A COVID Contact Tracer’s Perspective on Building Trust and Supporting Community

November 11th, 2021 | Viewpoint

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Early in the pandemic, Julie Attys volunteered for an organization doing case investigation and contact tracing in Greater Boston. She didn’t realize that she was launching a career path.

At the time, Attys was a master’s degree student at Boston University with just a few months left before graduation. She had worked in Haiti on public health education and planned to build on that experience with the contact tracing efforts.

Within just a few weeks, however, it became clear that the need was bigger than expected and the agency moved from relying on volunteers to hiring dozens of people. Attys was hired as a supervisor overseeing a team of outreach workers.

“What surprised me was how quickly and how massive the spread was across so many communities,” she said. “I don’t think anyone was prepared for how large it was going to be.”

Attys graduated in May and continued to work on community outreach. When the need for workers declined in Boston, she moved to New Hampshire to lead a team through that state’s response initiative. There, she met and worked alongside several JSI staffers. A few months later, JSI asked her to join the organization, where she is now a consultant working on public health preparedness and response, HIV, and data analysis projects.

The communities Attys worked within Boston and New Hampshire were miles apart in more ways than geographically, but the lessons were similar. In Boston, the crowded city was dominated by residents experiencing financial hardships, served by a labyrinth of nonprofits, churches, and advocacy groups. New Hampshire, in contrast, had a more rural population with distinct public health infrastructure.

From a public health perspective, the need was the same—to isolate those who had or had been exposed to the disease. The reactions were similar too; concern about how to get food and necessities, worry about caring for family members, and fear of losing work. But from a community perspective, the approach had to be different.

“You always have to step outside the health issues and think about all the other things that affect individuals and why they do what they do,” Attys said. “You have to understand what their barriers are going to be.”

That awareness had to start even before the phone calls were made, Attys said. Callers needed to understand how those on the other line would react, what they needed to hear to be comfortable, and how they could be connected to the services they needed.

“We had to support these individuals and allow them to safely isolate and quarantine. We had to understand the implications of telling people to change their lives. It’s not just cut and dried.”

One of the biggest barriers was a lack of trust. It required understanding where people were coming from and their experience with public health workers, which varies by community, Attys explained. This means, whenever possible, working with community members, who are familiar with their community’s needs and solutions.

Now that the relationships have been established, it’s important to strengthen them in preparation for the next emergency, Attys said. In Boston, this could be working through churches, nonprofits, and other agencies serving the community. In New Hampshire, it’s working with local emergency planning entities who have these relationships.

“We need to continue to demonstrate who we are and what our role is, not just when there’s a pandemic or something else drastic happening,” she said.

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