When the coronavirus broke out in China, the surveillance state went into
overdrive. Thermal scanners were installed in train stations, a color
coded surveillance app tells citizens whether they can leave their homes,
a nd millions of security cameras revealed who was breaking quarantine.
Many deemed the lockdown and surveillance measures draconian, but
ultimately successful.
The outbreak was largely contained to the Hubei province, a nd after 76
days of quarantine, the city of Wuhan is starting to open back up.
It's highly unlikely that we'd go that far in the U.S., where our values
and our laws call for greater individual liberties.
The DNA of this country is heavily libertarian enough that that would just
be a non-starter.
But could I imagine small incursions here?
Possibly. Do I think it's necessarily a bad idea?
I don't know. I think I'd need to see the details of implementation.
Researchers and health officials in the U.S.
are scrambling for more comprehensive and granular data, raising the
question of what kind of personal information we should collect in a time
of crisis. So far, the severe lack of testing, as well as our
decentralized healthcare system, has made it hard to understand the true
scope and spread of the disease.
All the modelers are working to some extent in the dark when it comes to
knowing how many folks are already infected or have been infected and
recovered. So in the meantime, we're being told to stay home and many are
still wondering what it will take for life to return to normal.
Apple and Google say they can help.
The tech giants have teamed up to build a tool that will alert smartphone
users if they've been in contact with someone who has coronavirus.
This is called contact tracing and it's helped a number of East Asian
countries to slow the spread.
For it to work though, the public needs to trust that these tech companies
won't be able to access or misuse their sensitive health information.
And while what's been proposed is an opt-in tool, c oncerns swirl that it
could eventually become mandatory and that it will prove difficult to roll
back data gathering efforts after the crisis passes.
In times of emergency, we tend to be willing to give up much more of our
privacy than in normal times.
But once given up, that new status quo tends to persist even after the
emergency is over.
But as we try to get our economy up and running again, a sophisticated
contact tracing tool could be a major part of the solution.
The United States has been slow to aggregate comprehensive data about the
crisis. One reason is simply a lack of widespread testing.
Narrow testing criteria, along with a series of delays and missteps in the
test development process, made it impossible to measure the extent of the
pandemic early on.
Another reason is the United States' decentralized health care system,
which gives states the power to decide what data to gather and release and
what to withhold. Many states have in turn delegated a lot of their
authority to individual municipalities.
What that means essentially is that you have decision makers that are more
diffuse than in other countries.
So much of what we know about the clinical outcomes, severity and risk
factors for Co vid-19, comes largely from data that were published in
China a s the epidemic unfolded in real time.
Even with 95 percent of the country under stay at home orders, experts say
a lack of reliable data can leave citizens confused about what actions to
take, especially since most of us are still leaving sometimes, w hether
it's for exercise, groceries or essential work.
People are making all sorts of individualized decisions about how seriously
they're taking that advice.
And the availability of this information, including trend lines, might
allow them to make the best of these choices they can.
It's a question of, do I want to know or should I know that the street two
streets away from me, every single person on that street 's infected?
But two streets on the other side, nobody is.
Information is power.
It's empowering to understand what's going on around you and how it's
happening. But even knowing more granular location and demographic data
may not be enough to stop the spread.
The prevalence of presymptomatic and asymptomatic carriers means that
those hypothetical neighbors on the other side of the street could be
infected too, they just didn't see a reason to get tested.
This is where contact tracing becomes important.
Contact tracing is a simple concept and an old concept.
Public health departments usually implement it in the early stages of an
epidemic. And the traditional way that they do this is by interviewing the
person and they asked them, where have they been?
Who has been to their house?
Where do they work? And so forth.
And then they just start making calls.
China, Taiwan, South Korea and Singapore have all instituted some degree of
technologically enabled or analog contact tracing, which many credit with
helping to slow the spread.
In many cases, these efforts were aided by mass testing, more centralized
universal health care systems and numerous other surveillance measures,
many of which would not pass muster in the U.S.
The Chinese government's close contact detector app tells users if they've
been in proximity to someone who's confirmed or suspected of having the
virus, but it makes no attempt to privacy.
