Date: 24..3 2020
Shri Udhav Thackeray
Honorable Chief Minister,
Government of Maharashtra
CC-Shri Rajesh Tope
Honorable Minister of Health
Government of Maharashtra
Re: Concern over breach of confidentiality of patients suspected of, or diagnosed with Coronovirus (COVID-19)
We, the members of Jan Swasthya Abhiyan, are extremely concerned with the breach of privacy and confidentiality of persons suspected of or diagnosed with COVID-19.
We are aware that this is a public health crisis and measures need to be taken by the State to address its containment and management.
The breach is happening through the publication of names in papers, or online on websites or through the marking of houses. A list of more than 400 quarantined people in Nagpur was made Public on March 21st by the State authorities. In Mumbai 100 quarantined residents of the Borivali-Dahisar area have their full with details of their names, addresses, contact numbers and the date till which they are supposed to remain in quarantine – has been circulating on WhatsApp,.
We would like to point out that continued, adequate surveillance of such individuals can be done without resorting to such exposure of identity. The concerned Public Health Official can monitor the person via mobile calls and when such a call is made, the concerned person’s location can also be accessed by the authority by using available technology; something routinely done by many commercial outfits including the travel companies like Ola, Uber. The person’s consent for this should be taken at the airport itself for this surveillance of maximum of 4 weeks.
Displaying names of such persons is not only a breach of confidentiality, it also does not ensure the containment of the disease, rather, it gives a false sense of security that no one else will be infected.
These are arbitrary and reactionary measures that do not serve the purpose and would instead cause fear, isolation and stigmatization. Such measures will drive the disease underground, as people will not come forward for testing, and will likely worsen the situation and hence, should not be undertaken at all.
We request you to adopt procedures and other measures that would not only contain the disease, but also restore the confidence of the people in the health system.
It is important for the authorities to desist from causing potential harm to the person who may be infected, by disclosure of their personal details in the public domain.
If disclosure is made it may lead to reluctance to approach the health care facility for treatment and testing. In addition, the distrust that would be created between the doctor and patient on breach of confidentiality must be avoided at all costs.
Trust is the bedrock of the doctor-patient relationship that has serious implications for access to information and health care and should not get affected due to the arbitrary, unnecessary decision of the State to reveal names of patients in the public domain. Therefore maintaining confidentiality is essential.
In case, it is found that the person is not taking precautions and is placing other at a significant risk of exposure, despite counseling, some public health measures may be taken to prevent such a person from infecting others. Quarantine in places with adequate facilities could be resorted to, identifiable persons at significant risk of exposure should be tested and counseled, and it should be ensured that all persons are taking adequate precautions not to spread the disease.
In case of death of the patient from COVID-19, it may be important to state it on the cause of death certificate, but such cause should not be revealed to the public at large. Adequate provisions and precautions should be taken by the authorities on the final rites of the person. Confidentiality should be maintained, as it would further stigmatize the bereaved family.
It is essential that the State puts in place the above mentioned measures, so that the confidence in the public health system is maintained and people are not stigmatized and discriminated against.
The media should also be directed not to reveal the names and addresses of persons with the infection or who are at risk; orders preventing the media from sensationalizing and revealing the names and personal details of the patient and those at risk should be made urgently by the State. (Annexed is an order to this effect by the Government of Odisha, Health and Family Welfare Department, dated 21/03/2020)
We sincerely hope that our concerns will be given serious consideration and that the Maharashtra governments will be directed to revoke any orders and discontinue any procedures that breach confidentiality of persons diagnosed with COVID 19 and those at risk.
Kamayani Bali Mahabal ,Brinelle D’Souza and Avinash Kadam
Contact – 9820749204 ,9004688770,9869055364
Convenors JSA- Mumbai On behalf of Jan Swasthya Abhiyan
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