Director of Health Services Dr Marvin Manzanero confirmed to Love News this evening that he retains his post in the Ministry of Health and that the reports of his resignation yesterday were untrue. He did, however, note to our newsroom that there were concerns surrounding the amendment to Statutory Instrument 134 where he as the DHS was being made obligated by law to submit the identities and particulars of persons who have tested positive for Covid-19. The order goes against the patient/doctor confidentiality oath that medical practitioners are required to take and placed Dr Manzanero in a precarious situation. In our interview with him late this evening he explained that the concerns also involved the ethics and the patient/confidentiality agreement that he had his health staff signed unto earlier this year.
Dr.Marvin Manzanero, Director of Health Services: “All I can say is that I appreciate that very much. I can tell you from the personal standpoint and as I mentioned it to the NOC I have a particular ethical notion of how things should be done not only in terms of this, in terms of how work is done. As you would recall also and you see there’s lots of things that built up to this. I had asked back in March/April for all health staff to sign an oath of confidentiality from everybody and the reason is that back then we were already having issues with confidentiality internal to the Ministry of Health. If you would recall just as early as June/July you still had information being leaked out and we had some reports and some media houses rushing to say who was the next case of COVID-19 or how many cases in a given area until we managed to kind of set up a mechanism to avoid those kinds of situation and have one official source. I am doing an ethical degree and I’ve said it in different forums that I feel that in general there’s many ethical loopholes that we have. Forget what may have been or what’s in an SI I think from the general standpoint in healthcare there’s something in healthcare ethics that we are taught very early in school, the four pillars of ethics in medicine remain you know justice, autonomy, beneficence, nonmaleficence and if you go to the first cardinal situation that we have of “primum non nocere” first do no harm I am guided by that because before I’m a Director of Health Services I am a physician.”
Reporter: But were you prepared to resign ? Was there any truth about your pending resignation or that there was a possibility or consideration of it ?
Dr.Marvin Manzanero, Director of Health Services: “From my personal vantage point I had in my view three options in terms of how that could have been addressed. I don’t know that I disclosed any of those three options – and I’m saying this from a personal to anybody. I don’t know that I would need to disclose them now because I think what we were seeking to be addressed is what is going to be addressed.”
As Dr Manzanero informed our newsroom that he did not resign he did note that even if he had the intention, it would not had been with the National Oversight Committee (NOC) but rather through the public service. But while he did not resign he did table his concerns yesterday and an alternative method is now being sought for closer collaboration with the Police. Manzanero noted that he does understand the need for information for the police to do their jobs in enforcing the quarantine regulations.
Dr.Marvin Manzanero, Director of Health Services: “I believe the conversation you were referring to is one on Tuesday evening when you called me and read to me what the SI had said which I had not seen. I didn’t get a copy until that evening/ night when I got home. Yeah there’s concerns in terms of how you go about handling patient data. Confidentiality measures to begin with so those concerns were expressed to other persons including the Ministry of Health. It was presented at the NOC as the press release has said. It is understood what the intent of the SI is and that’s I think just trying to enforce the quarantine measures that should become applicable to everybody in terms of once you are positive or even if you are not positive but are close contact but I think the SI specifically speaks to those who are positive. From the health standpoint we’re also concerned with any high risk close contacts that should not really be out on the streets because you could be a potential case that has just simply not been diagnosed. So those concerns were expressed and what we have been asked from the health standpoint is to go back and review how we can strengthen that relationship maybe with the police because even though the Ministry of Health is the quarantine authority you would understand and appreciate that we don’t have necessarily- we require then the assistance of the security forces, the police in ensuring that that is complied with in terms of once you have to go and pick up someone from the street you will have to require the police or somebody to help you in doing that so that’s part of what the team is working on is trying to see how we can ensure that the gist and the essence of what it was intended is in there and it goes back and is reviewed.”
The news of Dr Manzanero’s supposed resignation yesterday stirred upset in many pockets of society. In fact, even his counterparts in the region had reached out expressing concerns and interest. Dr Manzanero expressed appreciation for the outreach and assures the public that it is all good, for now at least.
Dr.Marvin Manzanero, Director of Health Services: “I did not answer phone calls yesterday. I chose to not answer any phone calls from the media. I can tell you I got a lot of calls from people, lots of text messages on Facebook as well which I chose to not read yesterday. I started reading some of them today and this is people from in the region, people who I have met and I have worked with, colleagues in the region, colleagues in North America expressing their full support for I think this note I had made in terms of why I had levels of discomfort with what was in the SI as it was spelled out. I can tell you that I am deeply appreciative of all those notes. I don’t think I got a single note or I have not read a single note that did not say otherwise that they were fully supportive of the ethical stance I had taken and all I can say is I appreciate that very much.”
Love News understands that other options to strengthen the quarantine enforcement are now being drafted and should be tabled before Cabinet at its next meeting.