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Comer L, Donelle L, Hiebert B, Smith MJ, Kothari A, Stranges S, Gilliland J, Long J, Burkell J, Shelley JJ, Hall J, Shelley J, Cooke T, Ngole Dione M, Facca D. Short- and Long-Term Predicted and Witnessed Consequences of Digital Surveillance During the COVID-19 Pandemic: Scoping Review. JMIR Public Health Surveill 2024; 10:e47154. [PMID: 38788212 PMCID: PMC11129783 DOI: 10.2196/47154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/23/2023] [Accepted: 03/20/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has prompted the deployment of digital technologies for public health surveillance globally. The rapid development and use of these technologies have curtailed opportunities to fully consider their potential impacts (eg, for human rights, civil liberties, privacy, and marginalization of vulnerable groups). OBJECTIVE We conducted a scoping review of peer-reviewed and gray literature to identify the types and applications of digital technologies used for surveillance during the COVID-19 pandemic and the predicted and witnessed consequences of digital surveillance. METHODS Our methodology was informed by the 5-stage methodological framework to guide scoping reviews: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the findings. We conducted a search of peer-reviewed and gray literature published between December 1, 2019, and December 31, 2020. We focused on the first year of the pandemic to provide a snapshot of the questions, concerns, findings, and discussions emerging from peer-reviewed and gray literature during this pivotal first year of the pandemic. Our review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guidelines. RESULTS We reviewed a total of 147 peer-reviewed and 79 gray literature publications. Based on our analysis of these publications, we identified a total of 90 countries and regions where digital technologies were used for public health surveillance during the COVID-19 pandemic. Some of the most frequently used technologies included mobile phone apps, location-tracking technologies, drones, temperature-scanning technologies, and wearable devices. We also found that the literature raised concerns regarding the implications of digital surveillance in relation to data security and privacy, function creep and mission creep, private sector involvement in surveillance, human rights, civil liberties, and impacts on marginalized groups. Finally, we identified recommendations for ethical digital technology design and use, including proportionality, transparency, purpose limitation, protecting privacy and security, and accountability. CONCLUSIONS A wide range of digital technologies was used worldwide to support public health surveillance during the COVID-19 pandemic. The findings of our analysis highlight the importance of considering short- and long-term consequences of digital surveillance not only during the COVID-19 pandemic but also for future public health crises. These findings also demonstrate the ways in which digital surveillance has rendered visible the shifting and blurred boundaries between public health surveillance and other forms of surveillance, particularly given the ubiquitous nature of digital surveillance. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-https://doi.org/10.1136/bmjopen-2021-053962.
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Affiliation(s)
- Leigha Comer
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Lorie Donelle
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
- School of Nursing, University of South Carolina, Columbia, SC, United States
| | - Bradley Hiebert
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Maxwell J Smith
- School of Health Studies, Western University, London, ON, Canada
| | - Anita Kothari
- School of Health Studies, Western University, London, ON, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Departments of Family Medicine and Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- The Africa Institute, Western University, London, ON, Canada
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Jason Gilliland
- Department of Geography and Environment, Western University, London, ON, Canada
| | - Jed Long
- Department of Geography and Environment, Western University, London, ON, Canada
| | - Jacquelyn Burkell
- Faculty of Information and Media Studies, Western University, London, ON, Canada
| | | | - Jodi Hall
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - James Shelley
- Faculty of Health Sciences, Western University, London, ON, Canada
| | - Tommy Cooke
- Surveillance Studies Centre, Queen's University, Kingston, ON, Canada
| | | | - Danica Facca
- Faculty of Information and Media Studies, Western University, London, ON, Canada
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Alberto IRI, Alberto NRI, Ghosh AK, Jain B, Jayakumar S, Martinez-Martin N, McCague N, Moukheiber D, Moukheiber L, Moukheiber M, Moukheiber S, Yaghy A, Zhang A, Celi LA. The impact of commercial health datasets on medical research and health-care algorithms. Lancet Digit Health 2023; 5:e288-e294. [PMID: 37100543 PMCID: PMC10155113 DOI: 10.1016/s2589-7500(23)00025-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/26/2022] [Accepted: 02/03/2023] [Indexed: 04/28/2023]
Abstract
As the health-care industry emerges into a new era of digital health driven by cloud data storage, distributed computing, and machine learning, health-care data have become a premium commodity with value for private and public entities. Current frameworks of health data collection and distribution, whether from industry, academia, or government institutions, are imperfect and do not allow researchers to leverage the full potential of downstream analytical efforts. In this Health Policy paper, we review the current landscape of commercial health data vendors, with special emphasis on the sources of their data, challenges associated with data reproducibility and generalisability, and ethical considerations for data vending. We argue for sustainable approaches to curating open-source health data to enable global populations to be included in the biomedical research community. However, to fully implement these approaches, key stakeholders should come together to make health-care datasets increasingly accessible, inclusive, and representative, while balancing the privacy and rights of individuals whose data are being collected.
