As the number of reported cases of novel coronavirus (“COVID-2019”) continues to increase both across the country and internationally, physicians in North Carolina have begun to ask about their duties to report infected patients, as well as other treatment issues that may arise during outbreaks of infectious disease.
On February 3, 2020, the North Carolina Department of Health and Human Services issued a temporary, 90-day order that all physicians and laboratories in the state report all suspected or confirmed infections of the novel coronavirus (COVID-2019). When infection is “reasonably suspected” to exist, physicians and laboratories must report “immediately” to the local health director of the county or district in which the patient resides. See here and here.
Under N.C. Gen. Stat. § 130A-142, those who report cases of infection pursuant to such state mandates receive immunity from any civil or criminal liability that they might otherwise face from disclosing that patient information. Also, under the Health Information Portability and Accountability Act (“HIPAA”), covered entities are permitted to disclose protected health information without individual authorization to a “public health authority” (like an authorized local health department) for, among other things, controlling disease, reporting disease, and public health surveillance (45 CFR § 164.512(b)(1)).
With respect to the physician’s role in participating in quarantine or isolation measures, the American Medical Association (“AMA”) has issued an ethics opinion discussing the balance of ethical duties both to the individual patient and also to the health of the public. Among other obligations, the ethics opinion states that physicians should educate patients about the nature of public health threats and the benefits of quarantine and isolation measures. It also states that physicians should “encourage patients to adhere voluntarily to quarantine and isolation.” Further, the ethics opinion states that physicians should “support mandatory quarantine and isolation when a patient fails to adhere voluntarily.” Going forward, the balancing of such ethical duties may present challenges to physicians, should quarantine and isolation measures be implemented, particularly when patients might be resistant to comply with quarantine or isolation orders. For more information on the AMA’s ethics opinion, see here.
If you have any questions about legal issues that might arise in connection with quarantine or isolation measures, contact Heather Skelton or Ethan Dunn.