The Biscayne Times

Monday
Aug 10th
Danger All Around Us PDF Print E-mail
Written by Francisco Alvarado, BT Contributor; Front cover and story photos by Armando Colls   
April 2020

Even as coronavirus rages on, the state shields vital information from public view

PCovericture this scenario: You log on to the Florida Department of Health’s COVID-19 online dashboard and click on a map of Miami-Dade County showing confirmed cases over the previous 24 hours. The map contains red dots that show the physical movements of infected individuals before they were diagnosed. How? Using cellphone GPS data and interviews -- both with permission and cooperation of the patient.

You click on a red dot that opens a window with the following information:

On Thursday, March 12, the infected individual reports he visited the Publix at 1776 Biscayne Blvd. at approximately 3:00 p.m. He was not wearing latex gloves and touched these objects: hand rails of the escalator from parking garage to store, packets of Greenwise chicken breasts, various fruits and vegetables, and cold cuts sliced and packed by a deli section employee. The individual used a debit card and entered his PIN at one of the Express checkouts.

On Friday, March 13, at approximately 8:30 a.m., he used the outdoor gym at Margaret Pace Park and touched most of the equipment.

Virus_1At that moment, you take a big gulp and notice a little tightness in your throat. You remember using the same gym equipment just an hour after the infected individual did. You try to count the number of times you touched your face to wipe off sweat after gripping the exercise machines. While you don’t show any symptoms, you make the decision to self-isolate until the end of March and stay inside your Edgewater condo.

In reality, you cannot find this level of detailed information on the state’s COVID-19 online dashboard. The most you can pry from the interactive website are statistics on a city-by-city basis. In fact, in Florida and the rest of the U.S., government health officials are prioritizing the privacy of patients over providing the public with detailed coronavirus data.

Tracking an infected individual’s prior physical movements could be a powerful tool for residents and public officials. With more granular information about the places frequented by a person who contracted the coronavrius, better decisions could be made for deployment of resources wherever there is cluster or a hot spot.

Virus_2When the Zika virus was attacking expectant mothers and their fetuses in 2017, local, state, and federal health officials were able to pinpoint geographical locations in Wynwood and South Beach where infected mosquitoes had been trapped. This allowed the Centers for Disease Control to issue travel warnings about those areas for pregnant women, women who want children, and their sexual partners. An outbreak of Zika, which can produce birth defects, had spread from Brazil across 86 countries, and Miami-Dade was ground zero in the U.S.

Three years later, Miami-Dade is a major center of another global viral threat, but much deadlier and indiscriminate than Zika. As of March 31, a total of 1926 county residents had contracted the novel coronavirus, the source of a pandemic that has infected more than 838,000 people and caused more than 41,000 deaths worldwide. Six of the casualties have been in Miami-Dade, which has the highest number of infected people statewide.

Yet unlike the Zika response, there is a severe lack of precise geographical data about confirmed and pending coronavirus cases available to the public. The Florida Department of Health, the agency in charge of releasing information on confirmed cases of COVID-19, the disease caused by the coronavirus, initially only provided numbers by county in the first three weeks of March, when the state’s outbreak began. Now the department provides statistics by city, but the general public has to go digging for the information on a cumbersome website. In addition, information about the number of cases at individual hospitals, assisted living facilities, and nursing homes has not been made available.

Virus_3tate authorities, including Gov. Ron DeSantis, have said they are reluctant to release more detailed information to protect patient privacy. Even Miami-Dade’s top elected official, Mayor Carlos Gimenez, can’t get precise geographical data on confirmed coronavirus cases. In a March 20 phone interview, Gimenez told Biscayne Times that he and his staff have asked state health department officials to release more geographical information about the positive cases in Miami-Dade.

“They have that information, but they don’t give it out,” Gimenez says. “We can’t do anything on our own. It’s all controlled by the state.”

In an e-mailed statement, a Florida Health spokesperson said the department will not compromise a patient’s confidentiality as it decides what information to disseminate to Florida residents.

“The Department of Health is adhering to state law intended to protect disease-exposed individuals from being identified, while also ensuring the general public have the information they need to prioritize their health and remain safe,” the statement says.

Covit_chartTo be sure, disclosing the exact geographical location (a home address) of a confirmed coronavirus case would likely violate the federal Health Insurance Portability and Accountability Act, or HIPAA, because it would identify specific information about a person’s medical condition, says Pamela Marsh, president of the First Amendment Foundation, an open-government organization based in Tallahassee. But she says disclosing which hospitals, assisted living facilities, and nursing homes have treated confirmed coronavirus patients would be fair game.

“Generally identifying which health-care facilities have had positive cases of COVID-19 would not, in my opinion, violate HIPAA because it would not identify the medical condition of any specific person,” Marsh says. “Rather, the information is vital to public health and to families with loved ones in facilities that are closed.”

Gimenez says information that shows where coronavirus cases are originating would allow the county to identify hotspots. “You can put stricter measures, get more testing into that hotspot, and do more to protect the elderly and our vulnerable population,” he adds. “I would hope if the state sees a hotspot, they would say, ‘Hey, can you help us?” so we can work hand-in-hand to do whatever is necessary to contain it in a specific area.”

