Sacrificing health privacy on the route to normalcy
Americans value liberty and privacy greater than everything else. One of the reasons that this pandemic has been so hard for our society is that responding to this crisis requires infringements upon both. If we are going to minimize the sickness and deaths caused by COVID- 19, we will have to, temporarily, continue to give up some of our freedoms.
We have already seen our attitudes toward privacy dramatically changing in the first few months of this pandemic. People want to know the zip codes with the highest rates of infection, which nursing homes have had COVID related deaths, and who the “super- spreaders” are. People openly share their risk factors— heart disease, diabetes, asthma— as a means of justifying their isolation.
Never before in our society have we considered disallowing employment or free movement based on disease status or immunity. In normal times, this would be considered discriminatory and likely illegal. But in the time of a global public health crisis, it would be wrong not to treat those without immunity differently. Our society has an obligation to protect them through policy and the non- immune have an obligation to stay home, wear a mask and protect the rest of us from the virus.
Antibody testing will become as normal as a blood pressure screen at CVS. Those with immuno- privilege will be able to enjoy restaurants, sporting events and activities at large public venues. Those without immunity will be isolated for their own good. On the basis of having antibodies or not, our society will be split into two classes until we have a vaccine for COVID- 19. Believe it or not, this will be a good thing, preventing deaths, keeping healthcare workers safe, keeping our economy open.
Contact tracing for everyone COVID- 19 positive in the entire country will become the standard. Contact tracing is inherently incredibly invasive and it has to be for it to work. It also requires Americans to trust state health authorities to hand over intimate details about their movements and relationships. It requires us to abandon many previously held notions of privacy for the good of our society. It will be extremely difficult to extract this information and to adequately protect it. This sensitive information may be used in inappropriate or truly discriminatory ways; but a loss of some privacy is the the cost of restarting our economy and keeping us healthy.
Any meaningful notion of health privacy will be abandoned until this crisis ends. Immunity certificates are likely to come to pass. Immunity status will be known by neighbors, employers, and friends to keep the vulnerable safe from this deadly virus. Letting everyone know, from your employer to your neighbor to the grocery store clerk, that you are in a high- risk category should be the norm. Along with designer cloth face coverings, immunity bracelets may be a popular Christmas gift for 2020.
Sacrificing our private health information is the price we will pay to resume even a modicum of normalcy in our lives. Public health and economic goals demand this of us. Radical health data transparency is likely our only way forward.