New Digital Tools Bring Up Old Ethical Dilemmas Around Public Health Surveillance In The COVID-19 Response

New digital technologies such as smartphone apps and localization data have been used to model and monitor the COVID-19 pandemic. But along with hopes that these tools will help curb the pandemic, their use by both authoritarian and democratic governments can invoke images of dystopian surveillance.

These tensions and more will be discussed Wednesday at Will Digital Technologies Save Us from the Pandemic?, the third panel in the Global Pandemics in an Unequal World Series, co-hosted by The New School, The Independent Panel on Global Governance for Health, and Health Policy Watch. 

Cities in China and the Republic of Korea have implemented contact tracing apps that require citizens to input information on daily temperatures and coronavirus symptoms. Taiwan uses a quarantine app that monitors location data on COVID-19 patients, ensuring they remain in isolation. In the United States, anonymized cell phone data has been used to model the spread of the disease. 

“Smartphone apps dominate global discourses on managing the pandemic,” said Sakiko Fukuda-Parr, director of the Julien J. Studley Graduate Programs in International Affairs and professor of International Affairs at The New School. “But let’s not forget public health infrastructure and methods that resulted in 20th century advances in controlling contagious diseases.”  

In the absence of a vaccine or cure, countries have turned towards “classic public health measures” such as contact tracing to map and control the spread of the virus. 

In the United States, which hosts the most coronavirus cases in the world, New York City’s army of contact tracers is doing things the old fashioned way – calling patients who test positive to identify those most at risk of onwards transmission.

Concerns Around Privacy Slow Public Health Surveillance Efforts In NYC
NYC subway resumes normal operation as city shifts to Phase 1. As cities, rapidly identifying new clusters of disease is important to help prevent a resurgence.

But as widespread protests against police brutality grip the United States, old concerns about the ethical use of public health surveillance have resurfaced in New York City, the original epicentre of the US’ COVID-19 epidemic. 

Contact tracing requires asking people for personal information about coworkers, friends, and family members they have been in contact with – and some are hesitant to divulge personal information in the current political climate. Some protestors have been concerned that information used for contact tracing could be repurposed by law enforcement or immigration officers, Naiya*, a community organizer from NYC told Health Policy Watch. 

“While contact tracing may provide critical data to inform policy, it’s use in a racist and carceral society can transform contact tracing into a weapon for state surveillance and for the policing and control of vulnerable people,” they said. “We have to envision community-led, resource oriented, and consensual efforts to contain the pandemic.” 

New York City’s contact tracing team doesn’t ask people about their histories attending protests, according to Sarah*, a contact tracer in Manhattan. Nor does the team ask about immigration status, or divulge patients’ COVID-19 test information to employers or law enforcement. 

Regardless, “some folks are skeptical to share info about their contacts,” said Sarah. “I think privacy is the big concern. For example, home health aides have been hesitant to divulge information about their patients.” 

“If people are hesitant to share, we give them a number to call back after they have done more research on us, and if they feel comfortable sharing their contacts at a later date.”  

Who Creates and Accesses Data in the Smartphone Age?

Some experts are worried that new technologies amplify existing concerns around the ethical use of public health surveillance. In one widely reported case, authorities used information from rideshare company Uber to track down potential contacts of a COVID-19 patient, leading to the suspension of over 240 accounts and two drivers from the platform. 

“Viewed superficially, that’s responsible — but what’s actually happening here is that a private company suspended the livelihood of two drivers and a number of others’ mobility, based on suspicion of exposure, without a whole lot of science,”  writes Sean McDonald, a senior fellow at the Center for International Governance Innovation.

“Concerns surrounding corporate and political interests converge in the contexts of this current global pandemic,”  writes Stephen Roberts, a Global Health Policy fellow at the London School of Economics, noting a growing unease with the increasing role of large, private tech corporations in assisting governments with managing emergencies.

The United Kingdom, for example, recently partnered with Google, Amazon, and data processing firm Palantir on a COVID-19 surveillance project. Google had previously sparked controversy by breaching patient privacy laws when transferring billions of identifiable patient records without consent for a clinical alert app, according to Roberts. Palantir infamously supplied data to United States immigration authorities to inform deportations and family separations. 

 “Public health technologies must be considered within their sociopolitical and economic contexts; and histories,” said Naiya. “In pursuing such measures, we must ask ourselves: Who is this tool benefiting? How do we protect Black, brown, indigenous, undocumented, and disabled communities from violence and retaliation?”

For more on this topic, tune in Thursday to the Will Digital Technologies Save Us from the Pandemic? webinar at 10AM EST/4PM CET.

*Names changed by request of sources

Image Credits: Marc A. Hermann / MTA New York City Transit, NHS England.