Privacy vs. public safety: How much should counties tell us about COVID-19 patients?
When health officials in southwest Missouri announced earlier this month that another resident had contracted the coronavirus, they released details about where the person had been in recent days.
The patient had shopped at a Walmart Neighborhood Market in Springfield on the morning of March 17. The day before, the person had lunch at a local Mexican restaurant and then went to another Walmart. On March 15, the patient had gone to a comedy club after dinner.
Anyone who might have been at those same places — with specific locations identified — around those same times knew to more closely monitor their own health.
Like Greene County, some health departments in other southern Missouri counties and elsewhere have provided that same kind of public information in the past two weeks.
But when Dennis Wilson, of Lenexa, tested positive for coronavirus on March 16, Johnson County health officials didn’t notify the magicians’ organization he belonged to or the Merriam hotel where he attended the group’s monthly meeting on March 5.
Family members said no one from the health department even asked about where he had been in the days leading up to his illness. And no information was released to the public in general. Wilson, 74, died on March 21.
Now, with two more members of that group testing positive for COVID-19 — one of them hospitalized — questions mount about why more health departments and county officials aren’t providing tracking information.
“I’m surprised that to our knowledge they didn’t try to track down the origin of contracting the disease, that they didn’t interview my mother about the places my father had been,” said Dennis Wilson’s son, Luke Wilson, an area physician. “We just don’t understand why they wouldn’t have called, especially on the early cases of those who contracted the virus, to get an idea of where in the community it was spreading from.”
Joanna Wilson, Dennis’ wife, said a man from the Johnson County Department of Health and Environment contacted her on March 18 — two days after her husband was admitted to the ICU at AdventHealth’s main campus in Overland Park — to see if she had any symptoms. But she said he never asked for any information on where her husband had recently been or whom he’d been around.
“He called me when I was sitting at my husband’s bedside,” said Joanna Wilson, who has not had symptoms, was never tested and remains in self-quarantine in her Lenexa home. “He didn’t ask for a list or say to make a list, he didn’t say, ‘We’re going to be having somebody get in touch with you.’ I was just amazed.”
While some health departments are actively alerting those who may have been exposed to the virus, others have provided scant information to the public. And, at least in Dennis Wilson’s case, don’t appear to be alerting all those who may have been directly exposed to someone who tested positive.
The Star sent a list of questions to the Johnson County Department of Health and Environment asking about its tracking procedures. In its responses, the department said people who are identified as a “close contact” of a person with the coronavirus are notified by health officials.
“Close contact is defined as closer than six feet to the person for longer than 10 minutes,” Health Director Sanmi Areola said in an emailed response. “Others are not considered a close contact and at a very low risk of contracting the disease. There is no utility in describing the locations people have been to if there is a low risk.”
Yet a picture posted March 24 on Facebook of the March 5 meeting of the International Brotherhood of Magicians Ring 129 shows about 25 people watching a magic demonstration.
Two days later, a member asks, “Has the Ring contacted the CDC of this situation of the people contracting this virus? For the sake of the other people that were in the presents (sic) of it.”
The two others who have tested positive sat next to Wilson at the magicians’ gathering. The organization has kept its members informed through its Facebook page.
Areola said the health department did attempt to track where Wilson had been before becoming sick.
“The family was contacted about activities during the incubation period,” he said in the email to The Star — an assertion the family continues to dispute.
Areola said the department learned “secondhand” that Wilson had recently attended the magicians’ meeting but said that “using the CDC guidelines on when a person is infectious, it was deemed that Mr. Wilson was not infectious at that time, the risk of transmission was low, so attendees were not contacted.”
The World Health Organization estimates that COVID-19’s “incubation period” — the time between catching the virus and beginning to have symptoms — is from one to 14 days, with it most commonly around five days.
Wilson’s wife took him to an urgent care clinic on March 12, seven days after he attended the meeting. He’d been experiencing flu-like symptoms for several days.
Areola said that when determining what information about a specific exposure should made public, “The privacy and confidentiality of any person with a positive case of any disease is our first priority and dictates the amount of information that is released.”
“Just being present in an area does not constitute an exposure,” he said in the email. “The first goal of contact tracing is to identify individuals the patient had prolonged conversations/close contact with. If there are instances where an individual was in close contact with a number of unknown individuals (e.g., a conference), then we would release that on a case by case basis.”
Across Kansas, few counties are releasing details of possible coronavirus exposure to the public. Typically, county officials release the age and gender of the positive patient and nothing more.
Montgomery County, in the southeast part of the state, announced its first positive case Saturday night. The release stated that the patient was a man over the age of 60.
Before long, people online wanted more information:
“Citizens have a right to know what town this individual lives in,” one man wrote on the Montgomery County Chronicle’s Facebook page.
Added another: “How are we suppose to better protect ourselves if we don’t know what town?”
Others questioned why the county didn’t provide information on where the person had been and when.
Another Kansas county, Morris, with a population of roughly 6,000 about 120 miles southwest of Kansas City, did release specific exposure information after two individuals tested positive for the virus. The release included five locations the individuals visited in Council Grove on March 12 and 13 “while symptomatic.”
“Anyone who may have been at the same location and time and are symptomatic should call their health care provider,” the release stated.
In communities in southwest Missouri, many of them small and more rural than Johnson County, health departments have released information to calm anxious residents. Greene County, though, has roughly 300,000 residents and is where Springfield is located.
“We saw a lot of rumor mill and a lot of fear based on misinformation,” said Kathryn Wall, of the Springfield-Greene County Health Department. The decision was made in two cases to provide some details of the patients’ activities “to set the record straight.”
