisdictions are attempting to overcome this barrier by employing multi-lingual contact tracers, there may be a better way.
Despite states employing tens of thousands of “disease detectives”, and technology companies developing several types of exposure notification apps, it would be fair to say that contact tracing during the current COVID-19 pandemic has not been as effective as was hoped. The reasons for the limited success of contact tracing are varied and include:
One further issue identified in some locations is the inability to communicate with non-English communities. For example, in the Maryland zip code with the highest number of COVID-19 cases, 56% of the population is Hispanic, but only 60 of the state's 1,350 contact tracers speak Spanish. Furthermore, Maryland zip codes in which Hispanics account for 10% or more of the population have infection rates five times greater than zip codes in which Hispanics account for less than 1% of the population
Similar issues have been identified in non-English speaking communities around the country. In Harris County, Texas, contact tracers are struggling to communicate with significant Chinese, Vietnamese, and Hindi communities; Minneapolis has a shortage of contact tracers who can speak Somali, Oromo, and Hmong; and, in Cook County, Illinois, public health officials cannot recruit enough Polish-speaking contact tracers to communicate with more than 40,000 immigrants with limited English.
Although multi-lingual contact tracers can contribute towards overcoming language barriers for more effective contact tracing, they do not resolve the whole issue inasmuch as there will still be areas of the community not served by a contact tracer who can speak their language - notwithstanding the logistical issue of identifying what language an individual speaks from a name and phone number. For example, the surname Lee is popular in the U.S., France, Scandinavia, and throughout most of Eastern Asia.
A more practical solution is to use a population database which identifies individuals by ancestry. Unfortunately it is not possible to use decennial census records as individual data remains confidential for seventy-two years in order to protect respondents' privacy. Therefore, an alternate database solution is necessary - one that can be organized quickly and inexpensively, and that does not have a significant management overhead in order to keep the database up-to-date.
Public Health Departments looking to build a quick and inexpensive database for identifying non-English speakers should consider implementing a comprehensive mass notification platform - not for its mass notification capabilities (although these may be useful for other communication issues), but rather for the platform's SMS opt-in/opt-out and auto-translate capabilities. The logic behind this suggestion is as follows:
As the information being requested from the individual is name, phone number, and preferred language, this eliminates the privacy concerns with regards to health information. There should also be no mistrust of the state and federal government once contacted because the user has volunteered the information, and there is no need to download an app. Any cellphone user can use this service.
A further advantage of using a mass notification solution for contact tracing is geo-polling capabilities. This can be used to manage simultaneous follow-up calls to individuals who are self-isolating in order to determine which have developed symptoms of COVID-19 as a result of being in contact with an infected person. This can lead to the faster identification of further contacts who should also self-isolate.
Geo-polling works by sending a text message in a question and answer format, which the individual responds to by pressing numbers on his or her keypad. A typical question and answer text in this scenario would be:
Q: Have you developed symptoms of COVID-19?
A1: Yes - and I have had a positive test.
A2: Not sure - I need to get tested.
A3: No - and I have had a negative test.
A4: No - I'm fine.
The responses are compiled on the platform so contact tracers can follow up to get the details of contacts from those who answered A1 and provide help to those who answered A2 (as well as scheduling a further follow up contact at a later date). The compiled answers also provide Public Health Departments with an indication of how effective their contact tracing efforts have been.
Some mass notification platforms have the ability to auto-translate text messages into more than sixty languages, proving to be a suitable solution for all jurisdictions struggling to communicate with non-English communities.
Tara is a Marketing Coordinator on the Rave Mobile Safety marketing team. She loves writing about all things K-12, State & Local, Higher Ed, Corporate, and Healthcare, and manages the Rave social media channels. When she's not working, she's taking care of her smiley, shoe eating, Instagram-famous fur baby, Enzo!
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