Secrecy and the virus are best friends.

Bacteria and viruses have plagued humanity for millennia. There are crucial things that we don’t know about Covid-19. We do, however, know lots about how to contain and to defeat viruses. The scale of this pandemic demands that we use absolutely everything we know in the war against it.

I’ve learnt, in my work with infectious diseases across the globe, that it will take more than medical science to win this war. We must demolish the secret weapons that cruel viruses and bacteria use against us: secrecy, embarrassment and shame.

I know a woman who was seriously ill for almost a week. She lay in bed for days. The exhaustion, cough and fever were concerning enough for her GP to have her tested for  Covid-1. However, she wanted very few to know about her ordeal. I met one of her colleagues in a socially distant situation. They worked very closely together just before the business closed. So here’s the conundrum: Which is more important? Confidence or safety?  The answer must be safety. The colleague lives with elderly parents and she needs to know about this.   

Secrecy, shame and embarrassment are friends of diseases. Leprosy, the world’s oldest known communicable disease, is testament to that. The shame and stigma cause men, women and children to keep secrets from their families, friends and relatives. This provides the cover for the invisible infection to transfer from one contact to another. Secrecy makes it harder to trace contacts. Secrecy frustrates every effort to win the war. 

Viruses don’t play favourites. They simply find a host and take it hostage. Any host will do.  Perhaps this virus has begun to lose the fight already. Royalty, government officials and celebrities have helped to turn the tide in sharing their diagnoses. They’re overturning the rules of the game, destigmatising the illness. Let’s hope that more people will be brave enough to self identify.

Never was there a time when openness was more important. Right now, it can save lives. All of us need to work together. To win, we need to know who is sick and how ill they are. We need to figure out how they contracted it. And we need to know to whom they may have passed it. Contact tracing is as vital to our cause as social distancing and hand washing. Without contract tracing, the virus will silently slip from person to person and we will neither control its effects nor limit its reach.

I see it time and time again in my work with leprosy: we find several cases, but we can’t find the source. That’s because the “index case”, the person who first had the infection, remains silent. That silence condemns others to lives of needless disability and suffering. It often forces others into lifelong isolation and misery.

Silence around Covid-19 is a matter of life and death. Health officials need to be able to trace everybody who has been exposed. It is not business as usual by any means. This is no time for Irish pride, reserve and privacy. We cannot stay home or go to work and mask symptoms. No matter how mild the symptoms, sick people must speak up because the consequences can be disproportionate for others.

Privacy is a sensitive subject. There are many good reasons why we value our privacy and the protection it affords. The health authorities and media have been careful in their reports: “a male in the East, a female in the West”. Privacy, however, is not imposed. It’s something we choose. In all aspects of our lives we choose the privacy settings. Privacy is  something we can waive. It’s something we should waive when other’s lives are at risk.

We are all in this together. We will not overcome this pandemic without the trojan work of health staff, scientists, strategists and everybody engaged in keeping our essential services running. Their task is unenviable. Very close behind that front line, equally important, are the teams of men and women racing against the clock to trace contacts. All of these people are real life heroes, taking life threatening risks for all of us. And right alongside them  are people like you and me. Our part is simple, even if a minor inconvenience. Play by the rules and we’ll come out the other side. Stay at home unless strictly necessary. Cough into your elbow. Avoid shaking hands. Wash hands not just regularly, but thoroughly. Self isolate if you are ill. Keep two metres apart. All of these things save lives.

But here’s the piece that nobody’s publicising: self identify if you are ill. Tell your family, friends and neighbours. Afford them the knowledge and opportunity to seek the care they need. It really is a matter of life and death.

Speak up. This is no time to keep secrets.