If you test positive for the coronavirus that causes COVID-19, who has a right to know?

AP Photo/Jens Meyer

Something unusual is happening in the news and across social media sites: People are sharing their private medical information. Celebrities, doctors, stay-at-home parents, and others are going public about testing positive for the novel coronavirus. But do they have to?

While a highly contagious disease caused by the virus continues to disrupt communities around the world, people may have a moral or ethical responsibility to tell certain others that they’ve tested positive, says Aziza Ahmed, a law professor who studies health law at Northeastern. If someone who tested positive for the novel coronavirus is inviting a friend over for dinner, that person may have a moral responsibility to disclose the diagnosis to their friend.

“But that’s very different from a legal responsibility,” she says.

Portrait of Aziza Ahmed

Aziza Ahmed is a law professor in the Northeastern University School of Law who studies the legal, regulatory, and political environments regarding health in U.S. domestic law. Photo courtesy of Aziza Ahmed

Because it’s not just affecting one demographic population in particular, Ahmed says she’s seen less evidence of a negative stigma associated with testing positive for the novel coronavirus than there was for being HIV-positive in the 1980s.

“You can see how people might be nervous to disclose that they have or had COVID-19 out of fear that they would be ostracized,” she says.

If, for example, data showed that a certain demographic population were more likely to contract the disease, other parts of the population might develop an unfair negative bias against that demographic.

How, then, should we weigh privacy against public health?

To understand the context, consider HIV and AIDS, says Ahmed, who is writing a book about the response to the AIDS crisis in the U.S. During the early years of the AIDS epidemic, a number of states in the U.S. passed laws that require people who know they have HIV to disclose that fact to sexual partners.

But it’s much more difficult to transmit the human immunodeficiency virus—the virus that causes AIDS—than it is to transmit SARS-CoV-2—the virus that causes COVID-19. HIV can only be transmitted through contact with infected blood, sexual intercourse, or breast milk. Compare that to the novel coronavirus, which spreads primarily through droplets of saliva that hit the air when a person coughs or sneezes, according to the World Health Organization.

The difference is what makes it easier to hold a single person accountable for knowingly spreading HIV, Ahmed says.

The novel coronavirus can spread so easily that it would be difficult for a court to hold someone individually responsible for infecting others, Ahmed says—the same way that it would be difficult to hold someone individually responsible for giving you the flu.

Even without the courts, there are ways that an infected person’s identity may be exposed in the effort to bolster public health, Ahmed says.

When a person tests positive for SARS-CoV-2, local public health officials try to establish the person’s contacts with other people to determine who else may have been infected. Those officials then contact the people on the list to advise that they self-isolate in order to prevent the virus from spreading any further. The process is anonymous, but if someone on the list had recently been in touch with only one other person, it would be fairly easy to determine who the infected person was.

Absent a legal mandate to disclose a positive diagnosis, Ahmed says, we still have a moral responsibility to protect our communities.

“It seems fair to say that we might try and regulate an intentional attempt to expose another person to an infectious disease,” she says. “But, is there a good way to hold someone accountable that can recognize the complexity of our moment in which confusion reigns? Not really.”

For media inquiries, please contact Jessica Hair at j.hair@northeastern.edu or 617-373-5718.