Yesterday, the hottest news of the day was fake news that Director Of Health services Dr Marvin Manzanero had resigned his post. As we told you, he did not resign, but we can confirm that there was some serious tension over this: clause 22-A in the latest QUARANTINE REGULATIONS.
It says, quote "the Director of Health Services shall provide the minister responsible for national security with the name and address of every person that has tested positive for COVID-19; the name and address of every person placed in self- isolation; and the name and place of quarantine of every person placed in mandatory quarantine.
The Director of Health Services commits an offence if he fails to provide the information to the Minister responsible for national security.".
Now that requires Doctors to do something unethical - which is to breach patient confidentiality. Manzanero said he learned about the provision on Monday night, hours before it was to go into effect. He spoke to us via Zoom from his office in Belmopan half an hour ago:
Dr. Marvin Manzanero, DHS
"So, I finally got it on Tuesday evening, I read it, I had my reservations and those reservations were made, I made it known to CEO Tuesday and Minister Marin. I had my reservations in terms of the ethical elements that are attached to it and those were represented to the NOC today, I had asked for a timeslot to present that to the NOC, I had my reservations in terms of the SI because routinely, my one is a technical report for the Ministry of Health. I was heard and at the end of the day, what the press release had said as ministry have given an option of seeking alternatives to how we can meet that specific objective that the SI was intending to carry out."
Jules Vasquez
"So, at any point, did you say this goes through, I have to resign. If we cannot find a compromise, a working compromise, then I must go my own way. Was that something that you said, stated?"
Dr. Marvin Manzanero
"Resign is not a word that said ever at the NOC. I said what I had to say based on for me, which is ethics, the ethics of a professional, before the Director of Health Services, I'm a physician but I think there is personal and professional convictions behind that would have not allowed me to have my conscience at ease at what was being requested and so I said what my position was. I mentioned what the team from the technical advisory group had said, what the regional management teams had said in support of what they thought was the process. I never told any of my staff what my idea was going into the NOC, I said I'll go ahead with the feedback you are giving and my stance but I never disclosed my stance to any of my staff. I presented what my take was on it and I had a difficulty in providing the information, so I was heard and I was asked if there was alternative that could be given and I said if we are given the opportunity to work on the alternative and I think that was the gist of the discussion yesterday."
Jules Vasquez
"But as we move forward, do you have that level of comfort that this sacred ethic patient confidentiality will not be violated and it's sacrosanct will remain inviolable?"
Dr. Marvin Manzanero
"Well that's my intent, I am not necessarily going to be the guardian because I am seeing patients as Director of Health Services but I am the overall custodian of that data which is done by individual doctors on a daily basis and continual basis. I think patient's data and the trust in the system cannot be eroded."
A release from the National Oversight Committee said an alternative way of dealing with the issue of COVID-19 positive persons who break quarantine and the law will be presented to Cabinet.
Today Manzanero said that there is already a legal dimension to the quarantine requirement:
Dr. Marvin Manzanero
"Some of that is already happening, for example there is a quarantine form that is given to people whilst they land in the airport and we had drafted that in April, we are actually just modifying it earlier today but as you move along you improve, you learn, the airport situation is fluid, it changes, so we are modifying that form to make it shorter but without losing gist of what it is, which means if you break the quarantine situation, if your positive or if you had close contact then it talks about imprisonment, it says 6 months, its clearly there cited in the quarantine form which is given to people when they come in through the borders if you are a positive case. So I have shared that with minister and we have this in place already, we're already working with people who are going to a party and are positive for example - the only way you know is to verify that information with the Ministry of Health. So, I also mentioned, I felt that we already doing elements of that. In some areas it is easier and I think we have a closer working relationship with police departments, I met with the teams yesterday before I went to NOC for example and Corozal, the Corozal medical offices chief of staff was very clear in her articulation to me to say doc, in Corozal we will not have a problem, we have a very good relationship with the officer in command in Corozal, whenever this situation requires assistance from the police, we can call on them and they will come and help us."
