A Covid-19 outbreak among the Amish this spring showed the real need for public health officials to build trust among a community that typically limits engagement with the government.
Despite the pandemic, the Amish community in the Greater Holmes County Area of Ohio continued to hold community gatherings. During the outbreak in May, there were at least six social gatherings, including a logistical meeting to plan church services, three church services, a wedding, and a funeral, US Centers for Disease Control and Prevention and Ohio state and county health officials wrote in the CDC’s weekly report Thursday.
The team said those gatherings likely contributed to the rapid spread of Covid-19. Some community members also had misconceptions about what would protect them from infection. Some said they thought wearing a mask would cause them harm. Others thought if they took vitamins and herbs it would protect them.
The local public health department learned about the outbreak after a couple tested positive in mid-May. The husband, who had chronic obstructive pulmonary disease, had to be hospitalized for a couple of days. Another adult family member with cancer who tested positive for Covid-19 died May 21.
Community leaders told the Wayne County Health Department that a number of people in the community had symptoms so the department set up testing at the local school. In total, 30 people tested positive for Covid-19. The report suggests there may have been more cases, but the more traditional members of the community may not have gotten tested.
The local health department interviewed some of the Amish at the testing site and learned about some of the misconceptions about the ways to stop the spread of the disease.
Researchers also learned that the community didn’t have access to updated and trusted guidance. Most rarely, if ever, used the internet or email. Nonetheless, many understood the importance of social distancing and knew that coughing and sneezing could spread the virus.
Wearing a mask was not socially or culturally acceptable, some members of the community said. Some were also reluctant about social distancing, because communal cultural practices were central to the Amish identity.
The CDC said it is important for health departments to build trusting relationships with the Amish. The departments should use culturally sensitive language when they reach out to community leaders and emphasize the message that mitigation behaviors protect the family and the community. Health education materials should be shared through Amish newspapers and local radio stations. Access to testing needs to be convenient and timely.