In the six months since we first became aware of the novel coronavirus, we have learned hard lessons about how the disease spreads and what we can do to contain it. Efforts worldwide have concentrated on population lockdowns, scientific research on treatments and vaccines and contact tracing of infected people. Contact tracing, a time-tested strategy employed successfully to control sexually transmitted disease and tuberculosis, has fallen to a messy patchwork of state health departments and tech start-ups to ramp into high gear in the US. The Trump Administration, reluctant to recognize the scope of the public health emergency, should lead in the development of standard systems, ensure data privacy and encourage the nation’s citizens to adopt it.
Traditionally, local public health departments have conducted extensive interviews with victims of contagious diseases, their friends and families to track the spread and enable testing, quarantine and treatment. The COVID-19 pandemic presents a unique challenge in a disease that spreads by aerosol droplets from people in close proximity for a relatively short period of time. Those exhibiting symptoms will often not have the ability to recall who they came in contact with making tracing those contacts nearly impossible. We do, however, already possess a technical ability to track those contacts with our mobile devices.
In Israel, the government ordered telecom carriers to share location data with security services for contact-tracing. This gave authorities access to detailed data that usually is reserved for military purposes. The Knesset (Parliament) needed to pass emergency legislation to accomplish this but this action was credited with checking the spread of infection in Israel and the Palestinian Territories.
Several countries including Australia, Iceland and New Zealand have developed contact tracing application software that citizens voluntarily install on their devices. These apps use bluetooth technology and the voluntary input of data if an individual is infected to alert other application users that they have been in close proximity to someone who has tested positive. New Zealand is one of the only countries on the planet that is now COVID-19 free.
Apple and Google, whose mobile phone operating systems account for nearly 98% of all smartphones, are jointly developing software that will use bluetooth technology and location information. Initially, the data has been made available to application developers to utilize but updates expected in the next few weeks will build tracking functionality into the system with the ability of the user to opt in or out.
Using this as a sole methodology for contact tracing runs the risk of missing many underserved populations who do not own smartphones. It is by no means the silver bullet but another tool in the public health toolbox.
What is missing from this discussion are the privacy guarantees. We need a national coordination of these efforts to make sure that any adopted technologies actually helps public health workers in their work and doesn’t make it harder to do., We also must ensure that these systems protect privacy and that collected information is not used for marketing or other profit making purposes. Ultimately, we need a cheerleader-in-chief to encourage and empower us to use the technology for the greater good.
- The Bloomberg School of Public Health at Johns Hopkins University has several White Papers on COVID-19 public health strategies
- The American Civil Liberties Union (ACLU) has published guidelines for contact tracing apps
- The Centers for Disease Control has outlined principles for case investigation and maintaining privacy
Jumbo Privacy A privacy consulting firm has been sounding a warning about the app that North Dakota deployed