The second instance was Springfield’s fourth coronavirus case, and that person had been in contact with international travelers who had been visiting the area. A news release alerted the public to where the travelers and the local patient had been over four days earlier this month. The travelers were from France and were tested when they returned.
“They are considered cases there, and are not represented in our current case count,” the release said.
In order to protect the patients in each of those instances where exposure information was released to the public, the gender and age of the two were not provided. Each was identified simply as “our case” or “the case.”
With public health, one of the “central tenets” is a duty to warn, said Wall, the department’s public health information administrator.
“What that means to every community is unique,” Wall said. “We recognize in Springfield that we are overly cautious. … In these two scenarios there was just enough of a risk there we wanted to make sure people were aware of it.”
Camden County, near Lake of the Ozarks, recorded its first case of COVID-19 more than a week ago. Since then, several more have been confirmed.
Bee Dampier, that county’s health administrator, said that immediately after her office was notified of that first positive case, her staff spoke to people inside the patient’s household to determine where he may have been in recent days. Within hours, the office reached out to individuals the man — who was extremely ill — may have been in contact with.
Then it was time to give more information to the public, Dampier said.
“It was mostly to calm the fears of our citizens,” she said. “We had people clear on the other side of the lake freaking out.”
Last week, the county health department issued a release, including a list of several locations the person had visited between March 13 and 19, before testing.
That list included a Walmart, a grocery store in Sunrise Beach and the Camdenton bus barn.
Some counties around her are providing “exposure” information to the public and some aren’t, Dampier said.
“I think it has to be a community by community picture of what can be effective in your community,” she said. “You need to take into consideration, we’re a small, relatively rural area. You guys (in the Kansas City area) are metro. … It would be so much more difficult to track a case up there.”
But in Johnson County, officials said they must maintain residents’ privacy.
When three men tested positive for the coronavirus earlier this month, Kansas officials said only that they had been at a Florida conference together.
Officials did not name the conference. Nor say when they flew home or on what flight. Or give any details about where they’d been once they returned to Kansas.
When asked why, the department said in an email:
“Specific details will not be provided by our department in order to protect a person’s privacy. We cannot control what other entities decide to do. Reporting a conference that three individuals attended would have risked their anonymity.”
Yet when a Broward County man tested positive for the coronavirus earlier this month, the Florida Department of Health announced that the 70-year-old had attended an EMS conference in Tampa in early March. The agency recommended that anyone who attended the conference should notify their health department if they experienced any symptoms of the virus.
And after two Florida poll workers, who had been working the day of the primary earlier this month, tested positive, the public was informed. Officials identified the locations where the workers had been and what they had done there.
A government should release as much “aggregate information” as possible as long as it doesn’t identify a patient, stigmatize vulnerable groups and induce additional panic, said I. Glenn Cohen, a bioethics expert at Harvard Law School, in an email to The Star.
“Government always owes us transparency in general, but especially in a pandemic crisis when it is asking Americans to completely upend their daily lives and make sacrifices, sharing accurate information is necessary to maintain trust and make sure people continue to be willing to make those sacrifices,” he said. “So the default should be sharing information unless there is a very good reason not to.“
In Kansas and the Johnson County area, after the three men tested positive, some voiced frustration on social media about a lack of information during a global pandemic.
“Why on earth won’t they identify the conference that these guys attended? That’s irresponsible...,” one man tweeted.
Tweeted another: “WHAT CONFERENCE. Please tell us.”
Others wanted to know what flight the men were on and what airline.
Health officials didn’t provide further information.
Same with the Dennis Wilson case.
On Thursday — five days after his death — the manager at the hotel where the magicians’ meeting was held told The Star that no one from the health department had contacted him. He wasn’t aware that two others who were at the March 5 meeting at the Hampton Inn & Suites in Merriam also had tested positive for the virus.
“That’s a real shame,” said K.C. Hicks. “They definitely did not contact us. And I would have been the guy who would have gotten the call.”
Hicks said he had not heard of anyone becoming sick who had recently been at the hotel.
“I’m actually very grateful that my staff has been in good health,” he said.
Wilson was a retired school superintendent who served in districts in Kansas and Missouri. He died just five days after tests confirmed he had COVID-19, the first death to be reported in Johnson County.
For the past 25 years, Wilson had been a hobby magician, performing on stage and for corporate events, private functions, festivals, fairs and school fundraisers. Like the couple who is now sick, he was a member of the International Brotherhood of Magicians Ring 129, the organization’s Kansas City-area chapter.
All three had attended the chapter’s monthly meeting, according to the chapter president, David Sandy.
Roger Miller, a magician who attended the meeting with his wife, told The Star the couple was shocked when they learned from Joanna Wilson’s Facebook posts that Dennis Wilson, their longtime friend, had coronavirus.
“We started counting back on the calendar how many days it was, and if we were exposed would we show any symptoms by now?” Miller said. “We’ve had calls from friends wanting to know how we were doing. And knock on wood, we’re doing OK so far.”
Joanna Wilson told The Star that because the health department didn’t seem interested in tracking down the people her husband had been in recent contact with, she did it herself.
“I notified everybody that I knew we’d been around during the time we thought he had it,” she said. “But you don’t know what the parameters are in terms of how long or when things actually started.”
On March 10, two days before she took her husband to urgent care, the couple had gone to Parsons in southeast Kansas to visit some friends in the town where they previously lived. After her husband tested positive for coronavirus, Joanna Wilson let the people in Parsons know.
“And they reported it to their health department,” she said. “And do you know, the health department in that little bitty county, they have been monitoring them down there? They have to email their temperatures to them twice a day.
“I know Johnson County would be swamped in comparison — but you would think they’d be somewhat interested in doing the same thing. Especially since my husband died.”
This story was originally published March 31, 2020 at 5:00 AM.
