Ethics and Responsibility: The Social Contract of Contact Tracing after WHS Outbreak

Fessing up is hard. But it could be life-saving too.

That’s at the heart of many of the responses Wilton residents have had upon hearing that multiple Wilton High School students failed to follow state restrictions on being in groups larger than what’s permitted at parties and other gatherings last weekend.

With some of the students now diagnosed as COVID-19 positive and many others who were exposed through extended close contact, Wilton’s Health Director Barry Bogle on Wednesday, Jan. 20, ordered the school closed and in-person activities to cease for two weeks to try and limit any further spread of the virus.

The order forced the Wilton Public School district to move WHS to remote learning for all students for two weeks, through Feb. 2.

Complicating matters further is that when they announced the closure Wednesday, school and town health officials said some participants and their families were not cooperating with contact tracing efforts. As a result, attempts to notify other people who may have had contact with or been exposed to one of the COVID-positive individuals were roadblocked.

Many residents were angry that their neighbors took part in gatherings that were bigger than allowed and where some people didn’t take appropriate precautions like wearing masks. But others were just as upset that some of the students in question were said now to be refusing to take part in contact tracing.

“Why does someone feel they have the right to put my family at risk by not cooperating with contact tracing. Absolutely baffling,” wrote Janet Siegel on GOOD Morning Wilton‘s Facebook post on the story.

“Not cooperating with contact tracing is irresponsible. It is also potentially dangerous to members of our community. Seems to me that this is the sort of thing that should bear some sort of consequence,” Nina Cavallaro DePeugh wrote in a comment that many other readers ‘liked’.

Those are just two of the many comments that have been made on Facebook and elsewhere.

First Selectwoman Lynne Vanderslice has been spearheading Wilton’s response to the COVID-19 pandemic since before the first case was even diagnosed in town 11 months ago. She hopes that anyone who isn’t participating in contact tracing will change course, calling it the “right thing to do.”

“Part of growing up is learning to be accountable for your actions. I ask all students who attended these gatherings to call or email the Wilton Health Department or the school to assist with contact tracing. Parents, please assist your student.

“We talk a lot about Warrior Pride in Wilton. There is no better way right now to show that pride than by stepping up to do the right thing to help your fellow students, your teachers, and your community.”

For many people hit with the whammy of a possible COVID-19 diagnosis or exposure, the idea of participating in contact tracing may carry with it a whole variety of feelings, everything from shame or guilt to the burden of responsibility for others, or even to, ‘Hell no, it’s no one else’s business.’

So just what happens during contact tracing and why is it important? Why do some people choose not to participate? We spoke to several people for some insight, including at least one family whose child was involved in at least one of the gatherings over the weekend.

The Basics of Contact Tracing–Why It’s So Important

To dig into contact tracing, GOOD Morning Wilton spoke with Tyler Shelby, an infectious diseases researcher and an MD/Ph.D. student at the Yale School of Medicine and the Yale School of Public Health‘s Department of Epidemiology of Microbial Diseases.

GOOD Morning Wilton:  Why do the state and local municipalities do contact tracing? Why is contact tracing important?

Tyler Shelby:  I know this is sort of the first context that many people have heard about contact tracing, but it’s a very traditional public health intervention for many infectious diseases–it’s used for tuberculosis, measles, sexually transmitted infections.

The idea is essentially to stop onward transmission of those diseases within the community, and it typically falls within the jurisdiction of public health agencies, either local health departments or state health departments typically are in charge of this type of thing.

GMW:  When you say to slow or stop the spread within a community, how does contract contact tracing function in that way?

Shelby:  Let’s say you have somebody who’s diagnosed with COVID-19 (or any of these other diseases I mentioned), the idea is to speak with them and figure out who they’ve interacted with during the period of time in which they were infectious. That timeframe changes depending on what disease you’re talking about, but in all cases, the idea is to find people you may have transmitted the disease to.

The goal is never to punish people or have negative repercussions. It’s really about protecting those individuals, finding them and testing them, checking them for symptoms, and then monitoring them so that they can be connected to care if needed.

