Analysis: First Responders’ Needs for Personal Medical Information
One of the obvious challenges facing public health practitioners and healthcare workers is the asymptomatic nature of COVID-19. Testing remains the only way to identify those with the virus, and lack of testing has marred data collecting charting the virus’ spread.
A legal question emerging is the extent of COVID-19 patients’ personal information that should be revealed to first responders such as police officers. As Illinois courts consider this issue, Dr. Ron Hershow, associate professor of epidemiology at the University of Illinois Chicago (UIC) School of Public Health, contributed to an amicus curiae brief submitted by the American Civil Liberties Union outlining a public health and community health perspective on privacy rights during a pandemic.
Hershow agrees community health efforts are supported by the release of information like the number of infections in a particular area. At the same time, he notes patients have strong privacy rights outlined in state and federal law, as well as medical and public health ethics. He writes identifying information should only be released in narrow circumstances where disclosure would actually promote public health.
While at face value it may appear that providing first responders with personal information of those infected, Hershow’s brief argues the opposite may be true. He cites an Illinois Department of Public Health guidance:
“Providing first responders and law enforcement with the identity of positive COVID-19 cases has limited epidemiologic and infection control value and therefore IDPH does not recommend notification to law enforcement of individuals who have tested positive for COVID-19. Rather, IDPH recommends that first responders and law enforcement take appropriate protective precautions when responding to all calls.”
He argues this approach is sensible given that testing rates are low and testing has largely been restricted to those with severe symptoms. Likewise, he notes research stating individuals with COVID-19 may be most contagious before they develop symptoms.
The specific features of the COVID-19 pandemic make it such that information about individuals’ diagnosis is not particularly helpful and could give first responders a false sense of security when considering when to take particular precautions.Professor of Epidemiology|
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Hershow recommends first responders wear masks and gloves, and goggles when appropriate, whenever in direct contact with a member of the public. He writes the wearing of PPE is critical not just for the safety of first responders but also to protect the public with whom they interact, since first responders may also be infected with the virus despite having no symptoms.
Regarding the needs of COVID-19 patients, Hershow cautions public stigma may prevent some individuals from coming forward for medical care. In particular, he notes undocumented people and families with mixed immigration statuses tend to have less than average access to healthcare and may already have a historic distrust of the medical profession and/or police.
“It is crucial to reduce all barriers to screening for individuals, including reducing fears of stigma and discrimination that surrounds any infectious disease,” Hershow wrote. “[Current data] likely dramatically underreport[s] the number of infections because community spread has outpaced testing efforts across the state and nation.”