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< | Contact Tracing during COVID-19 - out with medical secrecy? (draft 1) | >
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The Failure of Digital Contact Tracing during COVID-19 | | | -- By YanisAliouche - 13 Oct 2023
Introduction | |
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< | The COVID-19 pandemic represents the first time a wide exception to medical secrecy was implemented . Individual’s personal liberties and privacy were greatly hindered to mor efficiently combat the spread of the virus. | >
> | The COVID-19 epidemic represented a massive shift in governments and populations reliance towards technology in order to ensure the continuation of work, education, and general communications amidst the health crisis. Because of this extensive reliance arose the question as to whether the development of new digital platforms could help combat the ever-developing epidemic. Governments decided to put this to the test through the implementation of COVID contact-tracing apps. This essay aims to address how the faith of governments in digital contract tracing and covid tracing apps was misplaced and failed when combatting the spread of the virus. | | | | |
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I'm not sure what work this sentence is supposed to do. It creates more objections in the reader's mind (all other existing mandatory public health reporting is different why? Medical privacy is a thing of yesterday and has been routinely violated everywhere since whenever. If this is about contact tracing, then why is it different than all traditional public health, more of which was disregarded during the epidemic than was followed?) than it provides a statement of your idea. Let's lede this right.
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> | Off to a bad start: the lack of expertise of governments in app development
To start out, the lack of expertise of state governments in app development did not help these apps get off to a good start. Constant delays and errors in the development of the apps already put in question the efficiency of these apps. Teddy Gold, director of a nonprofit making pandemic response software witnessed the difficulty of coordination in governments, as app developers were sent from various administrative departments and offices to department in order to obtain adequate permissions – “States don’t develop apps”. This caused delays in the release of these apps overall, and created the sentiment that they were arriving too late: “It’s like the plane has crash-landed and everyone has died and the captain scrambles out of the rubble and he’s like, ‘Okay guys, in an emergency landing there are lifejackets under your seats”. | | | | |
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< | Notably, the World Health Organization endorsed contact tracing as a primary method in breaking “the chains of human-to-human transmission by identifying people exposed to confirmed cases, quarantining them, following up with them to ensure rapid isolation, and testing and treatment in case they develop symptoms” . | >
> | Governments didn’t have the time and resources to get it right, and in consequence, many rushed development. In Norway for instance, the app Smittestopp was shut down shortly after its release as the ‘the risks of intensified surveillance outweighed the app’s as of yet unproven public health benefits” . In India, after the app that was downloaded more than 77 million times, it was found that it was able to leak users’ precise locations. The government then fixed the issue and began paying security researchers who found vulnerabilities in their app. This policy adopted by some of releasing these apps then refining and correcting their issues after affected the peoples’ trust in the government, a component vital in the struggle against the pandemic. It seems that these efforts were more about showcasing government engagement in fighting the virus rather than implementing effective means. | | | | |
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< | France adopted two different methods with regards to tracing: Manual Contact Tracing, consisting of interviewing infected persons to identify their contacts, and Digital Contact Tracing, implementing an app ‘TousAntiCovid’ which would send out alerts when a person encountered someone who had COVID. | | | | |
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< | This essay will explore how France, despite the recognition of the right to privacy as a fundamental right, created legal exceptions to this right during the COVID-19 pandemic. It will assess the effectiveness of the addressing privacy concerns and address ongoing privacy concerns. | | | | |
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Why France? You aren't there, you're here, where Gallic provincialism isn't charming.
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> | Ineffectiveness of the Apps
Ultimately, digital contact tracing failed to be efficient. Firstly, not enough people used the apps for them to be functional. An Oxford study stated that for these to be effective, 60% of the country’s population would have to download and use the apps. Many states failed to achieve these numbers: in Germany 21.7% of the population had the app. In Ireland, 26.3%. In New York and New Jersey, 4% had the app downloaded a month after release. Even those that did download the apps may not have isolated following receipts of exposure notifications. | | | | |
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> | For the people to engage in this digital contact tracing, governments needed to gain people’s trust: trust in the government and trust in their response to the epidemic. | | | | |
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< | The legal framework allowing impediment on the right to privacy
In France, the right to privacy enjoys constitutional and legal protection. It first finds such value in Article 2 of the 1789 Declaration of the Rights of Man and the Citizen, imbedded in the preamble of the Constitution . Legally, Article 9 of the Civil Code guarantees “everyone has the right to respect for his private life”, and article L1110-4 of the Public Health Code creates professional duty of health professionals, ensuring a patient’s right to secrecy with a list of exceptions, if the patient consents. | >
> | Privacy and efficiency
The more data was collected by the apps, the more people may worry about the divulgation of their personal information – from location to sensitive information. For instance, digital contact tracing pseudonymizes data – it doesn’t anonymize it. In the case of centralized systems such as France or Australia where one this may pose issues when combining other data collected by the platform, which may lead to identifying individuals. | | | | |
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< | However, the arrival of the pandemic necessitated exceptions to these privacy protections. As member of the European Union, France adheres to the EU General Data Protection Regulation (GDPR). Article 9 of the GDPR prohibits the processing of personal data (including health data), but for some enumerated situations. Notably, article 9(2)(i), allows for exceptions when “processing is necessary for reasons of public interest in the area of public health…” . Thus, France passed the Law of May 11th, 2020, introduced “by derogation to article L.1110-4 of the Public Health Code” . The law allowed for the implementation of France’s contact tracing tools. What changes?
