Ethics in mitigation
Following the comparative success of South Korea and Singapore to flatten the Covid-19 curve, governments around the world have been discussing the merits and feasibility of tech-aided contact tracing systems. (Whether these comparative public health successes are actually attributable to such systems remains a point of debate.) In the US context, app-based tracing proposals have been floated by various think tanks, and Apple and Google have released protocols for their design.
Privacy concerns are paramount, as are questions of efficacy and the opportunity costs of new mitigation tools. In a white paper last month, Danielle Allen, Lucas Stanczyk, Glenn Cohen, Carmel Shachar, Rajiv Sethi, Glen Weyl, and Rosa Brooks examined the ethical and legal bases of pandemic mitigation.
From the paper:
"We are currently in the initial stage of facing the spread of an epidemic, with clear emergency needs to secure our health system while seeking to minimize lives lost and ensure that all patients, including the dying, are treated with dignity. We have to fend off a near-term catastrophe, and in that regard we are in our 'triage' moment. We are currently making triage decisions across all sectors of society.
Securing our health infrastructure and minimizing loss of life requires changing the trajectory of transmission through screening, testing, contact tracing, mobility restrictions, and social distancing. Whereas contact tracing and individualized quarantine and isolation suffice in non-pandemic circumstances, community quarantine and isolation become necessary under pandemic conditions in order to address the emergency. Here the challenging questions are to create the right package of temporarily adjusted norms, regulations, and laws around rights of mobility and association, and to determine whether the relevant packages of norms, regulations, and laws are best."
The authors propose guidelines for decision procedures that promote mitigation without violating civil liberties, justice, democratic institutions, or the "material supports of society." Link to the paper. h/t David Grant
- An evolving list of projects using personal data for Covid-19 response. Link.
- From a 2019 paper on the efficacy of contact tracing and epi models: "A major concern identified in future epidemics is whether public health administrators can collect all the required data for building epidemiological models in a short period of time during the early phase of an outbreak." Link. A 2018 paper on contact tracing's role in the 2014-2015 Ebola outbreak in Liberia. Link.
- Previously shared in this newsletter, a technical paper for the Decentralized Privacy-Preserving Proximity Tracing (DP-3T) protocol. The tweet-length summary from researcher Michael Veale: "Health authorities learn nothing about users. Users learn nothing about other users. Users learn if they were too close to others who tested positive. Governments learn nothing about users. No-one is coerced: everything based on genuine, voluntary consent." Link to the paper. (And link to a comic strip explanation of how it works.)
- An excellent blog post from Ross Anderson at Cambridge's Department of Computer Science and Technology on contact tracing in the real world. Link. See also "Apps Gone Rogue: Maintaining Personal Privacy in an Epidemic." Link.