Answers concerns raised about process
Okanogan County Community Health Director Lauri Jones explains contact tracing as a standard, essential public health technique used for 150 years to control the spread of disease.
Jones’ explanation at the county commissioners’ meeting on June 22 was in response to a letter from the Okanogan County Farm Bureau to the commissioners that expressed concerns about “involuntary enforcement of contact tracing.”
“Okanogan County Farm Bureau members are currently under increased, extreme pressure from Washington State to protect the health of their families, workers, and communities while still growing and harvesting food for our county, state, nation, and the world. …As law-abiding citizens, we will comply with voluntary contact tracing. We will not submit to involuntary contact tracing,” the June 14 letter said [bold and italics in original].
The Farm Bureau fears that involuntary contact tracing will increase division and polarization, violate civil liberties, and strain law enforcement, according to the letter.
“Forceful isolation could create unrest and reaction in Okanogan County. We want to maintain the voluntary aspect. People are thoughtful and concerned and will comply,” Okanogan County Farm Bureau President Dick Ewing said in an interview this week.
“The first thing is, I’d get rid of the words ‘contact tracing.’ It’s gotten political,” Jones said, preferring to call it “case investigation.”
“If you found 50 cows had died, what would you do?” she asked the Farm Bureau representatives at the meeting.
Jones gave a short lesson on the history of public health and how epidemiologists trace disease outbreaks. The first use of what’s now called contact tracing was in London in 1854, during a cholera outbreak. Health workers interviewed people who’d lost family members and ultimately tracked the disease to a single water system contaminated by a leaking sewer pipe.
Since then, the technique has been used to control tuberculosis, sexually transmitted diseases, and food-borne illnesses like salmonella. Jones pointed to a well-known 1993 outbreak of E. coli in Seattle that killed four children and sickened hundreds before it was traced to hamburger meat at a Jack in the Box restaurant. The discovery resulted in the recall of the contaminated meat.
In the COVID-19 pandemic, health workers are using case investigations to track new infections and anyone who may have been exposed. When Public Health gets a report of a positive COVID test, they call the individual to see how he or she is feeling and ask about where the person has been in the past 14 days to figure out how the person was exposed, Jones said. They ask the person to isolate for 14 days so as not to infect others. Health workers will help the individual get food and other necessities so he/she can remain at home.
Health workers also obtain a list of anyone that person has been in contact with so they can call those people to let them know they may have been exposed to COVID, but don’t name names. “We don’t rat you out,” Jones said.
No right to infect
One of the Farm Bureau’s board members became alarmed when she saw a talk by Gov. Jay Inslee that mentioned the ability for health officers to involuntarily isolate someone, Ewing said.
“The proclamations set forth by Governor Inslee and local health departments do not justify the draconian actions being taken. Have the citizens of Okanogan County not suffered enough socially, economically, and politically over these dictates?” the letter said.
If someone with a contagious disease knowingly leaves isolation, the health officer has the authority to arrest that person, Jones said. “People don’t have a right to infect others,” she said.
The Colville Tribes are issuing fines to people who don’t comply with isolation, but Okanogan County is not, Jones said.
“That’s not how we do it,” she said. “We don’t go door-to-door. If people don’t want to provide a list of contacts, we don’t push it. We’re not an enforcement agency — we’re working for public health for everyone,” Jones said.
The Farm Bureau representatives were reassured by Jones’ explanation and agreed that the term “case investigation” is preferable, Ewing said.
“The point the Farm Bureau was concerned about is whether the hammer would come out first, or whether health officials would use an education process so people take control of their own lives to protect other people,” Ewing said. The governor’s address suggested “a very strong hammer,” he said.
The prospect of forced isolation and fines exacerbated a situation where people have been forced to stay home, can’t work, and face economic decline, Ewing said. “It fits into the overall climate,” he said.
Jones decried the “blatant lies” and misinformation that have cropped up on social media. “We have no ability to surveil people. We’re not doing anything different than we’ve always done. We’re not here to be a punitive agency. We want to make sure that people are safe,” she said.
Four Farm Bureau members attended the commissioners’ meeting in person, although meetings have been restricted to a total of five people to comply with state regulations on gatherings. The letter was signed by Ewing and 10 others from the Farm Bureau.
Public health officials across the country have been the target of threats. Jones has been featured in reports in the Washington Post and on National Public Radio about health workers who’ve been receiving death threats and had personal information and addresses published on social media.
Jones has explained contact tracing before, including on Facebook Live. The video, from April 15, can be watched on the Okanogan County Emergency Management Facebook page. The direct link to the video is https://www.facebook.com/Okanogan.County.Emergency.Management/videos/238828057526632.