There’s a lot we still don’t know about the new coronavirus, but here’s what researchers and health officials do know.
The Republic | azcentral.com
When a teenager who had the measles visited Phoenix last August for the World Hip Hop Dance Championship, public health officials shared details of his precise whereabouts.
He had spent his weekend at the Arizona Grand Resort and Arizona Mills mall, they announced in a news release and had watched “Fast and Furious Presents: Hobbs and Shaw” at a theater in the mall.
When another traveler with the disease passed through Tucson International Airport several months earlier, state officials warned people of potential exposure if they had been at the airport between 6 a.m. and 10:40 p.m. that day.
If the coronavirus hits Arizona, don’t expect similar details about infected individuals. State officials are likely to share only a patient’s age range and the county where the case is located —a 9,200-square-mile area, in the case of Maricopa County— but little else.
That’s because standard practice among public health officials nationally is to share only a level of detail they decide is necessary to keep the public safe. More detail, officials said, risks upsetting health care providers by revealing where patients are being treated, or deterring individuals from seeking treatment out of fear they could be publicly identified.
Public health officials are compelled to share information if they think people can act on it.
They may publicize hepatitis A outbreaks at restaurants so affected customers can get vaccinated or seek treatment. Or they may publicize details about measles patients’ whereabouts so that people who aren’t vaccinated may reconsider their ways or stay home if they start experiencing symptoms, said Will Humble, executive director of the Arizona Public Health Association.
In addition, the measles is so contagious that officials must share precise movements of infected people: It persists in the air for hours, greatly expanding the number of people potentially exposed to it.
The new virus, known as COVID-19, is believed to spread through personal contact or respiratory droplets expelled when infected people cough or sneeze, Humble said.
When it comes to any action people could take, it’s the basics: wash your hands, don’t go to work sick, don’t send your kids to school sick, Humble said.
Does more information protect the public?
But Missy Rodey, who worked as a patient advocate for more than six years, said she would like to see public officials release infection data at the neighborhood level and identify which hospitals are treating coronavirus patients.
Rodey, who lives in a retirement community north of Tucson, has a husband with chronic obstructive lung disease and said she would likely alter her usual routine if she knew of a nearby case.
“I’m out and about in the community every day. And it is my responsibility to maintain my level of hygiene such as that I would avoid contamination,” she said. “Just having worked out at the gym, wiping down the equipment is very important to me. But I might even go a step higher than that if I knew there was an outbreak here.”
She said she wouldn’t necessarily avoid a particular hospital if she knew they were treating coronavirus patients. But if she had to make a visit she would ask the facilities precisely how they are containing infectious diseases.
“Every individual who goes to the hospital for any reason has the responsibility to be his or her own advocate,” she said. “There are lot of mistakes being made in hospitals and not through any lack of intent but just because there are humans involved.”
Rodey won’t get that level of detail for a couple of reasons.
For one, patients might avoid visiting hospitals they know are treating coronavirus patients, which could be dangerous for people experiencing emergencies.
“We grappled with this a little bit with Ebola as well. We were looking for facilities to be Ebola treatment centers and not everyone wanted to sign up for that,” said Jessica Rigler, assistant director of public health preparedness for the Arizona Department of Health Services. “There was a concern that people might stop visiting those facilities if they thought maybe Ebola patients were being treated there.”
And two: hospitals and labs may not report required data to the state if they lose trust that officials will keep their information confidential.
“They have a duty to protect confidentiality,” Humble said. “If they’re disclosing data and information to someone they don’t trust, now they’re in a position to decide, ‘Do I comply with the law? Or do I protect my patients?'”
As of Monday, more than 89,000 people worldwide had contracted COVID-19 and more than 3,000 had died, according to the Associated Press. The disease has been most dangerous for elderly people and those with existing health problems.
In Arizona, by Tuesday 32 people had been tested for the virus but only one tested positive and another is presumed to be positive. One patient was a male in his 20s who had traveled to Wuhan, China, and was diagnosed on Jan. 26 in Maricopa County. He was released from isolation more than a week ago.
The other patient is also a man in his 20s in Maricopa County. He isn’t hospitalized.
Officials are expecting to see new cases, but say the risk here remains low.
Arizona health officials say their plan is to personally contact people who are exposed to coronavirus, which health officials do with meningitis cases, said Rigler.
The state may choose to share more details on a case-by-case basis, she said.
What Arizona law allows to be disclosed
Arizona law prohibits health officials from releasing the trove of raw data they collect on communicable disease cases, even if they were to withhold names and other identifying information.
They do publish aggregate numbers from that data. For the flu, for example, the state regularly publishes statistics on the number of people diagnosed by age, gender or county.
Rigler said the public should expect a similar format if the coronavirus becomes widespread.
Laws that make communicable disease data confidential are standard across the country. They are designed to protect people’s privacy and encourage them to come forward if they get sick, said James Hodge, director for ASU’s Center for Public Health Law and Policy.
Releasing much more information than a couple details about individual cases could put people at risk for being identified and stigmatize them, Hodge said.
“With very minimal data, we can run very publicly available searches to figure out which person we’re talking about,” Hodge said. “A lot of Americans rally around people and do the best they can to be contentious of their status but some are scared. Some are going to do certain things that are egregious and discriminatory.”
People would be less likely to voluntarily submit for testing and treatment if they knew they could be identified, he said.
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