Originally Published in Hideaway News on July 31, 2020
We all expect our medical information to be kept confidential by health care providers, hospitals and public health entities through HIPAA. Similarly, our medical information with our employers is protected by the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). Even outside of these settings, most of us in the US have a reasonable expectation of privacy regarding various matters, including our health information. But these are special times when there is real worry and fear of getting and spreading the virus, and we might think that there is a case for breaking medical confidentiality. However, before we do that, we should look to science and the health authorities to determine the following:
Is revealing the identity of someone who is COVID-19 positive truly going to protect us and reduce the spread of the virus to others?
The CDC has made it very clear that the only people who need to be informed are CLOSE contacts, those who were closer than 6 feet from you for at least 15 minutes in the 2 days prior to symptoms. This exposure is regardless of whether either party was wearing face coverings. It says that the person just needs to be informed that they are a close contact without disclosing the identity of the positive case. It has also made it very clear that employers should inform workers and persons that came in close contact with the positive person, again without revealing their identity, as provided in the ADA. Close contacts will be asked to follow CDC guidelines pertaining to them.
So if you have not been notified by NET Health, your employer, the affected person or their family that you were a close contact of a positive case, then you don’t need to do anything different from the average person. And you don’t need to know their identity.
Having had casual contact with a waiter at a restaurant, being handed groceries, delivery boxes or food, going through the checkout counter at the golf shop, talking to someone for five minutes at the beach, being handed a bill after someone mowed your yard… these are all NOT examples of close contact and should not cause you undue concern. People with such contact do not need to be informed that they were exposed, do not need to be quarantined and do not need to take special precautions. They simply need to do what the rest of us are doing – watch for symptoms, and call their doctor and get tested if they have symptoms.
The person testing positive has a reasonable expectation of privacy. They should not be made to feel guilty if they don’t want to disclose their medical status to everyone. They should not feel coerced into revealing their status to anyone but their close contacts. There is no risk reduction to the person who had casual contact with the positive case and no benefit to our community at large in terms of virus spread by actually knowing their identity.
On the other hand, “outing” someone with COVID-19 could be potentially damaging to a person’s life, professionally, economically and socially, well after the isolation period. There have been instances of people losing their jobs and being verbally or physically attacked because someone felt that they should not be out, even though it had been weeks since they recovered. Stigma from COVID-19 can persist, causing isolation and depression from ostracization. So let us be very cautious about going down the slippery slope of invasion of medical privacy if there is no health benefit to anyone in the community. If however, someone chooses on their own to publicly share that they tested positive, let us be compassionate and not judgmental.
The best thing that each and every one of us can do right now to prevent the virus from spreading in our beloved community is to continue to social distance, wear face coverings when that is not possible, wash hands and avoid large gatherings.
Wishing us all the very best of health!
Sue Royappa, MD, MPH
Chief Health Officer
City of Hideaway