As Trumpcare emerges what will happen to the Sunshine Act and the healthcare transparency ecosystem?
When we look at the current COVID-19 crisis and the actions that will be required to restart our society as we know it, we’ll necessarily have to consider the impact on both our civil liberties and civil rights.
On Monday, April 7th Dr. Anthony Fauci, NIAID Director, was asked by a reporter when we will be able to get back to our normal way of life. Dr. Fauci replied, “If back to normal means acting like there never was a coronavirus problem, I don’t think that is going to happen until we have a situation where you can completely protect the population.”
Dr. Fauci went further to predict that the future may be very different. “But when we say getting back to normal, we mean something very different from what we’re going through right now,” he added, “cause right now, we’re in very intense mitigation. When we get back to normal, we will go back gradually to the point where we can function as a society.”
As a nation, we are clearly struggling to get this situation under control which is the issue at hand right now. But we are all wondering when will ‘StayAtHome’ and ‘Shelter in Place’ end? When will be able to return to school and work in safe virus free environments?
As our anxiety and fear about the future increase, we need to start seriously thinking about what the future will look like.So, what do your civil liberties and civil rights have to do with a functioning society in the age of coronavirus?
Before we answer these questions, let’s take a look at current COVID-19 management in Hong Kong, China.
The following is based on an account of a Chinese native re-entering Hong Kong during the coronavirus outbreak. Let’s call her Sue. Here’s how home quarantine is being managed for people who DO NOT have COVID-19 symptoms.
Upon arrival at the Hong Kong Airport Sue disembarked from the plane and joined a long queue waiting patiently with every other arriving passenger to be processed before being allowed to return to their homes.
While in line everyone was handed a packet of information and instructed to download a ‘StayHomeSafe’ app. The information packet contained manuals with COVID-19 information, advice hotlines, temperature charts, along with a COVID-19 testing kit. A wrist band, each with a unique QR code, was also provided to Sue which will link to the ‘StayHomeSafe’ app. The Border Protection Department uses the app to track all recently returned travelers. The wrist band and app are linked to the individual’s Hong Kong ID/Passport number, home address, and mobile phone.
Passengers who did not have a temperature were processed through emigration and returned to their homes. The next step in the process required Sue to spit into a bottle included in the test kit and send it to the nearest designated lab for testing. The results are returned to Sue within 24hrs indicating if she has the virus or the antibodies. Either way, home quarantine isolation is 14 days.
In the next step of the process, Sue opens the app, enters her PIN and walks around the extremities of her apartment to map the space. The app uses geofencing technology, which is different from GPS location tracking, created by a company called Compathnion Technology, based in China. If she ventures outside the mapped area in the next 14 days an alert goes to the health department and the police, who can easily find her using geolocation on her phone which is linked to the wrist band.
For anyone who breaks the rules, it is an immediate HKD25,000 ($3,200) fine and up to 6 months in prison. The app pings Sue’s phone a minimum 3 times per day to check her location, to ensure she is within her mapped area.
Sue also has to take her own temperature twice a day and enters it into a table which the government can request at any time.
Are you willing to?
- Wear a wrist band and download an app to your phone so the government can track your location during a pandemic?
- Spit into a test tube and have the government test you for coronavirus and antibodies?
- Stay in your home for 14 days of disciplined home quarantine?
- Share your personal health data with federal, state and local authorities?
First, let’s define civil liberties and civil rights. While often used interchangeably, there is a subtle difference. Scholars generally define “civil liberties” as freedom from government actions such as unreasonable searches and seizures. In contrast, “civil rights” are commonly understood to be rights that are afforded to citizens by the government, such as the right to privacy or freedom of speech.
As of this writing, during this pandemic, our Federal Government has not established laws “for the good of the community” as China, Singapore, and South Korea have. But local communities and states are starting to exhibit trends toward limiting people’s movement within and across state borders. But contact tracing to identify all individuals with whom you may have come into contact and geo-tracking people to ensure home quarantine and the sharing of personally identifiable information has yet to go into effect here in the US.
