A Web-Based Digital Contact Tracing Strategy Addresses Stigma Concerns Among Individuals Evaluated for COVID-19

Abstract

Introduction: Conventional contact tracing approaches have not kept pace with the scale of the coronavirus disease 2019 (COVID-19) pandemic and the highly anticipated smartphone applications for digital contact tracing efforts are plagued by low adoption rates attributed to privacy concerns; therefore, innovation is needed in this public health capability. Materials and Methods: This study involved a cross-sectional, nonrepresentative, online survey in the United States of individuals tested for COVID-19. Testing survey items measured the performance of conventional contact tracing programs, quantified the stigma related to the notification of COVID-19 close contacts, and assessed the acceptability of a website service for digital contact tracing. Results: A sample of 668 (19.9%) individuals met the inclusion criteria and consented to participation. Among the 95 participants with COVID-19, results were received after a median of 2 days, 63.2% interacted with a contact tracing program a median of 2 days after receiving test results, 62.1% had close contacts, and 37.1% of participants with COVID-19 and close contacts did not disclose their results to all close contacts. Among all participants, 17% had downloaded a mobile application and 40.3% reported interest in a website service. One hundred and nine participants perceived stigma with the disclosure of COVID-19 test results; of these, 58.7% reported that a website service for close contact notification would decrease this stigma. Discussion: Conventional contact tracing programs did not comprehensively contact individuals who tested positive for COVID-19 nor did so within a meaningful time frame. Digital contact tracing innovations may address these shortcomings; however, the low penetration of mobile application services in the United States indicates that a suite of digital contact tracing tools, including website services, are warranted for a more exhaustive coverage of the population. Conclusions: Public health officials should develop a complementary toolkit of digital contact tracing strategies to enable effective pandemic containment strategies.

Keywords: COVID-19; contact tracing; digital contact tracing; pandemic containment; stigma; telemedicine.