Smithfield – In normal times, North Carolina’s county public health departments keep a modest profile in their mission to provide clinical services, vaccinations, children’s health screenings, wellness classes, pre-natal counseling and other services. But as the number of cases of COVID-19 rises daily, county health offices are assuming a central leadership role in patient care, contact tracing and resource coordination to battle a pandemic that has now claimed 33 lives in the state as of noon Monday.
“Local health departments are truly on the front lines of this crisis and have been working many months to respond,” said N.C. Secretary of Health and Human Services Mandy Cohen at her daily briefing on April 2. “We’re all in this together no matter what part of North Carolina you’re in. My heart goes to all of our local public health leaders.”
Officials of the Johnston County Public Health Department closely monitor COVID-19 cases involving county residents, checking their status daily and tracing contacts in hopes of stopping the spread of the virus. The office, staffed by nearly 140 full- and part-time employees, compiles and reports data to state health authorities and is the lead local voice in disseminating the latest guidance on avoiding the illness and slowing the pandemic. “As we continue to see an increase of cases in our county, we are reminded of the importance of staying at home in an effort to stop the spread of this virus,” Johnston County Health Director Marilyn Pearson regularly advises local residents through media statements.
While Johnston County has faced public safety emergencies before, typically in the wake of hurricanes and other weather events, the crisis may cast the public health department in its most visible leadership role ever. “This is the kind of all-hands-on-deck situation we’ve never really seen before,” says Johnston County Commission Chairman Ted Godwin. “Our law enforcement professionals, firefighters and emergency management personnel are all working hard and working together to help our residents get through this. The county’s public health office has stepped in with expertise, courage and confidence to manage resources and keep county leaders apprised of the situation, which changes rapidly.”
Providing timely and accurate information is another part of the department’s duties, as uncertainty and frustration heighten fears. “In the absence of credible information, people tend to assume the worst,” Godwin says.
As county health officials report new COVID-19 cases and the number of residents who die from the disease’s complications, they also update demographic data related to average age and the breakdown between genders. State and federal laws relating to patient privacy prevent public health authorities and medical facilities to offer specifics that could inadvertently unmask the identity of patients.
“Because some of our communities are small, we don’t want to release data that could be reverse-engineered and possibly compromise patient privacy,” explains Dr. Pearson, the county health director. “As our numbers grow, we may be in a position to release additional demographic information. There are state and federal laws that strictly govern this area.”
The most widely cited federal law regarding patient privacy is the Health Insurance Portability and Accountability Act, passed in 1996. Known as “HIPAA,” its sweeping provisions are complex and come with stiff penalties for even inadvertent violation. “HIPAA and the federal laws that followed it are complicated enough that people make a living assuring compliance,” says Saad Gul, a Raleigh-based attorney with the firm of Poyner Spruill who concentrates in privacy, data security and cyber liability issues. “But if there’s one principle at HIPAA’s heart, it is this: someone’s medical information may not be shared without their permission,” Gul says. “The concern for a community the size of Johnston County is that even a few facts are enough to get people guessing – and it doesn’t matter if the guess is right or wrong.”
-News Release
