Infectious disease experts say COVID-positive essential workers should be subject to tougher questioning when being interviewed by contact tracers and made to hand over banking and phone GPS records to check on their movements.
Victoria's contact tracing system faced scrutiny again this week after it emerged that a Melbourne truck driver, who unwittingly sparked a coronavirus outbreak in Kilmore, also spread the virus to Shepparton after failing to initially disclose all of his movements to contact tracers.
People queue for coronavirus testing at Shepparton Showgrounds. Credit:Simon Schluter
A cleaner, who seeded an outbreak at the Butcher Club in Chadstone – which has infected at least 38 people so far – also failed to disclose to contact tracers during interviews that she had worked at the store.
A Victorian contact tracer, who spoke on condition of anonymity, said most people were honest about their movements. However, in her experience, some people lied, provided false information, had verbally abused her and even refused to cooperate entirely with the contact tracing process.
“It can be really hard, some people you can just tell they aren’t telling the truth,” she said.
“I’ve been told to ‘shut up’ or to ask better questions. Some people have given me details of cafes that don't exist so you’re Googling the name of the cafe or restaurant while you're on the phone to them to check it and you say you can’t find it and then they get angry at you for questioning them about it."
The truck driver, who is connected to the Chadstone cluster via a family member, travelled from Melbourne into regional Victoria with a valid work permit. He breached rules including dining out and shopping at Bunnings. His conduct is now under investigation by police.
Infectious diseases physician and microbiologist Peter Collignon believes Victorian health authorities should be doing more to interrogate the facts behind evidence given in contact tracing.
His view is that all essential workers who test positive to the virus should have their phone and credit card records examined by health officials for the seven days prior to their interview.
"They are exposed to [many] more people than the average person and they are likely to be infectious in the days before they show symptoms," Professor Collignon said.
“It has to be a real balancing act between privacy and surveillance. But it strikes me that if you’ve got a definite infection and you're a public health risk we need to have a better handle on where people have been and and gone."
Ethicist Leslie Cannold said the idea of seizing a person's phone records for contact tracing posed an ethical dilemma, raising important questions about people's civil liberties versus the collective-wellbeing of others.
"There are ethics on both sides of this," Dr Cannold said. "It is both important to care about public health and also to protect people's human rights, but in this dilemma we now face with COVID those things are no longer possible to be done at the same time. We have to actually take from one to add to the pile of the other."
University of South Australia epidemiologist Adrian Esterman said “public health trumped privacy in this circumstance”.
However, he said the use of such private information should be restricted to contact tracing purposes.
“People should be given very strong privacy guarantees before handing over their information that the only thing that would be looked at is their location data and it would not be passed on to any third parties,” Professor Esterman said.
Deakin University epidemiology chair Catherine Bennett, however, was not convinced.
She suggested the focus should be on maintaining a robust approach to outbreak management, which includes isolating contacts of positive cases as well as their close contacts.
"If you isolate the contacts of close contacts then you’ve got fewer people you are relying on for that really detailed information to contain the virus," she said.
Professor Bennett said it was also important people felt they could safely disclose their movements without judgment to get ahead of the virus, not punish people for breaking the law.
"Given the confidentiality, I do agree that the possibility of being fined rises with failure to make full disclosure," she said.
"There is a very real challenge around getting the balance right between making it a grilling versus working with people and encouraging them to talk through their movements in a way that helps them remember. If you disclose where you’ve been, everybody wins in that situation.”
Victorian Chief Health Officer Brett Sutton said on Thursday he could request “almost anything” for the purpose of determining public health risk, and would consider using those powers if people weren’t being truthful with contact tracers.
"We rely on people to tell the truth," he said. “If there is any doubt about the full account that people are giving, there are powers in the Public Health and Wellbeing Act for me to demand information for the purpose of assessing a public health risk. I will consider that in circumstances where that might not be forthcoming.”
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