07 July 2020 - NW1135
Thembekwayo, Dr S to ask the Minister of Health
(a) How does his department conduct training for health officials and personnel in tracing down contacts to be cognisant of stigmas that may arise, (b) what intervention does his department have in place to deal with the stigmatisation of Coronavirus and (c) how is the privacy of patients and contacts protected?
(a) As part of training, healthcare workers and contact tracers were sensitized on how to assist cases and contacts to deal with stigma and its impact on their mental health and well-being. Stigma, as a major cause of discrimination and exclusion, affects people’s self-esteem, disrupts relationships and contributes directly to human rights abuses. Recognising the need for mental well-being during this period of Covid-19 pandemic, the National Department of Health has developed Standard Operating Procedures (SOPs) on contact tracing in SA, which also include section on mental and psychological support to community during the Covid-19 outbreak.
The following aspects were covered during trainings:
- When referring to people with COVID-19, do not attach the disease to any particular ethnicity or nationality. Be empathetic to all those who are affected, in and from any country. People who are affected by COVID-19 have not done anything wrong, and they deserve our support, compassion and kindness.
- As part of health education, contacts are requested to seek information only from trusted sources and mainly so that they can take practical steps to prepare and protect themselves and their loved ones, should anyone in the household test positive for Covid-19.
- In other households, psychosocial support is offered to the family members who are not working and who need to take care of child or elderly dependents.
In addition to what is listed earlier in terms of combating stigma and discrimination, here is what the Department of Health has done to assist people to cope, in order to reduce anxiety, namely:
- Protect themselves and be supportive to others. Assisting others in their time of need can benefit the person receiving support, as well as the helper.
- Seek information updates at specific times during the day, once or twice. The sudden and near-constant stream of news reports about an outbreak can cause anyone to feel worried;
- Gather information at regular intervals, from the Department of Health and NICD websites and local health authorities, in order to help you distinguish facts from rumours;
- Honour caretakers and health care workers supporting people affected by the disease in your community. Acknowledge the role they play to save lives and keep your loved ones safe.
National Contact Tracing Guidelines are currently being revised to emphasise the following issues that are covered during training:
- Contact tracing should not be used punitively;
- Contacts should be provided with details of how their information will be used, stored, and accessed, and how individuals will be protected from harmful disclosure or identification;
- Contact tracing and associated steps, such as quarantine of contacts and isolation of cases, should not be associated with security measures, immigration issues, or other concerns outside the realm of public health.
(b) Stigma is associated with a lack of knowledge about how Covid-19 spreads, a need to blame someone, fears about disease and death, and gossip that spreads rumors and myths. Stigma can also make people more likely to hide symptoms or illness, keep them from seeking health care immediately, and prevent individuals from adopting healthy behaviors. This means that stigma can make it more difficult to control the spread of an outbreak. As part of training of healthcare workers and contact tracers, the National Contact Tracing Team help prevent stigma by ensuring that contact tracers in provinces and districts:
- Always maintain the privacy and confidentiality of those seeking healthcare and those who may be part of any contact investigation;
- Quickly communicate the risk, or lack of risk, from contact with products, people, and places;
- Use of inclusive language and less stigmatizing terminology by sharing accurate information about how the virus spreads;
- Use of social media to spread facts about how the new coronavirus disease is transmitted and treated, and how to prevent infection, including speaking out against negative behaviors and statements, including those on social media;
- Engaging social influencers such as community leaders in prompting reflection about people who are stigmatized and how to support them, or respected celebrities to amplify messages that reduce stigma;
- All health promotion materials show diverse communities being impacted and working together to prevent the spread of Covid-19 and do not reinforce stereotypes.
- The use of news media and social media creates an environment in which the disease and its impact is openly and honestly discussed, to speak out against stereotyping groups of people who experience stigma;
- Suggesting resources for mental health or other social support services for people who have experienced stigma or discrimination;
- The contact tracers are expected to show empathy with those affected and make them understand the disease, and adopt effective practical measures to help keep themselves and their families safe.
- The Department carefully communicates with the public on Covid-19 to aid public/community implementation of the preventive measures and to avoid fuelling fear and stigma.
(c) The privacy of patients and contacts is protected by the following:
- Medical records of patients and contacts are subject to privacy and confidentiality. As part of training, healthcare workers and contact tracers are trained to better understand that patient information remains cordoned within the Prescripts of Protection of Personal Information Act (POPIA). All health care workers know that they are not supposed to divulge any information, of any patient in any media platforms. When such arise, there are legal implications to deal with the person divulging the information;
- The databases that are also used should be encrypted so that the information storage becomes secure. More work still needs to be done to ensure all data sources are aligned across all the provinces;
- All health care workers and contact tracers are expected to comply with Regulations Relating to the Surveillance and the Control of Notifiable Medical Conditions as outlined in the National Health Act, 2003 (Act No. 61 of 2003). Covid-19 is a category 1 notifiable medical condition (Respiratory disease caused by a novel respiratory pathogen). Confidentiality, protection of health records, and offences and penalties are dealt with in Chapter 4 of the Regulation.