To share or not to share? Cities, towns wrestle over whether to release COVID-19 case counts

  • The gates of Look Memorial Park in Florence were closed and the pedestrian entrance ways blocked with plastic fencing Saturday morning, April 4, as a result of a Northampton Health Department order during the COVID-19 pandemic.  GAZETTE FILE PHOTO

Staff Writer
Published: 4/10/2020 4:49:03 PM

NORTHAMPTON — As COVID-19 cases increase in western Massachusetts, many wonder how widespread the novel coronavirus is in their own city or town.

Bri Eichstaedt, a health agent in Easthampton, said that some residents have asked her about the health of specific people who live in the city. “I’ve gotten some calls saying, does this person have it? Does my neighbor have it?” she said.

HIPAA, the federal health privacy law, prevents sharing any information that detailed, she continued, and “whether your neighbor has it or not, you should be practicing social distancing.”

Of the nearly 19,000 statewide confirmed COVID-19 cases, 177 are in Hampshire County, 128 in Franklin County and 1,276 are in Hampden County, according to the Massachusetts Department of Public Health figures released Thursday. 

Municipalities have grappled with whether or not to make their case counts public. Some cities and towns post daily updates on the number of confirmed cases, while others have decided not to, citing privacy issues and other concerns. Still other towns have reversed their policies and recently stopped or started publicly posting case counts.

The state Department of Public Health has put the onus of whether to release the numbers or not on individual cities and towns.

“The Massachusetts Department of Public Health only shares positive case numbers and deaths by county,” a DPH spokesperson wrote in an email to the Gazette Tuesday. “DPH recommends that local boards of health respect the privacy and confidentiality of residents when providing case counts.” 

The DPH spokesperson also detailed the guidance it recently gave to local boards of health, including that if towns do share case or death counts, “please do so with the highest regard for privacy and confidentiality by not including any information other than the case count.”

Northampton saw its first confirmed case on March 18, but city officials did not publicize that for about a week. On March 26, the same day that Mayor David Narkewicz announced he had tested positive for COVID-19, the Health Department, in response to a Gazette query, said that four other people tested positive in the city. But as a rule, the city will not share a daily figure, citing HIPAA privacy laws, according to local health officials. 

“The case count is currently not high enough for us to release a count without compromising the confidential health information of our residents,” Jennifer Meyer, the city’s public health nurse, told the Gazette via email in late March. 

“That was where we were in late March,” Meyer said Friday. “In continuing to evaluate, whether we have five or 500 cases, releasing that data is not going to change what we’re saying.” The Health Department’s guidance is to only leave home for essential reasons, to socially distance from others, and to wash hands frequently.

Meyer also pointed out that the numbers don’t tell the whole story.

“The data is very smushy,” she said. “There is community spread, but there are cases that are not in our number. We can’t even anticipate how underreported they may be in the absence of testing … That’s what makes this so tough. We’re constantly asking ourselves, ‘What’s the line? How do we manage it?’ It’s about privacy but also about what’s the best use of our time: communicating to keep ourselves safe versus obsessing over a number? We’re feeling a lot right now, and we’re all trying to make sense of it. But numbers without context don’t mean a whole lot.”

That context is often an individual’s personal health information, which is “unsharable,” Meyer said. “Without that context, which is unreleasable, we feel that numbers will either create a false sense of calm, or invoke hysteria, neither of which would change our guidelines for how to best keep oneself safe.”

Eichstaedt agreed. However many people have COVID-19 in a city, all residents should be taking precautions, she said. “I understand everybody is curious and wants to know. I really do get that. But we really need to be assuming that everyone has it.”

Other municipalities view the issue differently.

Releasing the numbers and being transparent is critical, said Holyoke Mayor Alex Morse: “At the end of the day, it’s important for people to know how many cases we have in the city. It’s important for the community to understand the gravity of the situation.”

A daily report on the City of Holyoke’s website includes an updated count of confirmed COVID-19 cases. As of Thursday, 219 residents had tested positive — but the numbers, Morse noted, echoing Meyer’s point, do not show the full picture. “They are obviously not accurate given the low availability of testing,” he said of the case count. “They are likely much higher.”

The city is aware of privacy concerns as well. “That is why we are not disclosing anything by facility or by location — with the exception of the Soldiers’ Home,” said the mayor’s chief of staff, Mike Bloomberg.

Morse is interested in breaking down Holyoke’s data by race and ethnicity to identify potential disparities. A disproportionate number of black Americans require hospitalization to treat COVID-19, according to a Centers for Disease Control and Prevention report released Wednesday analyzing roughly 1,500 cases.

Other municipalities are also releasing case information. Last week, South Hadley posted figures on its website alerting residents that the town had approximately 30 COVID-19 cases that were either confirmed, suspected or pending. And in Southampton on Thursday, Town Administrator announced that a 69-year-old resident had died, the town’s first COVID-19 related death. 

Local officials grapple with release decision

Late last month, Easthampton Mayor Nicole LaChapelle included a city-specific COVID-19 case count in some of her office’s daily pandemic reports. At that time, she said that there were eight confirmed cases in the city.

“I did not feel great about releasing the case count,” LaChapelle said. Soon after, when the DPH released its guidelines cautioning local health officials sharing numbers to do so with the “highest regard for privacy and confidentiality,” LaChapelle announced the city would stop publicizing the figure.

“They made a very strong case that really resonated with me on not doing the counts by city,” she said.

Hadley officials followed a similar trajectory. The town posted case counts until early April when the Board of Health announced it was changing course and no longer posting the numbers. 

“Early on, when we realized that there was going to be a pandemic and a big issue with COVID-19, we agreed we would follow the Department of Public Health guidelines,” said Hadley Board of Health member Greg Mish. “We’re a small town. We’re a small board — we don’t have any full-time staff. We really do rely on them for guidance and help.”

Not all town officials agree with the Hadley Board of Health’s decision to stop releasing regular counts. Select Board member David J. Fill II expressed his frustration about the policy on his public Facebook page, which he uses to communicate with residents.

“I am speaking only for myself, not the rest of the board, but believe this is irresponsible and undermines our credibility,” he wrote. “Not having an accurate and dependable source of data only serves to increase rumors and misinformation.” He declined to speak further on the record about his stance when contacted by the Gazette.  

Initially, Amherst officials did not release a case count. “Then, because a lot of other communities are releasing individuals numbers, it made me worry,” Town Manager Paul Bockelman said at a Town Council meeting on Monday. “People might start to question, why are you not releasing the numbers?” The town started putting the figures on its website, and as of Thursday, there were 11 confirmed cases.

Bockelman doesn’t see any harm in releasing the figures. “If it would quash a little bit of any of the sort of skepticism,” he said at the meeting, “we thought it would be a benefit.”

However, Julie Federman, the town’s health director, said at the meeting that there is some risk in sharing the number when testing is not at full capacity.

“We don’t want people to sort of take heart that we only have 10 tested and confirmed cases,” she said Monday. “Because, really, the virus is in western Massachusetts, and we all have to protect ourselves.”

Greta Jochem can be reached at gjochem@gazettenet.com.




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