Facilitators and barriers to engagement with contact tracing during infectious disease outbreaks: A rapid review of the evidence

Abstract

Background Until a vaccine is developed, a test, trace and isolate strategy is the most effective method of controlling the COVID-19 outbreak. Contact tracing and case isolation are common methods for controlling infectious disease outbreaks. However, the effectiveness of any contact tracing system rests on public engagement. Numerous factors may influence an individual’s willingness to engage with a contact tracing system. Understanding these factors has become urgent during the COVID-19 pandemic. Objective To identify facilitators and barriers to uptake of, and engagement with, contact tracing during infectious disease outbreaks. Method A rapid systematic review was conducted to identify papers based on primary research, written in English, and that assessed facilitators, barriers, and other factors associated with the uptake of, and engagement with, a contact tracing system. Principal findings Four themes were identified as facilitators to the uptake of, and engagement with, contact tracing: collective responsibility; personal benefit; co-production of contact tracing systems; and the perception of the system as efficient, rigorous and reliable. Five themes were identified as barriers to the uptake of, and engagement with, contact tracing: privacy concerns; mistrust and/or apprehension; unmet need for more information and support; fear of stigmatization; and mode-specific challenges. Conclusions By focusing on the factors that have been identified, contact tracing services are more likely to get people to engage with them, identify more potentially ill contacts, and reduce transmission.

Impact of contact tracing on COVID-19 mortality: An impact evaluation using surveillance data from Colombia

“…It requires large numbers of skilled personnel to conduct parallel processes of both contact identification reported by detected cases and reaching out to reported contacts [ 7 , 15 ]. Moreover, contact tracing needs an integrated information and communication system, streamlined processes so the tracing can be done within 72 hours, trustworthy local health institutions to which the population feels they can provide information on contacts, and buy-in from decision-makers and health institutions [ 16 – 19 , 26 , 30 ]. Third, contact tracing efficacy depends on the impact on isolation for those suspected and confirmed cases.…”

“…However, contact tracing faces many challenges in LMICs throughout the policy cycle. Starting at the agenda-setting phase, where decision-makers might struggle to see the immediate value of this strategy compared to its logistical challenges, all the way to the implementation, monitoring, and evaluation where performance might be hard to measure [ 7 , 15 – 19 ]. Furthermore, implementing a coordinated response across levels of government (national, subnational, etc.)…”

Strengthening government’s response to COVID-19 in Indonesia: a modified Delphi study of medical and health academics

“…Our Delphi participants also emphasized the importance of enhancing testing and contact tracing . A test, trace and isolate strategy remains the most effective method of controlling the COVID-19 outbreak, until an effective vaccine has been developed [21]. The participants accordingly suggested that government should prioritize efforts to ensure that everyone can get a free, reliable COVID-19 test quickly and receive the results promptly.…”

“…The effectiveness of contact tracing and the extent of resources required to implement it successfully will ultimately depend on the social interactions within a population [28]. A recent review suggest that COVID-19 contact tracing systems could be facilitated by: clear communication about contact tracing; involvement of stakeholders in the development of contact tracing systems, particularly, digital applications; evaluation and quality assurance of the contact tracing system [21].…”

The feasibility of targeted test-trace-isolate for the control of SARS-CoV-2 variants

“…Models by the present authors 7 and others 8 have found that incorporating backwards tracing to identify infector individuals could dramatically increase the efficacy of tracing programs. However, testing delays, mistrust, and low compliance in some communities have undermined the confidence of health authorities in the benefits of TTI 9,10 . Moreover, efficacy sharply decreases when caseloads are high 11 , as is true for SARS-CoV-2 – but not yet B.1.1.7 12,13 – in many regions.…”