ROCHESTER, Minn. -- The first study to examine self-conscious emotions in connection to attitudes about testing, tracing and the COVID-19 pandemic has learned that a propensity to feeling shame as opposed to guilt reduces participation in illness surveillance.

The data come along as the Minnesota Department of Health faces new reports of "parents intentionally avoiding getting their children tested and encouraging others to do the same,” and as the Minnesota Senate advances legislation curtailing the public health response to COVID-19, threats that in many cases do not exist.

The study of emotions and participation public health surveillance was conducted by researchers in the United Kingdom and published earlier this month in the journal Frontiers in Psychology. It looked at responses from subjects taken over two days in April of last year, groups of 597, 606 and 693 within the United States, Italy and South Korea.

The countries were picked based on research showing they reflected differing orientations when it came to the cultural value placed on individual independence versus collective interdependence.

The countries also held differing levels of trust in government, and views on equality.

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To be effective, lockdowns, restrictions and active government surveillance "must rely, at least in part, on citizens' active cooperation with authorities," the authors wrote, "especially in countries characterized by democratic political systems."

COVID-19 testing and vaccination is optional in Minnesota, but a positive test result is reportable to public health, triggering data storage and follow-up calls to the infected person plus any contacts they share.

The state has also launched a mobile app that residents can download if they so choose to learn whether they are within 6 feet of another person who has recently tested positive for the virus. To be effective, all of these voluntary surveillance practices require cooperation and trust.

To understand why such requests can stir suspicion, the authors asked subjects about their plans to report an infection to health authorities, acquaintances or friends, as well as their feelings about guilt or shame were they become infected with COVID-19 and give it to others.

According to emotions research, guilt is when a person feels they have done something that could cause negative consequences, while shame is when a person feels they are a bad person who faces rejection by others.

The authors predicted a willingness to disclose infection status to public health or friends would come down to whether participants were motivated by guilt or shame.

Participants who endorsed guilt, they predicted, would be more likely to cooperate with disease surveillance than those who endorsed shame, and they found just that.

In all three countries, "feelings of shame at the idea of contracting the virus were negatively associated with individual compliance and self-reporting intentions," the authors wrote. Shame also predicted an individual's inclination to hide the illness from authorities or friends.

Those who said they would feel only guilt over contracting or spreading the disease, on the other hand, were more likely to say they would report their illness to authorities.

The authors believed these findings suggested "that stigmatizing or blaming individuals for contracting the infection could potentially backfire," and that "guilt may foster more constructive responses to transgressions."

The authors called out the use on social media of terms like "covidiots" or who mock those who break guidelines as stigmatizing and counter-productive for gaining participation in health surveillance programs.

Senate bill resistant to contact tracing

Skepticism and resistance to health surveillance were the focus of a virtual hearing of the Health and Human Services Finance and Policy Committee on Wednesday, March 24 for testimony on S.F. 1589.

The bill, authored by Sen. Michelle Benson of Ham Lake, sought to set limits "for contact tracing, digital contract tracing, immunizations, communicable disease testing, and the required disclosure of certain information."

Many of these limits on pandemic surveillance were pre-emptive in nature, restraining powers or practices that are not currently in place.

The bill also sought time limits for the storage of resident health data, and to prevent mandatory digital contact tracing by employers, which is also not currently in place.

Sen. Benson supported the expansion of "a Minnesota-ready testing-tracking and tracing program” in May of last year, with her only concerns then that patient privacy rights are protected.

December of 2020 however her concerns had changed to the questions asked of the calls. Health officials asked patients who had tested positive whether they had visited restaurants or churches, but not retail establishments.

On Wednesday, the Senate committee heard from Twila Brase, a registered nurse and president and co-founder of Citizens Council for Health Freedom (CCHR), "a patient-centered privacy-focused organization that seeks to protect patient and doctor freedom," according to Brase.

"We are not in a fight against a virus." the group states on the GiveMN website. "We are in a fight for freedom. We are in a fight for America."

CCHR is an associate of the State Policy Network, a conservative legislative organization with 63 affiliates in 50 states.

Brase spoke for not forcing participation in contact tracing, which does not currently exist, "but also supporting extending this protection to those who have been reported by the contagious to the Minnesota Department of Health."

That is not required either.

"Contact tracing has been in place for decades," countered Sen. Chris Eaton of Brooklyn Center. "It's public health 101. It's science. It's how we make sure that a disease does not spread to more vulnerable people ... I think this feels very political."

Benson countered that "we've moved from person-to-person contact tracing to digital contact tracing, where proximity via Bluetooth can tell if somebody has been within 6 feet of one another. That should be voluntary, and it shouldn't be a condition of interacting with your government or employer."

Dan Huff, assistant commissioner for the MDH told committee the department always provides those being contacted with a disclosure that their participation is voluntary and how the information will be used.

"We do not compel people to be tested," Huff said. "We don't compel people to be vaccinated. We encourage it strongly."

"To me this bill will put barriers in place in that will affect in a negative way our ability to do public health work that that needs to go on," said Sen. Melissa Wiklund of Bloomington

Benson returned to the potential for future restrictions to be codified today.

"Do you think disclosing that you've been vaccinated should be condition of going into the DMV?" she asked. "Should it be a condition of engaging with your government? If you agree to take part in contact tracing that should be entirely up to you and it shouldn't be a condition of employment."

The authors hope to include the Senate measures in an omnibus package, but it's fate in the DFL-controlled House is unclear.