Sex workers and strip clubs: Concerns public may not reveal 'sensitive locations' in Covid tracing

The Director-General of Health says sometimes people don’t want to disclose places that “could be a cause of embarrassment”.

Locations visited by people with Covid-19 are currently revealed publicly on the Ministry of Health website — but what happens if someone has gone somewhere they don't want to be publicly linked to?

Director-General of Health Dr Ashley Bloomfield says it can be a "huge shock" for people to be diagnosed with Covid-19, "and then suddenly your whole life is exposed before the nation".

It could be as simple as not wanting your partner to know you've been to three shoe stores in a day when you said you went to one, to publicly revealing you went to a strip club or brothel.

Public health expert Lesley Gray, a senior lecturer at Otago University, says contact tracing currently exists on a high-trust model.

"When we're looking at tracking and tracing where we've been, it's understandable that if people are concerned that if they become a likely contact or a case, their whereabouts might be made public for the benefit of contact tracing," she told 1 NEWS.

"If people feel that they wouldn't want their exact whereabouts to be known, they may not disclose everything to a contact tracer, or they may actively not record where they've been now."

Currently, the Ministry of Health uses the locations of interest to help people discover if they're a contact of a community case when they might not know it.

Recently, that's included places such as a Kmart store and KFC outlet where confirmed cases worked while potentially infectious, as well as a vape store where an infected person visited.

Each location is linked to a specific case; while the public don't know specifically who has the virus, that won't be the case for all their friends and families.

For locations where the contacts are easily identified and unlikely to be general members of the public — such as a private house viewing — they're not listed as locations of interest.

Adult entertainment.

As brothels and sex workers tend to make direct appointments, Aotearoa New Zealand Sex Workers' Collective says they ask confirmed cases to get in touch directly with the business or workers, even if they don't want to fess up to contact tracers.

"Sex work's generally been stigmatised, that's something that people don't like disclosing, even though it's been decriminalised for quite some time," community liaison Cherida Fraser says.

"It's changing and we know that sex workers take their health responsibilities quite seriously. We certainly know that sex workers are doing everything they can, but the big question has always been to do the with the clients. 

"Will the clients put in a sex worker or a brothel or a strip club on the contact tracing list?"

Gray says contact tracers so far have been doing an "awesome job".

"We really want to contact as many likely contacts in as quick as possible time, so if people start to hide or withhold locations that they've been to for fear of this information getting out into the general public, then that's not a good thing," she says.

"So how can we increase trust for those people that they feel confident they can give all the information to allow contact tracing to happen, without necessarily feeling that some sensitive information is now in the public domain?"

She says the Ministry of Health could consider better anonymising the data.

It could be done in a way that still protects the public interest while assuring confirmed cases their secrets are safe.

"Perhaps if people had confidence that if sensitive locations, exact details were not going to be relayed, how do we go about letting general population know if you've been in this area of that area, then you really should go and have a test, and I think that's a challenge for the authorities right now," Gray says.

"Many, many people go to supermarkets and I don't think there's any issue about declaring a supermarket here or a supermarket there .

"But if, for example, you'd visited a bottle store or an adult store, maybe the information that would be publicly available is if a person was in a particular street area and that could be a block or such, like we do that sort of thing in research."

For QR scanning in the Covid Tracer app , Fraser says sex workers and businesses often use a different trading name to retain client privacy.

"So bank statements and receipts won't ever say the name of the business is a brothel," she says.

"They will say something like a café or a mechanic or something like that as a trading name.

"And we know that there's brothels and independent workers who have a QR code where when they registered it, they registered as a different kind of business name so that their clients would be more comfortable scanning in."

A similar tip could be used with contact tracing, where the published 'location of interest' is still easily understood to those who've been there, Fraser says.

"It's for clients to feel safer that if somebody were to see that on their [contact tracing] diary, they would not realise they'd been to a brothel," she says.

Seven Sharp asks the PM if there should be repercussions for those who break the rules.

"And people who had been there would know that."

Gray also encourages enabling GIS tracing, which functions in a similar method to the Bluetooth in the Covid Tracer app.

The Covid Tracer Bluetooth doesn't track where you've been, but rather who you've been in contact with, by exchanging anonymous 'tags' with other devices.

If one person tests positive, officials can then send out a ping to other devices who'd been tagged by that person. The GIS tracing also works in a similar manner but can also be used to trace locations.

But it's not foolproof.

"It still comes back to the trust model, because if people don't want others to know exact locations that they've been to, they're not going to use Bluetooth, nor are they going to track and trace or declare where they've been," Gray says.

Even when locations are being kept quiet, Fraser says they still see a stir of speculation that it could be something salacious.

"I've certainly seen some commentary on social media where we have places that haven't been disclosed, and people have speculated that perhaps it was a brothel," she says.

She's also concerned about the public damage that could be done to the already stigmatised sex industry if a case is linked.

"Historically (there's) been this idea that sex workers have been harbingers of disease," she says.

"It would be problematic for our community if there was a public notice of Covid-19 being in a brothel because of the way people behave on social media and the outrage that people feel about sex workers, really, in the first place."

Even if you don't disclose it to contact tracers, the key thing is to make sure the businesses are informed, Fraser says.

And when talking to contact tracers, there are ways to be honest about your interactions without having to spill everything.

"They can say things like yes, I bumped into a friend and I had a long chat with her... We were closer than two metres and chatted for over 30 minutes," Fraser says.

"There are other things that they can say, they just have to make sure that the contact tracing people know that they are a close contact."

CONTACT TRACING HAS TO BE 'SENSITIVE PROCESS', ASHLEY BLOOMFIELD SAYS

Director-General of Health Dr Ashley Bloomfield says contact tracing, including the public disclosure of locations of interests, "has to be a really, really sensitive process".

"People may be in relationships that they don't wish to disclose to others, let alone the general public. They may have been to places that could be a cause of embarrassment," he says.

Adult entertainment.

"What we are trying to do is give people confidence they can and should disclose information so that we can manage the pandemic."

Sometimes that means the locations won't be publicly disclosed if they know who was there and contact everyone directly.

Bloomfield says it's "not common practice" for them to keep locations quiet if there is that wider public exposure.

"I can't think of one," he says.

Contact tracers continually go back and work with confirmed cases to make sure they're able to track down everywhere they went, Bloomfield says.

It includes looking at bank transactions and shopping receipts.

"The nature of the interaction between our public health staff and these families is very important," Bloomfield says.

"They are very professional and expert in building a trust with them and supporting them."

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