Florida Health’s spokesperson insists the department and the governor’s office have taken numerous proactive and preventative actions to protect the well-being of the state’s residents. For instance, the number of confirmed cases by city was added to the state’s daily updates on March 21.

Virus_5“To keep Florida residents and visitors safe, informed, and aware about the status of the virus, this dashboard will be updated twice daily,” the spokesperson said. “Additionally, the Division of Emergency Management works diligently to issue a daily report with city-specific data to ensure Floridians have access to risk assessments in their area.”

However, the city-specific data are not easy to track down, and not always reliable.

To find confirmed case counts by city, Florida residents must access the Health Department’s twice-daily updates via floridahealthcovid19.gov.

From there, it is not a user-friendly experience. A person has to scroll down the web page and click an orange box that is titled “Review case, monitoring and PUI information on the latest COVID-19 Daily Report.” The orange box is labeled “See the report.” No mention of city-by-city information.

Clicking the report box opens a pdf file of the daily update. The report, which is more than 50 pages, lacks a table of contents, forcing users to scroll down to the fourth page, which contains a chart that lists the number of confirmed cases by city.

But the information is not completely accurate. The count for the City of Miami appears to include cases in unincorporated Miami-Dade. There is no breakdown by neighborhood, so there is no way to know how many of the 1047 Miami cases reported on March 31 are in the Upper Eastside or Brickell.

Cities are not listed alphabetically, but rather by number of COVID-19 cases. To find out that Aventura has 30 confirmed cases, a person must scroll to page 5. A Miami Shores resident would have to scroll to page 8 to find that the village is listed among municipalities from 21 other counties that each have two confirmed cases.

The state only began releasing city numbers on March 22, about three weeks into the pandemic sweeping into Florida. And recently, WLRN reported about abnormalities in the state’s daily updates, including instances in which information about reported COVID-19 cases altogether disappeared, was removed and then re-added, or may have been altered, calling into question its accuracy.

Local governments in other states and nations have taken more proactive steps to provide residents with precise geographical data on confirmed coronavirus cases. In California, where 7477 confirmed cases have been reported, Los Angeles County puts out daily updates that list the number of positive cases in all 27 neighborhoods in the City of Los Angeles, plus 22 neighboring cities.

Government officials in Basque Country, an autonomous community in northern Spain, created an online dashboard that identifies hotspots with red dots on a map, has a pie chart showing the neighborhoods with the highest percentage of cases, and the top five cities with confirmed cases based on the rate of infection per 100,000 people.

In South Korea and Israel, government leaders have pushed the fine line between protecting the health and safety of the public and encroaching on civil liberties. South Korea used cell phone and credit card data from infected patients to trace their prior movements and find their contacts, according to the New York Times. The information was used to contact the cellphones of everyone who may have been near an infected person before they became ill. Anyone who was potentially exposed is quarantined at home and a GPS application tells police if the person goes outside, which carried an $8000 fine.

Israeli Prime Minister Benjamin Netanyahu enacted a similarly controversial measure when he ordered his country’s domestic spy agency to launch cellphone surveillance of individuals who were near someone sick with the coronavirus. Those people received text messages ordering them to self-isolate for 14 days.

Pamela Marsh, who was the former U.S. Attorney for the Northern District of Florida before heading the First Amendment Foundation, says such tracking of citizens’ movements here would violate their constitutional rights. “Unless there was some way a person could voluntarily ‘opt in’ to being tracked for health purposes, our laws would not permit such surveillance without the citizen’s informed consent,” she explains.

Even if a person opted in, there would still be a host of concerns about who obtains that information and how it is used, she says. “Who’s going to collect this information? The NSA? Google?” Marsh asks. “Is there anyone our citizens would trust to collect and hold this kind of personal, private information? This would be an enormous overreach by any level of government in our country.”

Still, medical ethicists argue that sharing more information about a patient’s prior movements is critical to containing the coronavirus crisis. In a recent New York Times article, New York University bioethics professor Arthur L. Caplan complained that using HIPAA as justification for limiting the release of coronavirus case data is “ridiculous,” and that the law “was written for a time when there were paper charts.”

The coronavirus, Caplan said, “will cause us to rethink a lot of things. We will also have to plan for better data exchange and testing.”

I. Glenn Cohen, an expert in bioethics at Harvard Law School, told the Times that sharing more data would strengthen the public’s trust in following the advice of health officials to stay home and practice social distancing.

“If the public feels as though they are being misled or misinformed, their willingness to make sacrifices -- in this case social distancing -- is reduced,” Cohen said. “That’s a strong argument for sharing as much information as you can.”

 

Feedback: This e-mail address is being protected from spambots. You need JavaScript enabled to view it


 

Art and Culture

ArtFeature_1BLM and COVID force a shift in themes

Read more...

Art Listings

Events Calendar

BizBuzz

Sales, special events, and more from the people who make Biscayne Times possible

Read more...

Picture Story

Pix_PictureStory_7-20A view of our past from the archives of HistoryMiami

Read more...