Users sign up with their full name and I.D.
number and if they're marked as contagious, the government gets all that
info. To identify contagion risks, China relies upon its vast surveillance
infrastructure, which includes security cameras equipped with facial
recognition software and a social credit system that tracks all citizen's
behavior. If you tried to transplant the Chinese system to the United
States, p eople would be up in arms and it likely would be much less
efficacious. South Korea and Taiwan have also managed to flatten the curve
while avoiding widespread lockdowns like we've seen in China and the U.S.
In South Korea, the government uses cell phone location data, video
surveillance and credit card records to monitor activity.
And if a citizen tests positive, an emergency alert is sent out that
includes their last name and a detailed record of their everyday travel.
An app monitors quarantined individuals to make sure they don't leave
home. And the government is now working on getting monitoring bracelets on
people who go into self-isolation for two weeks.
Similarly, Taiwan uses cell phone location data to maintain an electronic
fence around its roughly 55,000 quarantined individuals, which alerts
authorities if anyone strays too far.
The country actually passed enabling legislation on a very rapid basis,
literally a matter of days, to permit the government to do a variety of
things that it wasn't clear they were able to do under existing law, a nd
cabined in that government authority to this time of emergency.
But perhaps the country with the most realistic model for the United States
is Singapore, which has rolled out its own contact tracing app to
compliment intensive analog efforts on this front.
That is, lots of person to person interviews.
An app called TraceTogether that users can choose to install and that will
ping off surrounding phones to let them know if they have been in contact
with the case. And then only if it pings and lights up a contact, are
public health authorities alerted to the data.
Additional measures the country has taken, like requiring quarantined
individuals to verify their whereabouts multiple times a day, would likely
not fly in the U.S.
But overall, Singapore's swift and disciplined response was highly lauded.
Until mid-March, there were only a couple hundred cases and citizens were
still going out for work, school and leisure.
But now, cases are surging and the country went into lockdown at the
beginning of April. So if even Singapore couldn't contain the virus, many
are wondering what kind of response will it take?
Enter Google and Apple, who are teaming up in an unprecedented partnership
to create a contact tracing tool of their own, with much the same premise
as the TraceTogether app.
The two company's operating systems, iOS and Android, power nearly 100
percent of the world's smartphones.
It's absolutely unusual for Apple and Google, these two cutthroat
competitors, to join forces.
They're the only two companies in the world that could do this, right, as
the two major mobile phone technology providers.
If we're gonna do Bluetooth proximity tracing, it has to happen at the
operating system level.
And Apple with iOS and Google with Android, they're the ones who control
that. In mid-May, Google and Apple plan to release the tool, through an
update to their operating systems, that uses Bluetooth signals to log when
a user's smartphone comes into close contact with another user's phone.
Then, if someone tests positive for coronavirus, they'll use an app to
share that information and their phone will send out an alert to all the
other users it's come in close proximity to.
Individuals using the platform will be assigned a random and ever-changing
identification key to ensure anonymity.
The idea is that Google and Apple will build the infrastructure and public
health agencies will build the apps themselves.
A number of efforts are already underway, including an app called Private
Kit: Safe Paths being developed by the Massachusetts Institute of
Technology. The companies emphasize that these apps will be 100 percent
opt-in and that governments will not be allowed to mandate usage.
But to actually do contact tracing effectively , they would need to get
massive buy-in from users.
Yeah, I think it's pretty clear that if only 5 or 10 percent of the U.S.
population opts-in to this app , it's going to have very limited efficacy.
Now, in a place where I live, like Silicon Valley, we'd probably see very
high levels of participation.
But in other parts of the country, you'd probably see virtually zero
participation. As of mid-April, about 20 percent of Singapore's population
had downloaded the TraceTogether app.
But to stop the spread of the virus, the country's development minister
said three quarters of the population would need to use it.
Another contact tracing research group put the figure at 60 percent.
Either way, it's hard to imagine this percentage of the United States
population opting in.
