By the Moonshine Ink Editorial Board
In a break from the norm, we have decided to publish our opinion as a team.
April 11 marked the date the U.S. COVID-19 death toll surpassed that of Italy, once thought to be the epicenter of the outbreak. With this news, the suspicion that America’s response to the novel coronavirus has been lacking was confirmed. The virus, with its longer incubation period and silent contagion, has effectively exposed our country’s weak spots, such as the federal government’s dismantling of our pandemic unit in 2018. The time is now to identify any further weak spots and deal with them head-on. In our rural community, the Moonshine Ink team believes we need to lift the veil of secrecy that some public health officials have refused to move.
We know Tahoe/Truckee has been identified as a potential “hotspot” in California (it’s debatable, see Tahoe Peak or Plateau?), yet information on testing and disease transmission has been hard to come by. So has reporting directly from the frontline.
The best way to combat an uncontrollably spiking death toll is to spread real information, not germs. As the novel coronavirus’s effects rocket around the world and through our lives, we are in fast-track learning mode.
Moonshine Ink’s team pivoted to breaking news and as we’ve done so we’ve been running into barriers around key information. Local officials have cited patient confidentiality as a reason to keep data, as well as access to the frontline, under wraps. Thus, our community remains in the dark.
Singapore and South Korea contained disease transmission in part by campaigns to inform the public about positive cases and where these patients traveled. In a word, these countries have experienced success in fighting the spread of the virus by being transparent.
(It bears mentioning that the larger part of their effective strategies was aggressive testing. Our country, caught up some kind of creek without a paddle, has nowhere near the testing capacity, thus that tool in the arsenal is rendered null and void. Hence why we have extensive ‘stay at home’ orders.)
With case numbers and global trends changing by the minute rather than by the day, each hour is as important as the last. We need to know as much detail about each case’s location, severity, and likely path of travel, and time is of the essence. Our community needs to know the reality; how many people are infected, what’s happening in our hospitals, are enough of us being tested, and will we have enough beds, ventilators, and space to treat severe cases when our region reaches peak case count?
We’ve been working to compile a complete database of cases in our coverage area and have reached out to each entity in turn. After repeated attempts, we have not yet received the full data.
The standard for sharing data has been uneven. In the beginning, Washoe County, which carries the highest number of cases in our coverage area, shared gender and age of the patient for each positive identified. As greater numbers are being announced every day, those details, along with the method of assumed transmission (via international travel, domestic travel, or within the local community) and status of each patient have disappeared. We’ve reached out, assuming that with dozens of cases a day and 11 deaths reported as of press time, they had the information but weren’t sharing it for efficiency’s sake. But apparently, the county prefers not to share the data, as it’s yet to arrive.
Until the beginning of April, Placer County’s COVID-specific page updated case totals fairly regularly (it is of note that they stopped sending press release updates early on), but didn’t show much more than limited regional and demographic breakdowns. Washoe, Placer, and El Dorado counties are now displaying on their respective websites how many patients have required hospitalization (with Placer specifying ICU-dependent patients).
Positive case identification is one metric to determine the disease’s spread. Testing totals provide another. Nevada County’s dashboard was the first to show case counts by date, but they have yet to add any testing information. The Tahoe Forest Health System has made it clear that it considers testing totals not public information. Placer and El Dorado counties are currently the only two of our coverage counties disclosing testing totals (rather than just positives). This information is vital in understanding how widespread the virus is at a given point.
Today, Placer County has vastly improved the presentation of and access to their data, providing a public dashboard that goes well beyond those of other local governments. We would like to see more details about the specific local movement of COVID-positive individuals, as well as assumed or confirmed transmissions, but we appreciate the improvement. Their tool as of press time breaks down the locations of infected parties, testing totals (including negative and pending results), demographics of infected persons, and day-by-day breakdowns of new cases. We encourage Placer to continue to expand and innovate ways to make more information accessible, and for other local entities to take note.
When we learned that Nevada County’s first confirmed COVID-19 case was likely contracted when traveling, we asked which countries, or even just continents, the patient had been to, but were told that information is confidential due to privacy issues.
To resist sharing information or providing access to healthcare facilities, the invocation of patient confidentiality, often under the umbrella of HIPAA, the Health Insurance Portability and Accountability Act passed by Congress in 1996, is commonplace. Yet HIPAA doesn’t limit journalists talking to healthcare workers or getting data that is scrubbed of identification info. Moreover the public needs to see and feel the reality of what’s going on in our hospitals (always with social distancing and safety in mind, of course). Tahoe Forest Health System has a pre-existing policy against media photography inside, which has been tightened and expanded during the pandemic.
Our editorial team has been in constant communication with the officials responding to this pandemic. We want to thank these contacts genuinely for their unending work to combat COVID-19 and their aid in our reporting efforts. At the same time, it is our job to call for transparency in government.
The free press was established by our country’s founders to be the watchdog of government. It was by intention that this “fourth estate” was placed outside the corridors of power so that it could act as an independent check. But in order to double- and triple-check the statements and numbers put forward by the frontline institutions, we need full access. The Freedom of Information Act normally provides an avenue to enforce public information to be shared, but the agency has ground to a halt in the face of the pandemic.
There’s an urgency for the transparency we’re asking for. We believe people are far more likely to respond to government orders when armed with all the information and reporting to understand the threat they’re staying home to fight.
We understand the difficult balance between public disclosure and not inciting panic.
But to fight the virus, we need an army of informed and engaged citizens. Join us in asking the public health departments and hospitals to share details about cases, where transmission clusters have been found, and to do so expeditiously. Demand they give frontline access to our local media, an essential business as defined by the federal government, so we can report firsthand. Join our quest for transparency.