Technology and lockdown

Your opinion at the start - stage 1/6

This issue map is mainly based on a report from the Ada Lovelace Institute (‘Ada’ for short) called, “Exit through the App Store? A rapid evidence review on the technical considerations and societal implications of using [information and communication] technology to transition from the COVID-19 crisis”. Their context is the UK.

Ada describe the crisis as “the first pandemic of the algorithmic age”. They say that “data-driven technologies can help to save lives during the present crisis. But they may also expose people to new risks.” Open Up wants to help people to balance the two.

The report covers three technologies. Start, if you wish, by giving your initial view about which of them, if any, can best help us emerge from lockdown. (We'll ask you again at the end, after you have reviewed a range of arguments.)

Read background

Written by Perry Walker

Drag these using the hand symbol () so that they are in order, most preferred at the top

  • Digital symptom trackingmore

    Symptom tracking services take the form of apps and websites that encourage citizens to share some information about themselves (such as their age, gender and medical history), and report their symptoms, usually on a regular basis such as once a day. The data is collected by an organisation that makes it available for research by one or many organisations.

    The purpose is to increase understanding of the disease, support research and understand its spread. It can help politicians and public health authorities to understand what effect social measures such as lockdown and social distancing are having in reducing the spread of the virus.

  • Digital immunity certificatesmore

    A certificate consists of a digital token or other form of authentication that a person has been infected with coronavirus disease in the past and is now presumed to have a form of immunity for a period of time. Testing alone will be ineffective without a means by which tested individuals can certify their immunity.

    Certificates could be used in all sorts of ways. Employers could require employees demonstrate immunity to return to work, food delivery services could require customers to establish immunity before placing orders, or cafés could ask for immunity certification on entry.

  • None of these technologies are worth considering at present
  • Digital contact tracing (as a complement to face to face contact tracing)more

    Contact tracing uses devices carried by people, for example a smartphone, as a proxy for those people. It measures the proximity of those devices to each other and uses that as a proxy for contact. This data is analysed by a risk-scoring algorithm according to certain variables, such as length of contact.

    If it is likely that a person has come into contact with people infected with COVID-19, the device then notifies either the person or a public health authority to provide guidance or instructions.

    Face to face contact tracing involves speaking with patients to identify anyone who has had close contact with them during the time they are considered to be infectious. Each of those people is located as soon as possible, and placed in isolation or quarantine.

Health warnings

We should start with two health warnings. First, bear in mind the publication date of this report: 20th April 2020. This is a fast moving subject and aspects of the report, and hence our map, may be overtaken in the days to come. Second, our map simplifies a complex report of over 50 pages. We have sought to capture the most important points, but inevitably much of significance has been left out. We have particularly sought to capture material that enables the reader to consider these technologies in relation to three key values: social solidarity; civil liberties; and the effect on current health inequalities.

The Ada Lovelace Institute describes its mission as ensuring that data and AI (artificial intelligence) work for people and society. It wishes to promote informed public understanding of the impact of AI and data-driven technologies on different groups in society. Open Up has no connection with the Institute, but shares that desire to inform understanding.

We have used a few other sources. These are indicated in the text.

The risks and benefits that have to be balanced

It is important to look at any possible way that could allow us to ease lockdown. As well as the need to restart the economy, lockdown is giving rise to direct health risks (leaving vulnerable children without support and safeguards, exacerbating domestic abuse, mental health issues and suicides) as well as secondary health harms caused by a deep recession.

Against these potential benefits are the risks of using data-driven technologies. These include: inaccurate, irresponsible or imprecise use of data or technology, which can undermine public health strategies, exacerbate the spread of the pandemic or erode public trust and confidence in authority and government. Bad use of data can be counterproductive – it can obscure truths, hide abuses of power, and stigmatise or disadvantage groups already suffering from health inequalities.

There are difficult trade-offs here. Ada is clear that those trade-offs, and the principles that underlie them, need to be made explicit by decision makers.

Case studies: China and South Korea

China, where this outbreak started, has started to relax lockdown measures in cities and is using technical measures as part of its efforts to reduce the chance of further outbreaks. People who are found to have the virus are quarantined. Two health status applications are being used by local authorities, employers, cafes and restaurants to inform movement and work restrictions.The applications assign individuals a colour-coded health status that is used as part of measures to control where and when people can travel. This is believed to draw on data such as location, self-reported health data and national identity number.It is not clear how many mistakes are made or whether people can appeal their status.

South Korea has a programme of testing (including drive-through testing), mask distribution, contact tracing and quarantine.Law enforcement authorities check that these rules are being followed. Quarantined individuals are required to download a government app which monitors their location and is used to enforce quarantine, as well as connect them to health care workers.Contact tracing is enhanced through the use of mobile phone location data, and the government broadcasts messages about infected individuals’ movements.

Sources:

1. https://blogs.bmj.com/bmj/2020/03/30/population-level-covid-19-symptom-tracking-is-the-health-radar-we-lack

2. https://spectrum.ieee.org/the-human-os/biomedical/ethics/halting-covid19-benefits-risks-digital-contact-tracing

3. https://www.statnews.com/2020/04/10/immunity-certificates-covid-19-practical-ethical-conundrums/

4. https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19

5. Immunoprivilege – lessons from the 19th-century Deep South Excerpted from Kathryn Olivarius, ‘The Dangerous History of Immunoprivilege’, The New York Times, 12 April 2020 (quoted in the Ada report)

6. https://www.theguardian.com/world/2020/mar/06/more-scary-than-coronavirus-south-koreas-health-alerts-expose-private-lives