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Affiliation(s)
| | | | - Arnab K Ghosh
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Bhav Jain
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | | | - Ned McCague
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Markforged, Watertown, MA, USA
| | - Dana Moukheiber
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Lama Moukheiber
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Mira Moukheiber
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Sulaiman Moukheiber
- Department of Computer Science, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Antonio Yaghy
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; New England Eye Center, Tufts University Medical Center, Boston, MA, USA
| | - Andrew Zhang
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Leo Anthony Celi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA.
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Ribeiro M, Teixeira D, Barbosa P, Nunes NJ. Using passive Wi-Fi for community crowd sensing during the COVID-19 pandemic. JOURNAL OF BIG DATA 2023; 10:7. [PMID: 36686620 PMCID: PMC9844951 DOI: 10.1186/s40537-022-00675-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Sensing passersby and detecting crowded locations is a growing area of research and development in the last decades. The COVID-19 pandemic compelled authorities and public and private institutions to monitor access and occupancy of crowded spaces. This work addresses the detection of crowds in points of interest (POI) by using a territory grid analysis categorizing POIs by the services available in each location and comparing data gathered from a community passive Wi-Fi infrastructure against mobile cellular tower association data from telecom companies. In Madeira islands (Portugal), we used data from the telecom provider NOS for the timespan of 4 months as ground truth and found a strong correlation with sparse passive Wi-Fi. An official regional mobile application shows the occupancy data to end-users based on the territory categorization and the passive Wi-Fi infrastructure in POIs. Occupancy data shows historical hourly trends of each location, and the real-time occupation, helping visitors and locals plan their commutes better to avoid crowded spaces.
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Affiliation(s)
- Miguel Ribeiro
- ITI/LARSyS, Instituto Superior Técnico, Lisbon, Portugal
| | - Diogo Teixeira
- Mathematics, Instituto Superior Técnico, Lisbon, Portugal
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Donelle L, Comer L, Hiebert B, Hall J, Shelley JJ, Smith MJ, Kothari A, Burkell J, Stranges S, Cooke T, Shelley JM, Gilliland J, Ngole M, Facca D. Use of digital technologies for public health surveillance during the COVID-19 pandemic: A scoping review. Digit Health 2023; 9:20552076231173220. [PMID: 37214658 PMCID: PMC10196539 DOI: 10.1177/20552076231173220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December 2020 to provide a snapshot of questions, concerns, discussions, and findings emerging at this pivotal time. A total of 147 peer-reviewed and 79 grey literature publications reporting on digital technology use for surveillance across 90 countries and regions were retained for analysis. The most frequently used technologies included mobile phone devices and applications, location tracking technologies, drones, temperature scanning technologies, and wearable devices. The utility of digital technologies for public health surveillance was impacted by factors including uptake of digital technologies across targeted populations, technological capacity and errors, scope, validity and accuracy of data, guiding legal frameworks, and infrastructure to support technology use. Our findings raise important questions around the value of digital surveillance for public health and how to ensure successful use of technologies while mitigating potential harms not only in the context of the COVID-19 pandemic, but also during other infectious disease outbreaks, epidemics, and pandemics.
