Here's a timely practice question.
A clinic social worker is seeing a client remotely who has recently tested positive for COVID-19 after experiencing respiratory symptoms, which are ongoing. He is still is working in a job that involves many other people. "But it's fine, I wear my mask and I'm almost always more than six feet apart from other people," the client explains. He says he will lose his income if he stops working. What is the social worker's obligation with regards to public health?
A. Report the client to the local health department.
B. Refer the client to the clinic's medical director.
C. Make sure the client is always staying six feet apart from others.
D. Review CDC guidelines for those infected with COVID-19 with the client.
Have you encountered anything like this yet? How did you respond? How would you respond? Which of the offered answers would you select on the social work licensing exam?
Let's take them one at a time:
A. Report to the health department. While the client may be endangering others, there is no duty to warn as there might be (in some states) for a client planning a violent crime. Sharing the client's diagnosis would be a breach of confidentiality.
B. Report to the clinic's medical director. This may not break the client's agreement with the clinic regarding confidentiality, it is that the best step to take regarding public health. The social worker should be able to address the issue directly. It may be helpful for the client to talk to the medical director, but there are interventions the social worker can be trying right away to help the situation.
C. Unless the social worker is going to work with the client and running interference, this is not practical.
D. The client is apparently ignoring CDC guidelines regarding COVID-19 infection. Reviewing those standards is a good first step. Referral to the clinic's MD could work to further encourage public-safety-minded adherence.
So there you have it. Can't break confidentiality, but have to do something. That leaves referring or discussing. Like in many situations, the social worker should discuss (D, that is).
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