Kansas lawmakers’ reliance on ‘personal responsibility’ poisons well of public health

English physician John Snow is considered one of the founders of epidemiology. In a precursor to modern contact tracing, he tracked the origins of a cholera outbreak to a hand-pumped water well. (Wikimedia Commons/Public Domain)

Imagine a well in the middle of town pumping out contaminated water that’s making people sick. There are other wells in town, but nobody is sure which one is the source of the disease, which has reached epidemic proportions. People are dying and doctors are desperate to locate and stop the source of the infection.

Now, imagine a law that prevents doctors from asking sick people about which well they got their water from, or who they shared their water with. Patients may volunteer that information, but it is their legal right to remain silent on their movements and interactions with others.

Sound crazy? Of course it does. But that hasn’t stopped the state of Kansas from adopting just such a law, again choosing the sham of “personal responsibility” over science and the best medical advice. As part of a broad compromise between the Legislature and the governor, contact tracing in Kansas is now optional.

Let the word “optional” sink in a for a moment.

The “COVID-19 Contact Tracing Privacy Act” was part of the compromise reached in a special session in June between Gov. Laura Kelly and the Legislature, which believed she had overstepped her authority in closing schools and businesses and other responses to the pandemic. Kelly signed the bill and said it was a “victory” for Kansans because it preserved relief measures, even though she opposed parts of it.

Among other things, HB 2016 prevents the state from enacting new measures to limit gatherings or close businesses until Sept. 15. All of that power remains with the cities and counties until then. So far, local governments have chosen not to follow the governor’s lead on statewide mandates. On masks, for example, 90 of the state’s 105 counties opted out.

A sign on a hand-pump well at Wichita’s Old Cowtown Museum advises people not to drink the water. (Max McCoy)

The COVID-19 Contact Tracing Privacy Act was included in HB 2016 at the urging of Attorney General Derek Schmidt, who said it was necessary to protect the privacy rights of Kansans. While driven by some legitimate privacy concerns about authorities using cellphone data to monitor the movements of Kansans, the act as signed goes too far. It places individual privacy above the need for public health and endangers us all.

And, lucky us, we’re the first state to have anything like this.

The secretary of the Kansas Department of Health and Environment, Lee Norman, expressed his disappoint with the bill thusly: “The language passed in HB 2016 will undoubtedly slow our ability to do contact tracing and stop the spread of COVID-19 at a time when we are classified by the White House as a red zone for infections and spread.”

Those who are pleased about the passage of this act usually say something about how they trust Kansans to demonstrate “personal responsibility” in their actions, so we’ll be just fine.

Personal responsibility has long been cited for regressive policies that make it tougher on minorities, poor people and just about anybody who doesn’t live in a gated community or can’t afford business class health insurance. If you’re poor, it’s because you’re lazy. If you’re sick, then it must be your own fault because of poor personal choices. If you’ve contracted COVID-19, it must be because you just weren’t careful enough.

But shame is not an effective medical strategy.

Now, the tracing privacy act is temporary — it is slated to expire in May. But it even gets that exactly backward. We should have enacted temporary measures that allow for greater contact tracing, not less.

If our state leaders were truly interested in the “common good,” they’d be expecting Kansans to sacrifice a little personal freedom for the good of everybody. Instead, they’ve made it easy to be selfish, opt out of our civic duty, and thumb our noses at science.

Such foolishness hurts us all. Contact tracing is among the primary tools that public health officials have to combat the virus. Making it optional, out of a concern for privacy, is like saying that auto insurance should be a personal choice instead of a public good.

Not everyone will do the right thing. Making Kansas health mandates a matter of public option is a reflection of the lack of a coordinated national response to the pandemic, and it will result in more misery and more death.

In the 1840s, waves of cholera epidemics were ravaging London. The prevailing theory was that the disease was spread by bad air, but a doctor by the name of John Snow thought that didn’t make sense because so many victims had gastro-intestinal symptoms.

So he started investigating well water in London. Most residents got their water through hand-pumped public wells. Snow thought there might be a connection. So he began making maps. And he began talking to sick individuals about where they were getting their water.

John Snow was the first contact tracer.

Snow discovered that most of the infections were coming from wells that were supplied by a couple of private companies that pumped water from the Thames. Other wells got their water from upstream locations, but these two companies were pumping water from a polluted, downstream location.

In 1849, Snow published his findings and modern epidemiology was born.

But today, in Kansas, in the midst of a pandemic that has claimed hundreds of lives and will likely claim hundreds more, doctors and other professionals are prevented, in effect, from asking patients where they got their water.

All of us visit the modern equivalent of public wells in our communities — the schools and businesses, the nursing homes and doctor’s offices, the churches and the libraries. We need laws that make it safe to drink from the public good provided by these institutions.