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Affiliation(s)
- Lorie Donelle
- College of Nursing, University of South
Carolina, USA
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Leigha Comer
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Brad Hiebert
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Jodi Hall
- Arthur Labatt Family School of Nursing, Western University, Canada
| | | | | | - Anita Kothari
- School of Health Studies, Western University, Canada
| | - Jacquelyn Burkell
- Faculty of Information and Media
Studies, Western University, Canada
| | - Saverio Stranges
- Schulich School of Medicine &
Dentistry, Western University, Canada
| | - Tommy Cooke
- Surveillance Studies Centre, Queen's University, Canada
| | - James M. Shelley
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Jason Gilliland
- Department of Geography and
Environment, Western University, Canada
| | - Marionette Ngole
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Danica Facca
- Faculty of Information and Media
Studies, Western University, Canada
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Wang Z, Xiong H, Tang M, Boukhechba M, Flickinger TE, Barnes LE. Mobile Sensing in the COVID-19 Era: A Review. HEALTH DATA SCIENCE 2022; 2022:9830476. [PMID: 36408201 PMCID: PMC9629686 DOI: 10.34133/2022/9830476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022]
Abstract
Background During the COVID-19 pandemic, mobile sensing and data analytics techniques have demonstrated their capabilities in monitoring the trajectories of the pandemic, by collecting behavioral, physiological, and mobility data on individual, neighborhood, city, and national scales. Notably, mobile sensing has become a promising way to detect individuals' infectious status, track the change in long-term health, trace the epidemics in communities, and monitor the evolution of viruses and subspecies. Methods We followed the PRISMA practice and reviewed 60 eligible papers on mobile sensing for monitoring COVID-19. We proposed a taxonomy system to summarize literature by the time duration and population scale under mobile sensing studies. Results We found that existing literature can be naturally grouped in four clusters, including remote detection, long-term tracking, contact tracing, and epidemiological study. We summarized each group and analyzed representative works with regard to the system design, health outcomes, and limitations on techniques and societal factors. We further discussed the implications and future directions of mobile sensing in communicable diseases from the perspectives of technology and applications. Conclusion Mobile sensing techniques are effective, efficient, and flexible to surveil COVID-19 in scales of time and populations. In the post-COVID era, technical and societal issues in mobile sensing are expected to be addressed to improve healthcare and social outcomes.
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Affiliation(s)
- Zhiyuan Wang
- School of Engineering and Applied Science, University of Virginia, Charlottesville, USA
| | - Haoyi Xiong
- Big Data Lab, Baidu Research, Baidu Inc., BeijingChina
| | - Mingyue Tang
- School of Engineering and Applied Science, University of Virginia, Charlottesville, USA
| | - Mehdi Boukhechba
- School of Engineering and Applied Science, University of Virginia, Charlottesville, USA
| | - Tabor E. Flickinger
- Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Laura E. Barnes
- School of Engineering and Applied Science, University of Virginia, Charlottesville, USA
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Afroogh S, Esmalian A, Mostafavi A, Akbari A, Rasoulkhani K, Esmaeili S, Hajiramezanali E. Tracing app technology: an ethical review in the COVID-19 era and directions for post-COVID-19. ETHICS AND INFORMATION TECHNOLOGY 2022; 24:30. [PMID: 35915595 PMCID: PMC9330978 DOI: 10.1007/s10676-022-09659-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
We conducted a systematic literature review on the ethical considerations of the use of contact tracing app technology, which was extensively implemented during the COVID-19 pandemic. The rapid and extensive use of this technology during the COVID-19 pandemic, while benefiting the public well-being by providing information about people's mobility and movements to control the spread of the virus, raised several ethical concerns for the post-COVID-19 era. To investigate these concerns for the post-pandemic situation and provide direction for future events, we analyzed the current ethical frameworks, research, and case studies about the ethical usage of tracing app technology. The results suggest there are seven essential ethical considerations-privacy, security, acceptability, government surveillance, transparency, justice, and voluntariness-in the ethical use of contact tracing technology. In this paper, we explain and discuss these considerations and how they are needed for the ethical usage of this technology. The findings also highlight the importance of developing integrated guidelines and frameworks for implementation of such technology in the post- COVID-19 world. Supplementary Information The online version contains supplementary material available at 10.1007/s10676-022-09659-6.
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Affiliation(s)
- Saleh Afroogh
- Department of Philosophy, The State University of New York at Albany, Albany, NY 12203 USA
| | - Amir Esmalian
- UrbanResilience.AI Lab, Zachry Department of Civil and Environmental Engineering, Texas A&M University, College Station, TX 77840 USA
| | - Ali Mostafavi
- UrbanResilience.AI Lab, Zachry Department of Civil and Environmental Engineering, Texas A&M University, College Station, TX 77840 USA
| | - Ali Akbari
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77840 USA
| | | | - Shahriar Esmaeili
- Department of Physics and Astronomy, Texas A&M University, College Station, TX 77843 USA
| | - Ehsan Hajiramezanali
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX USA
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7
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The value of social interactions and incentives on the use of a digital contact tracing tool post COVID-19 lockdown in Singapore. Sci Rep 2022; 12:12416. [PMID: 35859056 PMCID: PMC9297674 DOI: 10.1038/s41598-022-16820-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 07/15/2022] [Indexed: 11/20/2022] Open
Abstract
We assessed the preferences and trade-offs for social interactions, incentives, and being traced by a digital contact tracing (DCT) tool post lockdown in Singapore by a discrete choice experiment (DCE) among 3839 visitors of a large public hospital in Singapore between July 2020 – February 2021. Respondents were sampled proportionately by gender and four age categories (21 – 80 years). The DCE questionnaire had three attributes (1. Social interactions, 2. Being traced by a DCT tool, 3. Incentives to use a DCT tool) and two levels each. Panel fixed conditional logit model was used to analyse the data. Respondents were more willing to trade being traced by a DCT tool for social interactions than incentives and unwilling to trade social interactions for incentives. The proportion of respondents preferring no incentives and could only be influenced by their family members increases with age. Among proponents of monetary incentives, the preferred median value for a month’s usage of DCT tools amounted to S$10 (USD7.25) and S$50 (USD36.20) for subsidies and lucky draw. In conclusion, DCE can be used to elicit profile-specific preferences to optimize the uptake of DCT tools during a pandemic. Social interactions are highly valued by the population, who are willing to trade them for being traced by a DCT tool during the COVID-19 pandemic. Although a small amount of incentive is sufficient to increase the satisfaction of using a DCT tool, incentives alone may not increase DCT tool uptake.
