Here on the Eastern Shore, seven people have confirmed COVID-19 infections, as this editorial went to press.
We are concerned, of course. We know it’s important to you that we work diligently to get you accurate information and facts.
We agree with a March 20 statement by the Maryland Delaware DC Press Association (MDDC), of which The Star Democrat is a member: “Local news media serves its communities every day and this is put into stark relief during times of crisis such as we are facing now. COVID-19 has upended the lives — and livelihoods — of every person in the state.”
Since last Sunday’s late afternoon press conference at the Talbot County Emergency Operations Center, we have worked to find out basic information about Talbot County’s — and the Eastern Shore’s — first confirmed COVID-19 case. We wanted to help our readers to know what other Marylanders have been told about the patients in their communities: the gender, age and general location of patients. We understand and respect the limitations on sharing information about patients under the 1996 Health Insurance Portability and Accountability Act, or HIPAA.
Since then, six more people on the Eastern Shore have been diagnosed with the novel coronavirus that is at the root of a pandemic that has killed thousands. And health officials in Caroline, Queen Anne’s, Somerset, Wicomico and Worcester counties have given the press the most basic of information.
Not so in Talbot County. Rumors abound, and some very credible folks have spoken off the record, but we have no sources willing to substantiate age, sex and location of the Talbot County patient. Residents have posted their perplexity on various social media sites; they feel they have a right to know where this person may have gone before he or she tested positive. We have been assured by county officials that transparency is an important objective during this crisis.
Let us be clear. We believe our medical facilities, health department, emergency services department and the people who oversee them and serve Talbot countians are doing the best they can with the best of intentions. We are all under enormous pressure to provide information and services to help keep our families and friends safe. Our emergency operations team has done exemplary work and is probably the best on the Shore.
But, at the very least, we want to be as informed as residents of other Maryland counties seem to be. On Tuesday, March 17, we emailed three Talbot County leaders and asked them to provide answers to four questions. County Council President Corey Pack and Emergency Services Director and Assistant County Manager Clay Stamp both deferred to Health Officer Dr. Fredia Wadley to answer our questions.
We asked, 1) How old is the person? 2) What is the person’s gender? 3) In which county did this person allegedly become infected? 4) Was this person self-quarantined before being admitted to the hospital?
Dr. Wadley took the time to respond thoughtfully and quickly. But we knew no more about the patient’s age, gender and location than we had before the email. She responded, in part: “As you are aware, the spirit of HIPAA is that one does not provide information that can be used to identify anyone. In large counties like Baltimore, Anne Arundel and Montgomery County as well as larger rural counties, providing some details might not be enough to identify a patient. However, in a small county and small hospital, that information can be used to identify patients. Health professionals are taking issue with some counties providing more details about patients especially if they are in small rural counties.
“I realize that inquiring minds want to know, but if that information is not important to the control of the infection, but detrimental to the person, then that is the rationale for not disclosing details,” Dr. Wadley wrote.
“Contact tracing has been done for this case to alert anyone that might have come in contact before and after symptoms occurred so we can take steps necessary to protect the public. Contacts in other counties are notified in the same way by their health department,” Dr. Wadley wrote. “It might be easier for Health Departments if we could just announce the name of the person and tell everyone in the county that has seen them in 14 days to watch for symptoms and see their healthcare provider.
“But neither you nor I would be happy about that approach if the confirmed case was one of us.
“We support transparency as much as anyone in this state and working 16 hour days to keep everyone informed,” she wrote. “However, transparency and patient confidentiality are two different things. And while we may disagree about what information can be used to identify a patient, I have given you my rationale for what I information I share. And I can assure you that if you have a reportable disease, that I will guard your identity just as closely and still contact the people that you have been in contact with one by one to protect the community.”
Dr. Wadley makes valid points, to be sure. We recognize the few degrees of separation among many demographics in this rural area. But we are not asking for patients’ names. What we are requesting, however, would not violate any one patient’s privacy. Even with the tips we have received this past week, we still do not know the patient’s name or address.
MDDC signed on to a statement coordinated by the National Freedom of Information Council to encourage government bodies to ensure transparency in their actions during this epidemic.
A broad coalition of 132 press associations, schools of journalism and liberal and conservative public policy groups signed a “Statement on Government Coronavirus Emergency Transparency and Public Access.”
In the statement, the group of signatories “strongly urge government branches and agencies to recommit to, and not retrench from, their duty to include the public in the policy-making process, including policies relating to COVID-19 as well as the routine ongoing functions of governance.”
“The fact that a government decision involves public health and safety is a reason for more, not less, transparency,” the statement declared.
We agree. We are not asking for transparency that would violate a patient’s legal right to privacy — just reasonably less opacity.