Especially when you consider that according to the Pew Research Center,
only 81 percent of Americans even own a smartphone at all.
And those who don't are often among the most vulnerable.
So we're leaving out elderly people, w e're leaving out homeless people,
we're leaving out people who are living in poverty who might not have
consistent access to electricity or to WiFi.
And we risk undercounting and underserving those very people who need
those resources the most.
But even if lower usage rates couldn't achieve comprehensive contact
tracing, some say these tools could still reveal powerful insights that
might help limit widespread shutdowns.
If in general over a population there's ten to fifteen percent penetrance
of adoption, t hen we'll actually have a good understanding of a good
amount of exposures.
By knowing that and actually applying data science to that, you can
actually create extrapolations, probably the overall map density of
infected individuals and potential exposures.
There's certainly a lot that remains unknown, but experts agree that a
digital tool can only ever be one part of a larger solution, which would
include traditional contact tracing interviews as well as widespread
testing. The biggest hurdle of all though, maybe getting a critical mass
of users to trust these companies with their data.
Over the past few years, big names in tech have regularly made headlines
for privacy violations, such as storing user's location data even when
they've supposedly opted out, a s Google did, or using deceptive settings
and statements to undermine privacy preferences, as Facebook did.
It's true , this app is being developed at a time where there has been
greater distrust of big tech.
Gebhart says t hat's why if digital contact tracing is going to work, the
companies need to be 100 percent transparent about what data they're
collecting, how they're using it, and when that data will expire.
So she doesn't see the opt-in system as a hindrance.
She sees it as a necessity.
Trust is going to be at the core of this.
It can't be coerced.
Coercion is going to make people want to get around it, avoid testing,
avoid treatment. It's important that you be able to turn it off and turn
it back on when you want.
I think that's another thing that might help adoption.
But some would argue that a voluntary app, intermittently used, could never
achieve its goals. Even if the companies say they'd never allow it, Mello
says she could imagine government-mandated adoption holding up in court.
The government would have to show that the steps it was requiring are
necessary to combat a public health threat and reasonable.
They also need to show that there's no less burdensome or invasive way of
getting this information, a nd I don't think that's a very difficult
showing to make at this point in time, given the prevalence of the virus
and the asymptomatic spread.
Another concern is what becomes of this contact data and health data after
the coronavirus crisis passes.
What I would like to see are commitments towards de- identification and
ultimately data destruction.
So even if we are sharing data, it should be held for limited purposes and
for limited periods of time.
On this front though, the U.S.
doesn't have a great record.
My fear is that we're going to adopt new surveillance powers and that they
wouldn't go away after the crisis is over.
I think that's one of the most important things.
And we've been here before.
After 9/11, the United States instituted mass surveillance and we're still
talking about that in the courts today.
Big changes that we make now, even if in theory temporary, have a tendency
to become sticky. Basically, proceed with caution s eems to be the general
sentiment among privacy advocates as Google and Apple move forward with
their development process, and its researchers and governments alike look
at how else to aggregate and utilize data during these uncertain times.
We are going to have other times when this happens, hopefully it's 100
hundred years from now, but maybe it's 50, m aybe it's 20.
And having the digital tools and understanding how we can prepare by
minimizing the economic impact, but maximizing the health benefit is going
to be important. And while we should always strive to minimize risks to
individual privacy, some say we also must consider what we risk as a
society by not aggregating and sharing the data that we have.
So there is a real tradeoff here.
And we have to think not only about the burdens on individuals from using
these data, but also on the burdens from not using these data, which might
include greater spread of the infection and greater persistence of shelter
at home o rders for all of us.
Few would argue that we should go the route out of China.
But as headlines heap praise on Singapore, South Korea and Taiwan's more
stringent and surveillance-intensive methods, it's clear there's an
appetite among some in the U.S.
for a more heavy-handed approach.
Gebhart though, says deciding between privacy and public health is a false
choice. We want to make sure that whatever we're building or using to
address this pandemic, that when we come out the other side, it's a world
we still want to live in. I think whatever technical solutions we put
forward as the solution right now, we don't want them to become tomorrow's
problem.