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Buchbinder M, Juengst E, Rennie S, Blue C, Rosen DL. Advancing a Data Justice Framework for Public Health Surveillance. AJOB Empir Bioeth 2022; 13:205-213. [PMID: 35442141 PMCID: PMC10777676 DOI: 10.1080/23294515.2022.2063997] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Bioethical debates about privacy, big data, and public health surveillance have not sufficiently engaged the perspectives of those being surveilled. The data justice framework suggests that big data applications have the potential to create disproportionate harm for socially marginalized groups. Using examples from our research on HIV surveillance for individuals incarcerated in jails, we analyze ethical issues in deploying big data in public health surveillance. METHODS We conducted qualitative, semi-structured interviews with 24 people living with HIV who had been previously incarcerated in county jails about their perspectives on and experiences with HIV surveillance, as part of a larger study to characterize ethical considerations in leveraging big data techniques to enhance continuity of care for incarcerated people living with HIV. RESULTS Most participants expressed support for the state health department tracking HIV testing results and viral load data. Several viewed HIV surveillance as a violation of privacy, and several had actively avoided contact from state public health outreach workers. Participants were most likely to express reservations about surveillance when they viewed the state's motives as self-interested. Perspectives highlight the mistrust that structurally vulnerable people may have in the state's capacity to act as an agent of welfare. Findings suggest that adopting a nuanced, context-sensitive view on surveillance is essential. CONCLUSIONS Establishing trustworthiness through interpersonal interactions with public health personnel is important to reversing historical legacies of harm to racial minorities and structurally vulnerable groups. Empowering stakeholders to participate in the design and implementation of data infrastructure and governance is critical for advancing a data justice agenda, and can offset privacy concerns. The next steps in advancing the data justice framework in public health surveillance will be to innovate ways to represent the voices of structurally vulnerable groups in the design and governance of big data initiatives.
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Affiliation(s)
- Mara Buchbinder
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Eric Juengst
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Stuart Rennie
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Colleen Blue
- Institute for Global Health and Infectious Diseases, UNC—Chapel Hill
| | - David L. Rosen
- Division of Infectious Diseases, Department of Medicine, UNC—Chapel Hill
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Explaining citizens’ resistance to use digital contact tracing apps: A mixed-methods study. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2022; 63:102468. [DOI: 10.1016/j.ijinfomgt.2021.102468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/20/2022]
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Akinbi A, Forshaw M, Blinkhorn V. Contact tracing apps for the COVID-19 pandemic: a systematic literature review of challenges and future directions for neo-liberal societies. Health Inf Sci Syst 2021; 9:18. [PMID: 33868671 PMCID: PMC8042619 DOI: 10.1007/s13755-021-00147-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 03/26/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has spread with increased fatalities around the world and has become an international public health crisis. Public health authorities in many countries have introduced contact tracing apps to track and trace infected persons as part of measures to contain the spread of the Severe Acute Respiratory Syndrome-Coronavirus 2. However, there are major concerns about its efficacy and privacy which affects mass acceptance amongst a population. This systematic literature review encompasses the current challenges facing this technology and recommendations to address such challenges in the fight against the COVID-19 pandemic in neo-liberal societies. METHODS The systematic literature review was conducted by searching databases of Google Scholar, Web of Science, PubMed, IEEE Xplore Digital Library, PsycInfo and ScienceDirect using the search terms ("Contact Tracing" OR "Contact Tracing apps") AND ("COVID-19" OR "Coronavirus") to identify relevant literature. The searches were run against the title, keywords, or abstract, depending on the search platforms. The searches were conducted between January 1, 2020, through 31st January 2021. Further inputs were also taken from preprints, published government and technical reports. We explore and discuss from the selected literature, the key challenges and issues that influence unwillingness to use these contact tracing apps in neo-liberal societies which include the plausibility of abuse of user privacy rights and lack of trust in the government and public health authorities by their citizens. Other challenges identified and discussed include ethical issues, security vulnerabilities, user behaviour and participation, and technical constraints. RESULTS AND CONCLUSION Finally, in the analysis of this systematic literature review, recommendations to address these challenges, future directions, and considerations in the use of digital contact tracing apps and related technologies to contain the spread of future pandemic outbreaks are presented. For policy makers in neo-liberal societies, this study provides an in-depth review of issues that must be addressed. We highlight recommendations to improve the willingness to use such digital technologies and could facilitate mass acceptance amongst users.
