Careful with patients’ info

Early this month, the Lambunao, Iloilo, house of several family members who had tested positive for COVID-19—including the patriarch who had died of the disease—was stoned shortly after the family had consented to have their names disclosed publicly to make contact tracing easier.

In Sultan Kudarat and Cebu, a hospital cleaning staff and a nurse, respectively, had chlorine poured on them while they were on their way home, because they were suspected of carrying the virus.

Such incidents could make for a strong case for the nondisclosure of one’s COVID-19 status and an argument for survival and self-preservation.

On the other hand, consider the case of several medical frontliners who had contracted the disease and died on duty—simply because some of their patients did not disclose their travel history.

Consider as well how difficult it is to trace the possible contacts of COVID-19-positive cases who could inadvertently be infecting others because they remain blissfully unaware of the risky encounter they’ve had. Given limited information, some of them would remain unreachable and unable to take the necessary precautions against further spreading the virus.

Hopefully, Republic Act No. 11332, or the Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act, would address these two conflicting issues: the protection of one’s private information and the public’s right to know.

The law makes it obligatory to report medical conditions that are of public health concern, such as the highly infectious COVID-19 illness, and penalizes violators with a fine of up to P50,000 or imprisonment of up to six months, or both.

With the exponential increase in the number of cases both globally and locally, even the National Privacy Commission (NPC) has thrown its support behind the law. The “Data Privacy Act (DPA) of 2012 does not prevent the government from doing its job, or public health entities from processing personal and sensitive personal information when necessary to fulfill their mandates during a public health emergency,” the NPC stated. At the same time, it stressed that only “pertinent information necessary in facilitating contact tracing should be collected, such as but not limited to: travel history, and frequented locations”; and that only information required to enable contact tracing should be disclosed to the public.

The Integrated Bar of the Philippines, the Philippine Medical Association, and the Philippine College of Surgeons have similarly urged suspected and confirmed COVID-19 patients to waive the confidentiality of their medical condition to help authorities conduct timely contact tracing and to protect health workers. But recognizing the risks to privacy, the groups also called for “adequate safeguards” to ensure that an individual’s private data would be entrusted to proper authorities and used responsibly.

After some initial confusion, Cabinet Secretary Karlo Nograles, spokesperson for the Inter-Agency Task Force for the Management of Emerging Infectious Diseases, clarified that the personal information would be given only to the Department of Health (DOH), the depository of private data, which it would share only as needed with local governments and law enforcement agencies to help trace people exposed to COVID-19 patients. The DOH will issue guidelines on contact tracing and data sharing, taking into account data privacy as well, Nograles said.

The need to safeguard private information cannot be overemphasized, as people could be driven to hide their health status and refuse to be tested should they fear that their data could be carelessly treated or disclosed unnecessarily.

Aside from clear guidelines on what information needs to be gathered, the task force should ensure that the data would be disclosed only to proper authorities and will not be used for any other purpose aside from contact tracing.

South Korea’s very detailed disclosure of information about a patient’s age, gender, and places visited, using CCTV footage and credit card transactions, has raised concerns about privacy, although an informal survey showed that most respondents “preferred the public good to individual rights.”

Singapore’s approach to contact tracing using a Bluetooth app for smartphones called TraceTogether appears to be more discreet. The app identifies nearby phones with the same app installed and tracks when you are in close proximity with these other persons. If the need arises, this information can be used to identify close contacts based on the proximity and duration of an encounter between the two users.

With the DOH still to formulate guidelines on data collection and disclosure, looking to best practices from other countries may provide safe passage through this tricky path.