Before, patients would have to give their consent for their data to be shared. Now, your personal data can be processed without your consent, marking a significant shift in the landscape of privacy protection. | >
> | However, privacy doesn’t paint the whole picture: it is true that people were ready to sacrifice their privacy if they were sure the app would ensure a road towards ‘normalcy’ – if they were efficient. If we look at Singapore for instance, many people opted into downloading the tracing app after the government promised to relax restrictions when adoption increased from 50% to 70%. Additionally, too much privacy could make difficult for public health officials and individuals to have information that may be important to better understand the spread of the virus. | | | | |
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< | For these contact tracing systems to be permissible, the law enabling them had to pass the Constitutional Council’s proportionality test, ensuring that measures infringing on privacy were proportionate to public health safety goals. Secondly, the effectiveness of these systems depends on the cooperation of the French population. For people to trust and actively participate in these systems, the government had to create an image of full confidentiality for the systems to succeed (authors speak of “perceived confidentiality”) . | >
> | Poor advertisement
The apps were often advertised in the wrong way – either not advertised enough, or advertised through the wrong lens: the technology was not meant to replace traditional means of tracing and public health methods generally, it was meant to accompany these. Governments however used the wrong approach – the Australian app COVIDSafe was advertised as a “digital vaccine” and a “road to recovery”. In Norway, the Prime Minister assured “if many people download the Smittestopp app, we can open up society more and get our freedom back”. At the time, we knew it was wrong. Today, we know this is untrue. | | | | |
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> | App mechanisms
The apps themselves proved to be quite ineffective. Many were easily hackable and could divulge lots of personal information in unwanted hands, as we explored with the issues present at app rollouts. In addition, the apps functioned through BlueTooth? or GPS, which posed significant challenges. Bluetooth signals moves through walls, meaning you may receive a notification for COVID exposure even though you were separated from the infected. The systems don’t know many circumstances, such as whether the individual wearing a mask… A study on contact tracing through Bluetooth revealed that Bluetooth’s distance measurements were highly inaccurate on a tram: the app sent false positives and false negatives for contact at a 50% rate – “the performance of such detection rules is similar to that of triggering notifications by randomly selecting from the participants in our experiments, regardless of proximity”. | | | | |
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< | Efforts to preserve the right privacy
During the Constitutional Council review of MCT system, they approved its limited use for specific purposes, finding that the limitation set for processed data was proportional to the goal of safeguarding public health. However, they objected to the inclusion of telephone numbers and email addresses for epidemiological surveillance and research, deeming it unnecessary. They also struck down part of article 11 of the Law of May 11th2020, which listed entities who would have access to personal data. Finally, time limits were established, allowing MCT systems only during the period strictly necessary to combat COVID-19, with a maximum duration of 6 months after the end of state of health emergency. Extending a state of emergency beyond a month require legal authorization. | | | | |
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< | MCT lacked in efficiency due to participants’ inability to identify people they encountered that they didn’t know, as well as significant consumption of time and resources. In response, the French governments introduced the StopCovid? app, later renamed TousAntiCovid? . It uses Bluetooth to record nearby app users’ pseudonyms of nearby app users when Bluetooth is enabled. Encounters are stored for 15 days, and if a user self-reports a COVID-19 diagnosis, nearby users potential exposure notifications within the past two weeks . The app pseudonymizes data through the ROBERT Protocol, ensuring it only collects data necessary for its purposes, excluding any data enabling the identification of mobile phones, owners, or users .
Privacy issues arising despite efforts
Despite efforts to protect personal information as much as possible through use of their contact tracking systems, multiple organisms reserve doubts as to the effectiveness of the protection.
Regarding MCT time constraints, France extended the use of its MCT systems beyond the original timeframe. The CNIL expressed concerns about the long-term use of these supposedly temporary systems, regretting that the government provided insufficient justification for maintaining these tools, despite the reduction of virus circulation . Data storage was also extended beyond the initial 3-month limit for research and epidemical purposes. The French Medical Council opposed, stating that its support of MCT systems had been based on the data period storage initially guaranteed. Additionally, while the Constitutional Council had partially reduced the list of stakeholders with access to personal data, it remained extensive.
In the case of DCT, pseudonymized data does not mean anonymized data. Centralized CT systems can lead to combining pseudonymized data with other data collected by a device, ultimately leading to the determination of one’s identity. TousAntiCovid? app uses the ROBERT system and a CLEA system, which generates QR codes for users to present as proof of vaccination when entering public places. It creates a timestamp and recognizes location information. Although independent from ROBERT, cross referencing information between the two systems allows for deduction of a person’s identity . Additionally, when someone is tested positive for COVID, CLEA’s processing of data stops as the person has no reason to enter public spaces – only ROBERT continues. Thus, when you see that CLEA has stopped processing data, it is safe to deduce that the person has contracted COVID.
In my view, the best way to improve the draft is to find the idea you want to convey to the reader, state it clearly, show how you came by it, deal with the relevant objections as you think necessary, and give the reader a way to carry the idea further for herself.
Whatever the organizing idea is, it is not "during a global health emergency involving the largely homogenized platform-based social communication and control system of the early 21st century, here are a bunch of acronyms related to the way one tiny unimportant self-deceiving bunch of incompetents did pretty much the same as everyone else but you need to read all the details about it because I am French."
I recognize that this sort of bullshit has been what Les Grands Personnages have defined as education since Napoleon, and that no Son of the Hexagon can be faulted for routinely delivering it whenever thinking is called for. But you have escaped. Lafayettes, nous sommes ici. In the New World we can have new ideas. Let's give it a spin: Find your inner Benjamin Franquelin.
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> | What worked? | | |
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> | The focus on the development of these apps should have been redirected on more efficient means of combatting the epidemic, notably sticking to what we know best: traditional public health methods: manual contact tracing helped identify the spread of the virus more concisely by directly identifying individuals and their recent contacts and settings. Investment in infrastructures where personnel and equipment were lacking – there was a need for more hospital beds, COVID tests, masks…
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