McALLEN, Texas (Border Report) — The coronavirus pandemic has thrust many municipalities into the role of communicators of information to the public and media. But how much information to release and what might violate federal privacy laws has led to confusion and a myriad of different amounts of details on COVID-19 cases, especially among border communities.
Several Democratic lawmakers now are calling for more federal guidance right now, including more information released on racial, demographic and nursing homes affected by COVID-19.
Further adding to the confusion on the border, is Mexico’s lack of information regarding coronavirus patients and fatalities in its northern border towns, like Nuevo Laredo, Reynosa and Matamoros. That is particularly troubling to local officials who recognize the vast number of residents and business associates who are still crossing daily between countries for necessary travel and who could be carrying the deadly contagion across international bridges.
“The problem is the information we’re getting at the national level is very scattered,” U.S. Rep. Filemon Vela, a Democrat from Texas who lives in Brownsville told Border Report on Friday. ” We don’t have a coordinated federal response on testing and so every community is out there on their own and so you have different models and they’re all counting things differently.”
Many communities are erring on the side of caution to avoid violating HIPAA laws and are releasing vague information like the approximate ages, while others release specific sex, age and even where patients work or live. Violations to the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and its Privacy Rule, could carry fines of $50,000 to up to $250,000.
The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) in February issued an online tip sheet giving the following guidance about sharing patient information:
“Under the Privacy Rule, covered entities may disclose, without a patient’s authorization, protected health information about the patient as necessary to treat the patient or to treat a different patient. Treatment includes the coordination or management of health care and related services by one or more health care providers and others, consultation between providers, and the referral of patients for treatment.”
The sheet states protected health information may also be disclosed without individual authorization for the following:
- To a public health authority, such as the CDC or a state or local health department, that is authorized by law to collect or receive the information “for the purpose of preventing or controlling disease, injury or disability.”
- To persons at risk of contracting or spreading a disease or condition.
- Or to a foreign government agency “that is acting in collaboration with the public health authority.”
The latter appears not to be happening with officials from Texas and Mexico. Vela said he had scheduled a conference call earlier this week with personnel from the U.S. Embassy in Mexico City, but due to other economic chaos concerning South Texas, he said that call has not occurred.
Right now, it appears that border communities are getting most of their information from local Mexican contacts, according to conversations with several community leaders. Missing is a centralized database that breaks down information by individual cities and Mexican towns. Google lists cases by Mexican states, but the state of Tamaulipas, for instance, spans 230 miles from Nuevo Laredo, across from Laredo, Texas, to Matamoros, across from Brownsville, on the Gulf Coast. Tamaulipas reports a total of 78 cases and four deaths.
That is significantly lower than the hundreds of cases of COVID-19 reported in South Texas border counties, just across the Rio Grande. As of Friday:
- Hidalgo County, which includes McAllen, has had 235 cases and three deaths.
- Webb County, which includes Laredo, has had 253 cases and 11 deaths.
- Cameron County, which includes Brownsville, has had 274 cases and Thursday reported its fourth death.
“Our testing system is screwed up here and it’s even worse over there and I think medical providers in Mexico are looking for the federal government to lead them through this and they would ordinarily look at us so their government would follow suit, but we’re in shambles, so if we’re not leading by example, consequently, it makes the situation even worse,” Vela said.
Last week, Vela and U.S. Rep. Bennie Thompson, D-Mississippi, who is chairman of the House Committee on Homeland Security, sent a letter to the Department of Homeland Security asking for more protective gear and equipment for U.S. Customs and Border Protection officials stationed at international bridges in South Texas, where they are at risk for catching the virus.
“The failure to provide them with basic protective equipment, testing, and guidelines to safely manage the flow of traffic through our ports of entry is unacceptable,“ Vela said. “The health of CBPOs and border crossers directly impacts the health of the Rio Grande Valley community.”
Reporting of cases varies in South Texas
The three largest South Texas counties are relatively close in case counts, but the way they disseminate information to the media and the public is far different.
Hidalgo County, for instance, gives out the age by decade and does not disclose some towns if they are too small in population. Cameron County, however, in announcing its fourth death on Thursday, specified in a news release on its county website that it was of an “82-year old female from the Veranda Nursing Home in Harlingen.” The statement said there have been a total of 50 residents of Veranda, 21 employees and five people affiliated with someone from the facility who have tested positive. And that this was the third death of a resident from that facility. It also listed another Harlingen nursing home, the Windsor Atrium, and said there have been a total of 20 employees and 17 residents and one death from COVID-19 at that facility.
