As the number of people testing positive for coronavirus in Maine rapidly increases, state authorities have generally been disclosing only the county where each person lives, rather than the town, leaving the public wondering whether the disease has been detected next door or many miles away.
The Maine Center for Disease Control’s practice mirrors federal policy and is followed by many other states, including all of those in New England, New York and New Jersey, said the agency’s spokesman, Robert Long.
“Maine CDC would release more detailed identifying information for specific instances when it can be part of a strategy to help reduce potential community spread,” Long said. The CDC did this in the cases at the OceanView retirement community in Falmouth, he said, in order “to limit community spread for a community with elevated potential risk.”
As of Tuesday, Maine had 32 confirmed or presumptive cases of coronavirus in seven counties: York, Cumberland, Androscoggin, Oxford, Lincoln, Knox and Kennebec.
Former Maine CDC director Dora Anne Mills – a senior official at MaineHealth and the sister of Gov. Janet Mills – said the practice of naming the county of residence originated with the passage of the federal Health Insurance Portability and Accountability Act in 1996, which set privacy standards for patient health information. Further information can be disclosed if there is a compelling public health rationale, and Mills said there isn’t with most cases of the new coronavirus, which causes the disease COVID-19.
“This is a fairly contagious disease, so people should not think if the disease is detected in Farmington it’s not in Chesterville,” Mills said, citing two towns in her native Franklin County, which as of Tuesday did not have a confirmed case.
Mical Raz, a public policy and health professor at the University of Rochester in New York, agreed that the Maine practice is sound.
“With the cases doubling in Maine, and in the absence of widespread available testing, it is nearly certain that we have widespread community transmission that we are not sufficiently detecting without testing,” Raz said via email. “It no longer matters if the CDC reveals counties or smaller units — essentially it is everywhere.”
“People should take it seriously throughout the state and throughout the nation,” she added. “In fact, if we said it is in one town and not in the other, people might be complacent. Right now we should assume it is everywhere.”
Jeremy Youde, a global health policy expert at the University of Minnesota Duluth, said providing more specific information can have a downside for public health, potentially scaring people away from interacting with the medical system for fear of being publicly exposed.
“You don’t want to give so much information that you could triangulate and somebody would be able to say that, ‘Oh, it’s this person,'” he said. “The fear is that people will withdraw from the system because they’ll say, ‘Oh, God, someone will know who I am.'” He said Maine’s approach appears to strike a proper balance between protecting privacy and serving public health imperatives.
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