Right to privacy, but what about responsibility?

HIPPA protects the right of patients to keep their medical history private. Privacy is extremely important, especially in small towns where everyone knows everyone. However, many of these small towns also have volunteer ambulance companies. These volunteer companies do abide by recommended body substance isolation (BSI) items, but these only include gloves, masks, and eye protection. EMTs routinely wear short sleeve shirts and shorts, all of which are their own clothes. Though common sense says for the individual to wear long pants and long sleeves if they have open wounds, they respond when a call comes in – they do not have work schedules. Therefore, they respond wearing what they put on in the morning – not necessarily expecting to respond to a call. In the cases of patients who have infectious disease, what are their responsibilities to the emergency personal who respond to their 911 calls? If they do have open wounds and blood is splatters, the potential for the EMT to contract whatever the patient has is very real. Without knowing if the patient has any infectious diseases, how can he or she prevent the spread of that disease? If the patient does disclose his or her status (assuming he or she does have an infectious disease), is it ethical for an emergency room physician to break doctor/patient confidentiality to inform the EMT that the patient has an infectious disease? d