GMW:  Talking about the nonjudgmental, non-punitive part of it, there is a fear people who may not want to participate in contact tracing have about the confidentiality of it. In a community of Wilton’s size, perhaps there’s a fear of the stigma of being identified as having COVID, or having been at a party that shouldn’t have happened, but did happen. If people have that fear, what would you tell them?

Shelby:  Stigma and this sort of fear exists for many health conditions. It’s a natural reaction to some of these ideas like contact tracing, right? It’s normal to feel that way to some degree. You’re being asked, ‘What have you been doing and who have you been seeing?’ So it can feel like you’re being interrogated by the contact tracers. So it’s a natural reaction.

But it’s important to know that the data is held confidentially by the state and local health departments. It’s not shared beyond what its intended purpose is. I’m going again, the end goal isn’t a negative repercussion, it’s not punishment.

Reinforcing that is really important, and emphasizing the pro-social benefits for your community:  It’s not about punishing you or your close contacts. It’s really about protecting your community and your family and your friends and the people that you’ve been around.

GMW:  There’s the science, but what can you say about the ethics of not participating in contact tracing?

Shelby:  At the end of the day, it is a personal decision that somebody has to make. But making the decision to not participate does limit the effectiveness of contact tracing. This is an intervention, especially that requires many people to participate. The more people that don’t participate, the less effective it is overall. The more people that choose not to participate really can have negative consequences for the community.

GMW:  Do you think that there should be fines or penalties for not participating in contact tracing?

Shelby:  I don’t know that there are any sorts of financial repercussions in place for not participating with contact tracing in Connecticut. That is one way to incentivize people to participate. I don’t know how successful it would be at the end of the day, but I know that there would be quite a bit of pushback.

It has been used in countries like Taiwan and other countries in Asia that have very robust and effective contact tracing programs. They do follow up with their contacts to make sure that people are staying home and things like that. So they take a more active role in sort of insurance and that people are following the guidelines.

GMW:  When you have a situation like Wilton’s, where there has been a tremendous amount of negative reaction on social media toward people involved in the gatherings and toward those who are not cooperating with tracing. What are your thoughts on that? 

Shelby:  It’s tough–we’re in a situation even beyond the context of COVID-19, where this past year has been particularly volatile. People are very opinionated and have strong feelings in one direction or another. So it can be easy to get fired up, especially on social media. But at the end of the day, that [public criticism] doesn’t always have a positive effect or doesn’t instill the change that you might mean to.

Educational pieces like this can be really helpful to spread facts rather than fiction. And also if you’re able to get ahold of people who have chosen to not participate in really finding out the reasons why. It’s a personal choice, and those are usually driven by logic. So understanding why those decisions are made and then providing facts to sway people in the other direction is probably more useful than just posting [criticism] on social media.

Family of a Party Attendee:  Why We’re Afraid to do Contact Tracing

Since the initial news broke on Wednesday, which included reports that participants in the gatherings were not cooperating with tracing, both town and school officials have said that many more people have begun to work with them.

“The health department experienced increased participation in contact tracing since yesterday’s order by the Health Director,” Vanderslice told GMW.

Similarly, Wilton Public Schools’ Superintendent Dr. Kevin Smith emailed that WHS principal Dr. Robert O’Donnell “spent a good chunk of time yesterday reaching out to families and reported a very high degree of cooperation.”

To many people, it’s clear-cut:  there’s no reason anyone should refuse to cooperate with contact tracing.

For others, the social media criticism that Shelby described is enough to scare them off. What’s more, says one parent of a high school student involved in the gatherings who is now quarantining, there is likely some hypocrisy at work.

“It’s the Facebook mafia. Nobody wants to come out. Even if they test positive, they don’t want to be counted in the [town COVID case] numbers. Because they are literally afraid of these self-righteous people who are saying that these children should be expelled from school and the parents should be fired thousands of dollars–they’re the same ones posting pictures down in Florida and Aruba who come back and get a rapid test, which you know is not accurate.”