On Monday, April 6th, Kittery Maine’s town Manager Kendra Amaral sent a letter to the governor requesting that municipalities be provided with addresses of positive COVID-19 cases. The town of Kittery has just under 10,000 residents. In a Seacoast Online article, Amaral said, “Not doing so effectively withholds vital information from the first responders about the risk of exposure when responding to a call for public safety service.”
As Dr. Fauci stated, our new normal is going to be something very different from what we are going through right now. We can’t stay confined to our homes indefinitely. But when and how should we reintegrate into society and what are we willing to change regarding our civil liberties? As a COVID-19 survivor, I’m anxious to get back to a somewhat normal way of life.
I’m lucky because I experienced a mild case of COVID-19, but will I be profiled and avoided by family, friends, and co-workers who are afraid of catching the virus?
Do I have to wear a mask now since I’m presumably immune to the virus?
How can we tell who has the virus and may be contagious?
How can we tell who has yet to contract the virus?
How can we tell who has recovered from the virus and is no longer contagious?
Do you know which category you fall into?
On March 24th Bill Gates wrote an opinion piece for the Washington Post Here’s how to make up for lost time on COVID-19 he states a three-prong approach to solving the problem and getting back to our new normal in a post-COVID-19 world.
“First, we need a consistent nationwide approach to shutting down.
Second, the federal government needs to step up on testing.
Finally, we need a data-based approach to developing treatments and a vaccine.
To bring the disease to an end, we’ll need a safe and effective vaccine. If we do everything right, we could have one in less than 18 months — about the fastest a vaccine has ever been developed (Vaccine development typically takes 3–4years). But creating a vaccine is only half the battle. To protect Americans and people around the world, we’ll need to manufacture billions of doses. (Without a vaccine, developing countries are at even greater risk than wealthy ones, because it’s even harder for them to do physical distancing and shutdowns.) We can start now by building the facilities where these vaccines will be made.”
So, if we are looking at least a year to develop a vaccine and then another year or two to develop and treat billions of people all over the world, how and when do we begin reintegration into society?
Just a few more questions to ponder.
Do we require all Americans to be tested and carry identification indicating our health status?
Are only people who have recovered from COVID-19 allowed to reintegrate into society?
Are we willing to take the risk of contracting the coronavirus when going to work until a vaccine is available?
Are we willing to share our health status with employers, gyms, local restaurants, and hair salons so we may gain entry into a virus-free environment?
Who will ensure that our public spaces are virus-free?
How will employers ensure that work environments are virus-free?
How will employers ensure that workers remain at the proper social distance and practice good hygiene to limit the spread of the virus?
Imagine if our government decided to open schools and kindergarten as Denmark is doing next week. How do we know who has the virus and who doesn’t? Will we accept virus spread during reintegration? Will we hold the school responsible if our children contract the virus? How will schoolteachers enforce social distancing and good hygiene for a classroom full of students? Do 5 and 6-year-old children understand social distancing?
All of the above questions relate back to the original premise of our civil liberties and sharing our personally identifiable information. But none of the questions can be answered without testing.
And this is the area where we are woefully behind. People will need multiple tests as we navigate the re-integration into society. The President has already had multiple tests, shouldn’t every American be entitled to the same level of healthcare?
Until we have rapid and available testing, we will not know the full extent of the coronavirus. States like Rhode Island are making strides to combat the virus through rapid tests and scaling throughput to 1,000 people per day. Rhode Island Gov. Gina Raimondo (D) said in a statement yesterday “Thanks to the partnership and generosity of CVS Health, we will be able to double our testing capacity and provide on-the-spot results to thousands of Rhode Islanders each day.”
On March 16th the World Health Organization (WHO) Director-General, Tedros Adhanom Ghebreyesus, MD pronounced in a media briefing, “But the most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate.
You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected. We have a simple message for all countries: test, test, test. Test every suspected case. If they test positive, isolate them and find out who they have been in close contact with up to 2 days before they developed symptoms, and test those people too. [NOTE: WHO recommends testing contacts of confirmed cases only if they show symptoms of COVID-19].”
While we begin to think about how much of our personal data, we are willing to share and how our civil liberties and civil rights will change in order to reintegrate into society, we should all focus on testing.
As the WHO Director-General stated, Bill Gates and I agree, testing should be the primary focus.