by Kristine M. Severyn, Ph.D., R.Ph.

With recent Congressional approval of free COVID-19 (coronavirus) testing, we see daily news coverage of outdoor “pop-up” coronavirus testing stations, with cars lined up for blocks on roads leading to shopping mall, grocery store, and sports arena parking lots.  Healthcare workers wearing gowns, gloves, masks, and face shields insert, what looks like, a long flexible Q-tip swab up people’s noses as they drive through the testing tent.  

Widespread coronavirus testing, contact tracing, and social distancing directives are major parts of the federal government’s plan to reopen the country from the pandemic, and are required of all states and cities accepting coronavirus federal relief funds (1).  While President Trump, state governors, and public health officials encourage more and more testing, people waiting for hours in their cars for coronavirus testing should be careful what they wish for. 

How could testing be harmful?

When you agree to a coronavirus test, you sign a form giving permission to send the test result to your state Department of Health.  All positive test results are assigned to a paid government “contact tracer,” who will phone you.  Your phone should display something with “COVID TEAM” on the caller ID, if you choose to ignore the call.  However, if contacts repeatedly ignore calls, texts, and letters, a contact tracer may appear at your door (2). 

In his April 24, 2020 coronavirus press conference Ohio Governor Mike DeWine described contact tracing as “one of the strongest weapons we can employ to help our family, friends, and ourselves stay healthy [to] isolate and kill” coronavirus.  Former Ohio Department of Health Director, Amy Acton, who still works for her previous salary behind the scenes with Governor DeWine, referred to contact tracers as members of her “army.”

The National Association of County and City Health Officials recommends that the country needs close to 100,000 contact tracers (3).  Ohio’s goal was to hire close to 2,000 tracers (4, 5).

House arrest and snitching

When the contact tracer phones, you will be ordered to stay at home for 14 days, and take multiple coronavirus tests until you are symptom-free and have a negative coronavirus test.  If disease symptoms develop, you should contact your healthcare provider.

The contact tracer will also ask you to reveal the names and contact information of anyone with whom you’ve recently had close contact, defined by the Centers for Disease Control and Prevention (CDC) “as any individual who was within 6 feet of an infected person for at least 15 minutes starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to positive specimen collection) until the time the patient is isolated” (6).  

If you can’t remember your contacts, the tracer will ask you to look through your cell phone to jog your memory.  The tracer will then contact any names you reveal, e.g., your friends, co-workers, family, and will then tell them to stay home for 14 days.  

To verify that you can isolate in your home for two weeks, the contact tracer will instruct you to send photos of the rooms inside your home to assure you have the government’s designated number of bathrooms, bedrooms, etc.  If not, you’ll be advised to move to a hotel to isolate yourself.

If you have children, and have no spouse or family to care for them, your contact tracer will contact the local children’s protective services to take your children out of your home during your quarantine.  Even your dog is not permitted to have contact with you (7).  Under the appearance of “helping you,” if you don’t have friends who can help you, the tracer will arrange for more government social services to deliver groceries to you and pick up medicine from the pharmacy (8, 9).

You and your contacts could potentially endure multiple episodes of such quarantines and house arrest, if you accidentally come into contact again with a person who tests positive for coronavirus.

How is contact tracing funded in Ohio?

The Ohio Controlling Board documents more than $82 million in contact tracing funds earmarked for Ohio’s 113 local health departments for 2020 and 2021.  Congress approved these funds in the Coronavirus Aid, Relief, and Security Act (CARES) and the COVID-19 Paycheck Protection Program and Health Care Enhancement Act (10). Additional funding is expected.

Is contact tracing voluntary?  

While Governor DeWine stated in his April 24, 2020 coronavirus press conference that contact tracing is voluntary, he was contradicted by former Director of Health Acton.  If you don’t follow your contact tracer’s “suggestions,” contact tracers are trained to report you to their “supervisor.”  You can then likely expect a written health department order that your house arrest is not voluntary (9).

Could the heavy-handed approach of other states’ contact tracing programs come to Ohio?  