The parent continues:  “When you jump on your soapbox and talk down about everybody, what they’re doing is scaring the crap out of these kids.”

The parent also said many of the rumors being floated about on social media aren’t correct, about which kids are involved and about what they did.

“You have all these people hiding behind their keyboards, sitting up on their mountaintops looking down on humanity, and they’re all hypocrites. Everybody assumes they know all the facts, and just attacks and attacks and attacks and attacks, but they have no idea what they’re talking about.”

Their student was tested and is quarantining–and despite the fears of backlash–is participating in contact tracing.

“The kids don’t trust the adults. And they shouldn’t. Because these are witch hunts,” the parent said, adding, “That’s why the kids are afraid.”

There’s a higher comfort level with school officials rather than the town. “If [WHS principal] Bob O’Donnell contacts somebody, they’ll cooperate. But they feel like if they have to go to the town and do it, and it gets out, their lives will be ruined.”

The parent continued:  “We cooperated right away. Said, ‘Yep, we were there. Here’s who else we know were there. And here’s who we’ve been in contact with.’ But people are not interested in the truth,” they said, adding the small-town nature of Wilton has its plusses and minuses.

“People should open the kimono [and reveal], ‘Here’s everywhere I’ve been, everyone I talked to, everyone I’ve been around, here’s my phone, let’s track where I was.’ That’s what we should be doing. But we’re scared. And these witch hunts have made it scary. When people say, ‘These kids should be expelled from school…’ Really? Let’s keep things in perspective, this has nothing to do with the school. This was not school-sponsored events, this was private parties. The town should have a problem, not the school.”

Penalties?

What about the question of penalties imposed by the school district or the town, something many people have raised. Are there fines for hosting, and/or attending private gatherings in excess of limits? What about for people who don’t participate in contact tracing?

According to Vanderslice, any host(s) may be fined $500 for a gathering in excess of the limit, and any attendee may be fined $250 for each gathering in excess of the limit that they attend.

“The municipal authority to [fine] and the amount of said fines is derived from the Governor’s Executive Order 9B. Either the Health Department or the municipal CEO is authorized under 9B, depending on the circumstances. A municipal CEO may appoint Municipal Designees who are authorized to enforce the sector rules not enforced by the health director. Wilton’s Director of Environmental Affairs and Wilton’s Fire Marshall are my Municipal Designees,” she said.

On the other hand, there are no fines for people who don’t participate in contact tracing. “It is purely voluntary,” Vanderslice noted.

But fines aren’t the first choice for town officials anyway.

“Our number one and immediate goal when there is a gathering in excess of limits is to secure the cooperation of the attendees to allow for contact tracing to control the spread and protect the other members of the public,” Vanderslice added.

As for the school district, Smith hasn’t yet discussed potential disciplinary consequences with the high school administration. “I’ve been focused on ascertaining the scope of the impact of these gatherings,” he added.

3 COMMENTS

  1. There may be no fines for people who do not participate in contact tracing, but students who fail to do so could be suspended by the Wilton schools – indefinitely. And when they are seniors, refuse to release their grades or give recommendations for college applications. Given what seems to be a lack of common sense and social responsibility by a number of WHS seniors and their parents, a cudgel is needed.

  2. COVID outbreak and contact tracing …
    This is beyond the issues of confidentiality … as members of the community these students are placing others at great risk. Why don’t parents take the responsibility of controlling their children? These students are in school, they need to be monitored and taught to respect the rules. This is serious and we, as a community, are concerned and, honestly, in fear of contracting the virus. It could mean life or death for many. And this, the irresponsible action of a few, is also a travesty of social responsibility, seriously impacting the education of the majority of students, and placing faculty, staff, and students at risk

  3. $650,000 for new astro turf… maybe it’s time to add an ethics class to the core curriculum. Neither psychology or sociology appear to adequately cover lessons in Egoism and Ross’s Moral Theory. Perhaps we’d have a different level of engagement if more people considered the Prima Facie Duties of non-malfeasance and reparation.

Comments are closed.