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Cascade City-County Health Department explains privacy laws

City-County Health Department explains privacy laws
Posted at 2:28 PM, Jun 16, 2020
and last updated 2020-06-16 16:28:37-04

Public health officials announced over the weekend that two new cases of COVID-19 have been confirmed in Cascade County.

The City-County Health Department in Great Falls said on Saturday: "This individual is a woman in her 50s with no history of travel or contact with a known case. The origin of this patient's infection cannot be determined, suggesting this infection was community-acquired." The case reported on Sunday is a man in his 60s, and also likely community-acquired, the CCHD said. The agency did not release any other details about either case.

As with previous reporting of COVID-19 cases, the lack of specific information - such as where a patient lives or works, or where the person may have traveled - has some people upset, but the disclosure of patient information is regulated at both the federal and the state level.

Trisha Gardner, the health officer of the City-County Health Department, shared the following information in a Facebook post on Monday to explain what information they can and can not release.

As many of you will already know, the State lab notified us this weekend about our two most recent cases. Both these cases have no clear source of infection, suggesting that these two infections were community-acquired transmission.

The City-County Health Department strictly adheres to the privacy rules laid out in the Health Insurance Portability and Accountability Act (commonly referred to as HIPAA). Montana has its own set of privacy laws, the Government Health Care Information Act, which are even more restrictive about what health departments are able to share. These laws are determined at state and federal levels and prevent us from disclosing any of our patients’ personally identifiable information to the public.

Some details may seem minor, such as the town someone lives in or where they have traveled, those details could in fact be enough to identify the patient. If the health department disclosed that a case lived in a specific town, almost any town in Montana is small enough that community members could say, “Well, I live in Small Town USA, and the only person I’ve seen with a cough for two weeks is my neighbor Jim. Jim has COVID!”

Or, imagine that CCHD tells the public that someone acquired COVID-19 while traveling to Norway. Traveling to Norway is rare enough that knowing that detail could inadvertently reveal the identity of someone with COVID-19, and their identity could then be shared with their community. This is why HIPAA exists, and it’s why we don’t disclose personally identifiable information about new cases, no matter what.

We also want our patients to trust that we will not share any of their information or anything that could potentially reveal their identity. It is possible that someone with COVID-19 could be ostracized. Anyone diagnosed with COVID-19 needs to be able to trust that they can cooperate with CCHD without fear of backlash or judgment from the community.

If a patient doesn’t trust us enough to cooperate fully with the contact investigation, then we will not be able to track down everyone who could have been exposed. So, rest assured, if you ever test positive for COVID-19, CCHD will not release any information that could compromise your privacy.

Here’s what CCHD will do: our experienced public health nurses will conduct a thorough, prompt contact investigation every time we receive notification of a case.

If you are diagnosed with COVID-19, someone from the health department will call to interview you. Here is what they will talk to you about:
• They will check on your health
• They will discuss who you’ve been in contact with since several days before you first started experiencing symptoms. This helps us identify close contacts from the time when you could have been an asymptomatic carrier of the infection.
• They will tell you to stay home and self-isolate
- Self-isolation means staying at home in a specific room, away from other people and pets, and using a separate bathroom if possible
- Self-isolation is critical to protecting those who you live with as well as your community
- Self-isolation helps slow the spread of COVID-19 and can help keep your friends & neighbors healthy
- If you need support or assistance while self-isolating, CCHD or other community organizations may be able to provide assistance.
- Call ahead to a clinic or hospital and seek medical care if your symptoms become severe. Severe symptoms include trouble breathing, persistent pain or pressure in the chest, confusion, inability to wake or stay awake, and blue-ish lips or face.

After that, the health department case investigator will call everyone who was listed as a close contact. This may include businesses or workplaces when applicable.
• A close contact is someone who was within 6 feet of a person with COVID-19 for at least 15 minutes.
• If you are a close contact, CCHD will encourage you to be tested, and you will be told to stay at home and self-quarantine for 14 days, starting from the most recent day that you were possibly exposed to COVID-19. The health department investigator will inform you of the dates of your quarantine.
- Self-quarantine means staying home, monitoring yourself, and maintaining social distancing (at least 6 feet from others at all times). You should remain in a specific room separate from other non-exposed people & pets in your home, and use a separate bathroom, if possible.
- If you need to be around other people or animals in or outside of the home, wear a cloth face covering. This will help protect the people around you.
- If you need support or assistance with self-quarantine, then your health department or community organizations may be able to provide assistance.
- Self-quarantine helps slow the spread of COVID-19 and can help keep your friends and neighbors healthy.
- Even if you are tested and it comes back negative, you will still be told to finish your fourteen-day quarantine. This is because it can take up to fourteen days for symptoms to develop and the virus to become detectable.
• You should monitor yourself for any symptoms of COVID-19 and notify the health department if you develop any symptoms. If you get any severe symptoms, call ahead and seek medical care.

What are key actions you can take to slow the spread of COVID-19 in our community?
• Pick up the phone when the health department calls, and follow the guidance they give you.
• If you are ill and need medical assistance, notify your healthcare provider first.
• Remember that now is the time to stay aware and make wise choices about your activities. Even though Cascade County doesn’t have as many cases as other counties, we are still seeing transmission within our community.
• We encourage residents to continue to diligently take the same prevention measures we have promoted all along:
- Stay home when you are sick
- Wash your hands frequently
- Don’t touch your face
- Cough into a sleeve or tissue (and then dispose of the tissue immediately)
- Disinfect frequently touched surfaces
- Wear a face covering when social distancing is difficult to maintain
- Social distance whenever possible
- Avoid large group gatherings

The bottom line is simple: Making a choice to help your health department in the fight against COVID-19 keeps you, your family, and your community safe. If you have any questions, call CCHD at 406-454-6950 or email us at health@cascadecountymt.gov. Stay healthy, Cascade County!

The CCHD says if you have symptoms consistent with COVID-19, call your healthcare provider and arrange to get tested. If you do not have symptoms but would like to be tested, visit Alluvion Health’s drive-through testing clinic (open 7 days a week, located in Westgate Mall parking lot). Call 406-791-7929 or visit AlluvionHealth.org for more information.