• Kentucky residents who opposed contact tracers’ quarantine and isolation house arrest advice were ordered to wear ankle monitors, similar to convicted criminals (11).

• Washington State Governor Inslee warned, “For those individuals that refuse to cooperate with contact tracers and/or refuse testing, [they] will not be allowed to leave their homes to purchase basic necessities such as groceries and/or prescriptions.” (12).

• Ventura County, California health officials warned that families could be relocated to coronavirus isolation facilities if the household did not have the government-recommended number of bathrooms (13).

• Arkansas Governor Hutchinson announced that his state’s Army National Guard would transport coronavirus-positive persons, who were unable to isolate at home, to government isolation facilities (14).

Risks to civil liberties, the economy, and society

Under the guise of protecting public health and protecting the community, Ohioans and all Americans can be intrusively tracked, monitored, and controlled by state health workers.  Privacy violations and the constitutionality of contact tracing remain major concerns (15-17).  Considering reports of faulty coronavirus tests and procedures (18, 19), are citizens being unnecessarily forced into house arrest, small businesses shuttered, organized sports cancelled, and entire schools closed, some for reporting even one positive coronavirus case (20, 21)?  

With the CDC roughly estimating coronavirus infection fatality rates as low as 0.5%, meaning 99.5% or more of those infected recover (22), arguably in the range of seasonal influenza, Ohioans should not be concerned about every positive coronavirus test (“case”) reported in the news, especially since many coronavirus cases are mild or asymptomatic.  Likewise, considering the weak evidence that asymptomatic coronavirus carriers routinely transmit the virus to others (23), Ohioans may wish to reconsider the wisdom of widespread testing of asymptomatic individuals.  Government public health policymakers have historically not advocated widespread testing for a virus, unless a patient appears sick or is high-risk.  To now test every person for a virus with such a low death rate represents a radical, questionable change in medical practice.

Dr. Severyn earned a B.S. in Pharmacy and a Ph.D. in Biopharmaceutics at the University of Cincinnati, with a concentration in pharmacology, toxicology, and drug kinetics.  She is a registered pharmacist who researches and writes on medical / legal issues, with special interest in public health and medical informed consent.

References:

1. CDC-RFA-TP18-1802, Cooperative Agreement for Emergency Response:  Public Health Crisis Response, COVID-19 Crisis Response Cooperative Agreement—Components A and B, Supplemental Funding, Interim Guidance, March 15, 2020.  https://www.cdc.gov/cpr/readiness/00_docs/CDC-RFA-TP18-1802_Sup-Guid-COVID-19-Crisis-CoAg_Supplemental.pdf

2. Contact Tracer Teams Growing Amid New Challenges, June 30, 2020. https://www.medscape.com/viewarticle/933213?src=mkm_covid_update_200630_mscpedit_&uac=345179HT&impID=2441524&faf=1&fbclid=IwAR3xnMXJ3K7XKbB4wO2E92luogz0mqjb_sjzS9LJmbofCkl0WBFeybaFdfo#vp_4

3. National Association of County and City Health Officials, Position Statement, Building COVID-19 Contact Tracing Capacity in Health Departments to Support Reopening American Society Safely April 16, 2020.  https://www.naccho.org/uploads/full-width-images/Contact-Tracing-Statement-4-16-2020.pdf

4. COVID-19 Contact Tracing, Ohio Department of Health, April 28, 2020.  https://coronavirus.ohio.gov/wps/portal/gov/covid-19/responsible-restart-ohio/contact-tracing/contact-tracing 

5. Coronavirus: Ohio hiring ‘disease detectives’ to conduct contact tracing, The Columbus Dispatch, May 12, 2020. https://www.dispatch.com/news/20200512/coronavirus-ohio-hiring-disease-detectives-to-conduct-contact-tracing    

6. Contact Tracing for COVID-19, Centers for Disease Control and Prevention (Updated June 17, 2020). https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/contact-tracing.html#:~:text=For%20COVID%2D19%2C,the%20patient%20is%20isolated.   

