National Council of Asian Pacific Islander Physicians: Recommendations for Culturally and Linguistically Appropriate Contact Tracing for the Control of COVID-19

The National Council of Asian Pacific Islander Physicians has released analysis and recommendations for culturally and linguistically appropriate contact tracing for the control of COVID-19:

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NCAPIP is a national health policy organization that represents physicians committed to the advancement of the health and well-being of Asian American, Native Hawaiian, and Pacific Islander communities.

The key elements of effective COVID-19 contact tracing are:

• widespread, continuous diagnostic viral testing for COVID-19 across a community
• case investigation or follow-up with those who test positive
• supporting isolation and health monitoring of those who test positive for at least 14 days, including referrals and linkages to needed treatment
• comprehensive identification and rapid notification of all contacts of the individual who tests positive
• supporting self-quarantine and health monitoring of those contacts for at least 14 days, and
• repeating the protocol for any contacts who subsequently test positive.

While there is general agreement on these elements of effective contact tracing programs, there has been little attention on how COVID-19 contact tracing should be implemented in diverse communities. This is even more vital as preliminary data indicate racial and ethnic disparities in COVID-19 cases and deaths, specifically among Black, Latinx American Indian, Native Hawaiian, and Pacific Islander populations

Accordingly, the National Council of Asian Pacific Islander Physicians (NCAPIP) offers the following recommendations for implementing culturally and linguistically appropriate contact tracing for the control of COVID-19:

1. In partnership with diverse community groups and physician organizations, the CDC and tribal, territorial, state, and local health departments should immediately co-design and make widely available plain language, culturally and linguistically appropriate community education materials about contact tracing in multiple languages and in alternate formats accessible by individuals with disabilities
2. The CDC and tribal, territorial, state, and local health departments should highlight the confidentiality and privacy protections in contact tracing programs to reassure community members that any personal health information will not be shared with law enforcement, police, or immigration enforcement agencies, or used for any other purposes
3. In partnership with diverse community groups, tribal, territorial, state, and local health departments should immediately co-design and implement culturally and linguistically appropriate contact tracing programs
4. The federal government and tribal, territorial, state, and local health departments should ensure equitable access to testing for COVID-19, including removing cost and other barriers to testing
5. The federal government and tribal, territorial, state, and local health departments should ensure equitable access to treatment for COVID-19, including expansions of Medicaid and suspension of implementation of the Department of Homeland Security public charge test during this national public health emergency
6. Tribal, territorial, state, and local health departments should ensure language assistance services, and communications access for individuals with disabilities, in all contact tracing activities
7. Tribal, territorial, state, and local health departments should ensure that all necessary wraparound services and supports for isolation and self-quarantine, including housing, food, childcare, income, and other supports are culturally and linguistically appropriate, and are available without cost
8. Tribal, territorial, state, and local health departments should collect and confirm comprehensive self-reported demographic data from all contacts as part of contact tracing, including zip code of residence, age, sex, race, ethnicity, primary language, disability status, sexual orientation, and gender identity
9. Tribal, territorial, state, and local health departments should hire and partner with community-based organizations to deploy culturally and linguistically concordant contact tracers to meet the needs of diverse communities
10. Tribal, territorial, state, and local health departments should continuously monitor and publicly report all contact tracing activities stratified by demographic data to identify and immediately address any identified disparities in access to testing and treatment, and in participation and adherence to contact tracing protocols

Given the emerging evidence of racial and ethnic disparities in COVID-19 incidence and mortality, ensuring culturally and linguistically appropriate contact tracing should be an urgent and immediate priority for the CDC, for tribal, territorial, state, and local health departments, and for all Americans who are committed to working together to end this pandemic.