Read a Border Report story on the two affected nursing homes in Harlingen, Texas.
On Wednesday, the City of Laredo and Webb County jointly released specific information on COVID-19 death: A “93-year-old woman with a chronic heart condition had tested positive for COVID-19 and was being treated at Laredo Medical Center when she died.” The statement also specified the death of a 63-year-old woman who died in transit to another hospital. But a statement on Thursday about the region’s 11th death only identified it “as a man in his 40s, with underlying health conditions” who died at Laredo Medical Center.
During a noon video conference with media on Friday, City of Laredo Health Department’s Health Authority Dr. Victor Treviño disclosed that six physicians and 16 nurses from Laredo Medical Center have tested positive for COVID-19.
“This puts a tremendous strain on the hospital and its ability to take care of patients,” Treviño said.
Carlos Sanchez, spokesman for Hidalgo County, says they are being much more conservative in their release of coronavirus data.
“The COVID-19 pandemic has caused a massive re-examination of federal and state privacy laws, particularly HIPAA. Every jurisdiction recognizes the need to balance the interests of alerting the community to potential COVID-19 infection against an individual’s right to medical privacy that HIPAA addresses. Various jurisdictions, in consultation with legal counsel, have come to different conclusions about what is appropriate to share. Hidalgo County is erring on the side of caution because of our respect for privacy rights while knowing our obligations to alert the public to potential infection dangers. Always looming over each jurisdiction’s decision on how to handle HIPAA concerns is the knowledge that the law comes with a lot of teeth,” Sanchez told Border Report.
Every jurisdiction recognizes the need to balance the interests of alerting the community to potential COVID-19 infection against an individual’s right to medical privacy that HIPAA addresses. … Always looming over each jurisdiction’s decision on how to handle HIPAA concerns is the knowledge that the law comes with a lot of teeth.”
Hidalgo County Public Affairs Director Carlos Sanchez
Calls for more information on nursing facility COVID cases
U.S. Rep. Vicente Gonzalez, a Democrat from South Texas who lives in McAllen, this week joined 77 other Democrats in calling for “standardized and comprehensive” data on nursing home cases. The lawmakers on Wednesday sent a letter to Department of Health and Human Services Secretary Alex Azar, and Centers for Medicare & Medicaid Services Administrator Seema Verma asking them to work with states, localities, and private labs to immediately collect and publicly report facility-level data on the number of longterm care residents affected by COVID-19, including cases and fatalities.
“We write to you to ask you to immediately collect and publicly report facility-level data on the
number of long-term care residents affected by the 2019 coronavirus disease (COVID-19),
including cases and fatalities. The Centers for Medicare & Medicaid Services (CMS) is statutorily obligated to ensure that agency standards and enforcement are adequate to protect the health, welfare, safety, and rights of nursing home residents. However, CMS and the Centers for Disease Control and Prevention (CDC) are failing to collect and publicly report current data on the number of residents and long-term care facilities that have been affected by COVID-19,” the letter read.
CMS and the Centers for Disease Control and Prevention (CDC) are failing to collect and publicly report current data on the number of residents and long-term care facilities that have been affected by COVID-19.”
Letter by 78 Democratic members of Congress sent April 17, 2020
“Without understanding the scope and impact of the pandemic within long-term care facilities, the Administration and the Congress lack essential information to adequately respond and protect older Americans and individuals with disabilities who rely on these facilities to survive and are particularly at risk for COVID-19,” the letter read.
The lawmakers want data publicized “on how COVID-19 is spreading in congregate communities where these individuals are heavily concentrated and where history suggests they are at particular risk.”
In the letter, lawmakers note that all current information has been gathered by journalists, not a centralized federal agency. They also called for data to be released delineating racial and demographic information, such as the number of Hispanics and African-Americans affected.
An article written by the Poynter Institute published earlier this month also called on more information to be released to journalists during this pandemic. It read: “Now, at a moment when the public demands reliable data about the spread and effects of COVID-19, journalists cannot get the data and images that would help the public understand the urgency of this pandemic. There would be no denying shortages of protective gear if we could see it.”
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