LINCOLN COUNTY — The local health department followed the news of the massive COVID-19 outbreak at Pacific Seafood with the announcement that it was monitoring six local businesses for potential workplace outbreaks, and although two of those establishments have since voluntarily disclosed that employees tested positive, the public remains in the dark about the other four locations.
When Lincoln County Public Health officials told the public last week they were monitoring potential workplace COVID-19 outbreaks, they said Oregon Health Authority guidance and privacy law prevented them from disclosing the names of the businesses involved. The department said it could only name those businesses if they had 30 employees or more and five workers with confirmed positive tests, in which case the state health authority would make the disclosure. This aligns with that agency’s recently implemented policy of publishing data on such outbreaks statewide in its weekly reports.
On the heels of the large cluster at Pacific Seafood, many local residents were shocked by the news of more outbreaks and dismayed that they could not know if they might be eating or shopping in establishments where one had occurred. Gauging by social media posts, the public was overwhelmingly grateful when two of those businesses, Newport restaurants Georgie’s Beachside Grill and Local Ocean, voluntarily announced they’d experienced outbreaks. Four employees at Georgie’s tested positive, the restaurant said, all of whom were asymptomatic and had no or extremely limited contact with clientele; and seven workers, all kitchen staff with no customer contact, tested positive at Local Ocean, with some experiencing symptoms. Both had closed their doors immediately following the report of the outbreak at Pacific Seafood as a precaution.
In response to requests from the public for more information on the remaining outbreaks, elected county officials and the health department have deferred to health authority policy in their decision not to disclose the businesses’ names. Health department Public Information Officer Susan Trachsel told the News-Times in an email, “We follow OHA guidance to preserve the identity of those who are positive.” However, when the News-Times contacted the health authority to ask if they’d directed Lincoln County not to disclose outbreaks, Public Information Officer Tim Heider said, “The state does not dictate to local health authorities how to report workplace outbreaks. You may know that OHA recently began doing so, and our threshold is five or more cases including close contacts in a workplace of more than 30 people.”
The federal Health Information Portability and Accountability Act, HIPAA, protects personal medical information like diagnosis with a disease from being disclosed by covered entities like health care providers and insurance carriers. Exception is made for public health purposes, such as containing a viral outbreak, for which those entities can disclose information to public health authorities. Authorities can issue reports to the public that make use of the information, but not in a form that identifies an individual.
The contention hinges on whether disclosure of a certain number of individuals at a given business will allow those individuals to be identified, and the health department seems to be relying on the Oregon Health Authority’s interpretation that a safe threshold is five cases, which the state agency said the county is not obligated to abide by. State law makes this decision entirely within the discretion of the local health department. Oregon Revised Statute 433.008 governs the confidentiality of information obtained during the investigation of an outbreak and notes, “Nothing in this section …prevents the authority or a local public health administrator from publishing statistical compilations and reports relating to reportable disease investigations if the compilations and reports do not identify individual cases or sources of information.”
Several Oregon counties make information available beyond what is published by the health authority. For example, Washington County includes daily hospitalizations in data posted to its website. The News-Times could not locate a county in the state that has disclosed a workplace outbreak of fewer than five cases, but just last weekend, the health department in Cowlitz County, Wash. — not governed by Oregon statue, but obliged to follow federal HIPAA — announced a single positive test of an employee at a local casino.
In response to a follow-up from the News-Times citing comments from the OHA and state law, Lincoln County Public Health Director Rebecca Austen said, “Public Health is very protective of our community and their privacy. We are consulting with our legal counsel and exploring other options for releasing information. If a business that does not meet the OHA threshold would like to report and do a joint release with us, we would be happy to do that.”
Lee J. Siegel, a semi-retired science writer who lives in Beverly Beach, said he emailed the health department and county commissioners concerned about the lack of disclosure and was told by Commissioner Doug Hunt that the county’s hands were tied by state rules.
Commissioner Claire Hall told the News-Times that this was her understanding, as well, but she said she would like to see additional disclosure if it was legally possible. “Public anxiety is high, and public confidence is low, and the more information we can share with the public, the more empowered they will be to deal with this pandemic.”
Siegel, 67, whose age group puts him at a high risk of complications from COVID-19, said he’s worried that the lack of information takes away his power to avoid exposure. „Public health is poorly served by failing to promptly and publicly identify the sites of potential coronavirus outbreaks,” Siegel said. “If an outbreak is suspected at a workplace but is not announced to the public until days later after testing, how many customers unknowingly patronized that business and may have been exposed to the virus?”
Siegel said he understands public health has to strike a balance. “The problem is complicated because if there is only one initially known coronavirus case at a business, identifying that company would identify the patient to other employees who knew a coworker was out sick, and that could violate federal medical privacy law,” he said. “But if a few days later, tests reveal multiple employees are infected, is that fair to vulnerable customers? How many people patronized that store without knowing they were risking infection?”
No updates on the remaining outbreaks have been released by Lincoln County Public Health, but Dr. Dean Sidelinger, the OHA’s epidemiologist, noted when he remotely joined Monday’s Lincoln County Board of Commissioners meeting to discuss Pacific Seafood that the county has had five workplace outbreaks since the fish plant outbreak — at four restaurants and “another business,” Sidelinger said. Trachsel told the News-Times she did not currently have information on whether that meant one of the potential outbreaks has been ruled out. If so, then the remaining outbreaks are at two restaurants and an as-yet unknown establishment.