Health and Healthcare Systems

COVID-19 contact tracing must be ethical and responsible. Here's why

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Dr. Steven Waterhouse
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  • Technology can automate contact tracing to ensure that it can be conducted quickly and effectively.
  • Standards must guide the deployment of contact tracing apps to protect user privacy.

As the world grapples with the continuing fallout of the COVID-19 pandemic, governments are moving to establish and expand systems for effective contract tracing. This will be essential to limiting spread and preventing a resurgence of the novel coronavirus. But implementation will not be straightforward: there are many different ways to conduct contact tracing, ranging from analog shoe-leather methods, to those that leverage technologies. Regardless of how it is conducted, without proper safeguards, contact tracing can increase the risk that people’s day-to-day behavior will be monitored and controlled.

Some experts have predicted that the virus will be with us for years to come. Given that potential, it’s crucial that appropriate, effective contact tracing standards are established that facilitate the protection of both health and privacy.


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What's contact tracing and why is it needed?

Contact tracing is a successful technique that has controlled plagues and viruses for hundreds of years, reaching back to the bubonic plague. At its heart, it takes the form of an “army” of human operatives who identify and isolate anyone who has been in close proximity to an infected person. Under this setup, anyone who tests positive for COVID-19 may be asked with whom they’ve come into contact during the preceding 14 days. Those contacts will then be manually tracked down and notified by phone.

Manual tracing is effective but slow. In fact, for some cities currently coping with super spreaders, manual tracing alone might be too slow to be relied on. Based on what we know about COVID-19, it’s possible that we need to identify contacts the same day people find out they’re infected. This will require the help of technology, in the form of contact-tracing apps that automate the work.

Contact tracing apps use location data gathered automatically from mobile devices to identify and notify people who have come into contact with anyone who tests positive for the virus. The ability of apps to identify and notify at-risk people automatically is much more efficient than manual systems based on interviews and phone calls. And contact tracing apps have another advantage over analog systems: people spend much of their lives looking at their phones. In some parts of the world, the average screen time has reached 4 hours and 23 minutes per day, ensuring that users can receive updates swiftly and effectively.

There is important traction in developing mobile apps for contact tracing. Two open protocols, Decentralized Privacy-Preserving Proximity Tracing and Pan-European Privacy-Preserving Proximity Tracing, are working to develop frameworks that can be applied globally. Multiple nations have signed on to take part in these efforts - a positive sign in our interconnected world.

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Risks to take into account

Automated contact tracing apps, if properly implemented, can reduce the risk of human error. But we must be careful not to substitute human error with mass surveillance, which could be made possible if adequate guardrails are not established early on.

An app that can track people’s movements to identify potential COVID cases can also be used to monitor other behaviors. Technology is amoral, which is why it's essential to develop standards to ensure contact tracing is done responsibly and that the technology that keeps us safe from illness doesn’t also put people's privacy at risk.

Protecting health and privacy

Contact tracing standards can limit the collection, storage, and sharing of citizens’ data so that it isn’t used for any purpose other than slowing the spread of COVID-19. These can include government mandates that ensure data gathered through contact tracing cannot be shared beyond relevant healthcare providers and other essential first responders. Rules should be established to make sure contact tracing data will not be retained after a certain period - ideally weeks or months, not years.

For the strongest protection, governments should adopt solutions that build these safeguards into the technology itself. The only way for data to be truly private is for it to live on individual devices and nowhere else, so that no middleman can retroactively search through transmission logs and identify a person’s tracing history. Encrypted messaging apps like WhatsApp already use this standard, and contact-tracing systems should follow suit. One way to do this is through the adoption of decentralized apps for contact tracing, in which people’s devices communicate directly with one another on an encrypted basis, bypassing a central authority altogether.

Exposure Notification is one such decentralized contact tracing model that is gaining traction. A collaboration between Google and Apple, it is an “opt-in” solution with a stated goal of monitoring community spread while protecting citizens’ privacy. A number of governments have expressed interest in Exposure Notification, and other projects are underway in parallel.

No solution is perfect, of course, and the decentralized approach is not without weaknesses. Apple and Google’s use of bluetooth for proximity data, with its 100-meter radius, could yield false positives. And the system’s reliance on IP addresses is a potential Achilles’ heel that could open people up to the very sort of invasive tracking the project purports to be trying to prevent. But there are known measures that can be taken to mitigate these risks, such as banning location tracking in apps that use any decentralized tracing system.

Looking ahead

A vaccine is many months away and cities around the world will need to find ways to control the virus while retaining the public's trust.

Though the overwhelming goal of the coming months will be to make progress against the global pandemic, it’s essential that any contact tracing solution prioritize and protect individual privacy. We have the technology to do this; all that’s needed is the will to implement it. Strong, clear standards around contact tracing that protect people’s right to privacy as well as their health will be a major step in the right direction.

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Health and Healthcare SystemsEmerging TechnologiesGlobal Cooperation
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