On 21 March 2020, a local Hindi newspaper, in Ajmer, Rajasthan, carried a report on 46 individuals who had been quarantined by the state health department. Not only did paper mention the names of local residents who had recently returned from a trip abroad, it even published their addresses.
Soon after the news item appeared, health activists in Rajasthan, led by Jan Swastha Abhiyan, wrote a letter to the chief minister Ashok Gehlot, cautioning him about the pitfalls of making patients' details public.
“Sir, we are afraid to note that, these measures, although being deemed important by the government to contain the virus, are in direct violation of ethics and patients’ right to privacy and confidentiality as outlined in different national and international charters, guidelines and principles.”Letter to CM Ashok Gehlot by health activists in Rajasthan
According to Chhaya Pachouli, a Jaipur-based activist and one of the signatories of the letter, such naming and shaming can have far-reaching repercussions in a country like India.
“This approach, rather than doing much good, would only breed wider stigma, discrimination, shame and fear among people which would deter them even more from coming out openly about their illnesses, travel and exposure history.”Chhaya Pachouli, Health Activist
However, news reports have not been the only ones guilty of identifying patients. In Rajasthan, health department personnel went from door to door sticking posters informing people 'not to visit' homes of those who were under quarantine.
A poster such as this usually has four categories:
- Date specifying the period of quarantine
- No. of persons in the household
But activists feel that this kind of labelling, though well-intentioned, engenders exclusion of those who are fighting the deadly virus.
“In these times of widespread panic, uncertainty and suspicion all around, the department and the health officials need to adopt approaches which forge an environment of social solidarity and support rather than undertaking an act like this which promotes fear, discrimination and social exclusion among people.”Chhaya Pachouli
Activists have drawn parallels between the discrimination faced by HIV patients and those suffering from COVID-19 following the adoption of such methods by state governments.
“We must take lessons from the past and the global experiences around epidemics and pandemics. We know how they can breed widespread stigma. Children of the affected families can be bullied or denied admission in schools, families could be excluded from social activities, they may be blamed for spreading the disease and face violence or abuses, people may be denied work and end up losing source of income, etc.”Chhaya Pachouli
Such large scale measures of pasting posters outside homes have not been restricted to Rajasthan. In Delhi too, they were seen outside those households under quarantine invoking a similar response of surprise and uneasiness.
When Bollywood singer Kanika Kapoor tested positive for COVID-19 on 20 March, many took to Twitter demanding her arrest. A relative of hers who is currently employed as an anchor at a leading new channel was also targeted by online trolls.
The UP police later booked her under three sections– 269 (negligent acts likely to spread infection of disease dangerous to life), 270 (malignant acts likely to spread infection of disease dangerous to life) and 188 (disobedience to order duly promulgated by public servant) – of the Indian Penal Code.
Karnataka's state health department recently received flak from people for uploading excel sheets on Twitter, revealing names and addresses of suspected COVID-19 cases.
Only the Odisha government has released an order so far, clearly stating that identities of patients should not be revealed. But this notification issued on behalf of the state health department is applicable only for maintaining confidentiality of patients in news reports.
Could there be better ways to control the spread of infection?
Instead of specifying personal details, a larger geographical area may be demarcated for the safety of others, activists advise.
“I also understand that in certain cases it might be crucial to reveal greater details about the suspect or the infected person so as to prevent widespread transmission of infection and to alert people. In such cases, we might reveal the name of their town, lane, their travel route, etc., but still revealing their names and home addresses should be avoided as much as possible.”Chhaya Pachouli