7. Pet Owners FaQ, Coronavirus Disease (COVID-19), June 23, 2020, Los Angeles County Department of Public Health.  http://www.ph.lacounty.gov/media/Coronavirus/docs/animals/FAQ-PetOwners.pdf

8. A Woman Gets Her Contact Tracer Certificates and Tells All, May 27, 2020, https://www.youtube.com/watch?v=qFUyZWw7qoc&feature=youtu.be

9.  COVID-19 Contact Tracing, online course offered by Johns Hopkins University, 2020. https://www.coursera.org/learn/covid-19-contact-tracing?edocomorp=covid-19-contact-tracing

10. Ohio Controlling Board, Fund / Appropriation Requests:  May 11, 2020: CB# OBM 0100102, $12,452,824.00, Account Category 550; June 1, 2020:  CB# DOH 0100565, $20,000,000.00, Account Category 550; July 13, 2020:  CB# OBM 0100112, $49,599,809.00, Account Category 550.

11. Kentucky orders quarantine-breakers to wear ankle monitors, April 3, 2020. https://nypost.com/2020/04/03/kentucky-orders-quarantine-breakers-to-wear-ankle-monitors/

12. Washington gov: Those who don’t cooperate with ‘contact tracers’ and tests not allowed to leave home.  The state will provide 'family support personnel' to check in on the non-compliant.  May 14, 2020.  https://www.lifesitenews.com/news/washington-gov-those-who-dont-cooperate-with-contact-tracers-and-tests-not-allowed-to-leave-home

13. Ventura County clarifies claims it would force people from homes into isolated coronavirus centers, May 7, 2020. https://www.foxnews.com/us/california-ventura-county-coronavirus-forcibly-removed-homes-quarantine

14. Arkansas National Guard transporting COVID-19 patients to isolation facility, July 15, 2020. https://www.fox13memphis.com/news/local/arkansas-national-guard-transporting-covid-19-patients-isolation-facility/M6QOEDIC4JEGLKO7L2AN4BVYDQ/?fbclid=IwAR0kV0D3bWOMtjrze27ivlGNG5jSU0hHhAbT2JXyTbVc9WnlfV8Cu0D9SBE

15. CORONAVIRUS.  Disease Surveillance and the Fourth Amendment, April 7, 2020. https://www.lawfareblog.com/disease-surveillance-and-fourth-amendment

16. Analyzing the U.S. Privacy Law Implications with Employee Contact Tracing Apps, April 21, 2020. https://www.jdsupra.com/legalnews/analyzing-the-u-s-privacy-law-36814/

17. Constitutional scholar tells Laura Ingraham why contact tracing will lead to real privacy concerns. May 22, 2020. https://www.foxnews.com/media/constitutional-scholar-warns-of-privacy-threats-from-contact-tracing

18. Accuracy of COVID-19 tests still largely unknown, Associated Press, June 14, 2020. https://www.modernhealthcare.com/technology/accuracy-covid-19-tests-still-largely-unknown

19. Florida Department of Health says some labs have not reported negative COVID-19 results, July 14, 2020; updated July 18, 2020.  https://www.fox35orlando.com/news/fox-35-investigates-florida-department-of-health-says-some-labs-have-not-reported-negative-covid-19-results

20. Coronavirus: Dayton schools will switch to online learning if necessary. Dayton Daily News, July 6, 2020 (online); July 12, 2020 (print).  https://nl.newsbank.com/nl-search/we/Archives?p_action=doc&p_docid=17C1117905090060&p_docnum=6

21. DeWine Sends Message About Masks To GOP Lawmakers; Suggests Schools Could Stay Shut, July 17, 2020.  https://www.statenews.org/post/dewine-sends-message-about-masks-gop-lawmakers-suggests-schools-could-stay-shut

22. COVID-19 Pandemic Planning Scenarios, Centers for Disease Control and Prevention, updated July 10, 2020.  https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html#five-scenarios

23. A study on infectivity of asymptomatic SARS-CoV-2 carriers. Respir Med . 2020 Aug;169:106026. doi: 10.1016/j.rmed.2020.106026. Epub 2020 May 13. https://pubmed.ncbi.nlm.nih.gov/32513410/