COVID-19 secrecy: Nigerian media, health privacy and public safety – Part 2
Continued from yesterday
Health records around the world are protected by ethics and by law. Researchers and governments protect health data, especially when it concerns people who voluntarily submitted themselves for medical tests or studies (Kalra, et al., 2006; Institute of Medicine, 2009). The benefits of protecting health data have been reported in studies on human relations, healthcare, drug development, and treatment protocols (Kalra et al., 2006).
The Institute of Medicine (2009) however observes that one of the problems of health data protection is a definition of privacy which means different things to different people. The difficulty often arises at the point when continued protection of health data would detract from efforts to protect others who are not suffering from a disease but may subject the sick, who willingly submitted to tests, to public odium. Researchers have therefore voiced concern that there is more need for openness due to harms that data protection can do to the medical practice and to the safety of society (Hammerstein 2012). The implication is that data protection can be an alibi for data secrecy, which is done for political expediency.
In some cases, some surveys show that patients were willing to allow access to their health records if that would advance the cause of healthcare, but generally, people want their health data to be protected (Institute of Medicine, 2009). This is why the laws and ethics of data privacy make provisions on how health information can be divulged to researchers, drug makers and even sociologists who need the data to work for a better-protected society. Goldman et al. (2006) report that unknown to many patients, their health records may be used by as many as 150 people in a single process of attending to their healthcare.
One of the harms of unnecessary data protection is the danger to public safety as a result of misleading information, conspiracy theories and fake news which often take the place of correct information, especially when the latter is in want (Carey, et al., 2020; Moshood, 2020). When conspiracy is allowed to grow, an effort to contain it is not only hard but may also become counterproductive. Many disease outbreaks have suffered such fate, including the Ebola outbreak in West Africa, Zika outbreak in Brazil, and not least the present coronavirus (Carey et al., 2020)
Data privacy generally refers to the collectability of data, authorization, generation, storage and use. In defining privacy, two words often come into play to express what is expected or considered in the case of breach of privacy – confidentiality and security (Kalra, et al., 2009).
Confidentiality refers to efforts to ensure that health information obtained from consenting patients or individuals in a defined relationship, such as doctor-patient communication, is not given out illegally to a third party. Security deals with evidence of effort made to ensure that unauthorised parties do not have access to confidential information (Kalra et al., 2009; Goldman et al., 2006). Security will be assessed if confidentiality is breached. For instance, in the case of a data leak, it will be ascertained if adequate security measures were taken, and if so, no one will be held liable. Government is expected to protect health data in the areas of security and confidentiality, but disclosure is still possible if it would guarantee public safety, and it could be done without identifying patients or exposing them to stigmatisation. This piece uses data from a qualitative survey with Health Editors to show that the situation in Nigeria is more of data secrecy than data privacy.
Privacy of patient health records, or politics of health secrecy?
Information spread on EIDs face a lot of public debates about the bounds of data security and confidentiality. There are widespread allegations that coronavirus, as a pandemic, is a child of information secrecy. The US accuses China (the birthplace of the new coronavirus) and the WHO of hiding important information about the disease, which caused its global spread. Definitely, more issues will arise from such allegations after the pandemic is subdued globally. As of May 29, 2020, the US had cut ties with the WHO over its alleged role with China in the spread of coronavirus.
However, a good part of the global fight against the pandemic has been based on data sharing and publication of preventive measures. The openness that should go with disease outbreaks was demonstrated around the world when high and low profile COVID-19 cases were widely reported and followed by millions. From Canada, Spain, France, and Germany, to the UK, the US, Russia, Iran and Saudi Arabia, coronavirus reporting was a sight to memorise (Palder& Mackinnon, 2020). One of the highest-profile cases, the British Prime Minster Boris Johnson, was almost watched like a television serial as the media dished out updates.
In Nigeria, the media have also been awash with coronavirus stories. But so much about the country’s media images reflect more of untold stories. Moshood (2020) argues that non-publication of necessary images about COVID-19 in Nigeria is not analogous to health data privacy protection. He connects the secrecy about COVID-19 in Nigeria to all the disbelief and uncooperativeness among Nigerians. He also draws instructive contrasts between Nigeria’s handling of COVID-19 and other countries, using the New York Times example.
By implication, Nigeria’s secrecy about COVID-19 is not as much a health issue as it is a political issue rooted in a culture of lack of transparency going back many years since independence. It is a practice in politics of health secrecy. Top among health-related political secrets in Nigeria in recent memory are the ailment and death of Musa Yar’Adua, former president of Nigeria (November 2009- May 2010); The 51-day and 103-day London treatments of President Muhammadu Buhari (March to August 2017), and former President Jonathan’s stomach pain (November 2013).
To be continued tomorrow.
Dr Mbamalu is the News Editor of TheGuardian.