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Affiliation(s)
- Alex Akinbi
- School of Computer Science and Mathematics, Liverpool John Moores University, James Parsons Building, Liverpool, UK
| | - Mark Forshaw
- School of Psychology, Liverpool John Moores University, Tom Reilly Building, Liverpool, UK
| | - Victoria Blinkhorn
- School of Psychology, Liverpool John Moores University, Tom Reilly Building, Liverpool, UK
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Ioannou A, Tussyadiah I. Privacy and surveillance attitudes during health crises: Acceptance of surveillance and privacy protection behaviours. TECHNOLOGY IN SOCIETY 2021; 67:101774. [PMID: 34642512 PMCID: PMC8497958 DOI: 10.1016/j.techsoc.2021.101774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 05/14/2023]
Abstract
The wide deployment of digital technologies for the management of the COVID-19 pandemic has triggered concerns about privacy and intrusion from government surveillance. This study investigates individual privacy and surveillance attitudes by developing a theoretical model to explain acceptance of government surveillance and privacy protection behaviours during health-crises, such as the COVID-19 pandemic. Results from a US sample reveal that people are concerned about the collection and use of their personal information via mobile applications and the monitoring of their online activities by authorities. Findings reveal the important roles of political trust and belief that governments' need to be proactive in protecting peoples' welfare during a crisis that can increase acceptance of surveillance and thus assist in the management of the health crisis. Implications for research and practice are discussed.
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Affiliation(s)
- Athina Ioannou
- Surrey Business School, University of Surrey, United Kingdom
| | - Iis Tussyadiah
- School of Hospitality and Tourism Management, University of Surrey, United Kingdom
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Mahmood M, Mateu J, Hernández-Orallo E. Contextual contact tracing based on stochastic compartment modeling and spatial risk assessment. STOCHASTIC ENVIRONMENTAL RESEARCH AND RISK ASSESSMENT : RESEARCH JOURNAL 2021; 36:893-917. [PMID: 34720737 PMCID: PMC8547309 DOI: 10.1007/s00477-021-02065-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 05/28/2023]
Abstract
The current situation of COVID-19 highlights the paramount importance of infectious disease surveillance, which necessitates early monitoring for effective response. Policymakers are interested in data insights identifying high-risk areas as well as individuals to be quarantined, especially as the public gets back to their normal routine. We investigate both requirements by the implementation of disease outbreak modeling and exploring its induced dynamic spatial risk in form of risk assessment, along with its real-time integration back into the disease model. This paper implements a contact tracing-based stochastic compartment model as a baseline, to further modify the existing setup to include the spatial risk. This modification of each individual-level contact's intensity to be dependent on its spatial location has been termed as Contextual Contact Tracing. The results highlight that the inclusion of spatial context tends to send more individuals into quarantine which reduces the overall spread of infection. With a simulated example of an induced spatial high-risk, it is highlighted that the new spatio-SIR model can act as a tool to empower the analyst with a capability to explore disease dynamics from a spatial perspective. We conclude that the proposed spatio-SIR tool can be of great help for policymakers to know the consequences of their decision prior to their implementation.
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Abstract
Faced with the biggest virus outbreak in a century, world governments at the start of 2020 took unprecedented measures to protect their healthcare systems from being overwhelmed in the light of the COVID-19 pandemic. International travel was halted and lockdowns were imposed. Many nations adopted measures to stop the transmission of the virus, such as imposing the wearing of face masks, social distancing, and limits on social gatherings. Technology was quickly developed for mobile phones, allowing governments to track people’s movements concerning locations of the virus (both people and places). These are called contact tracing applications. Contact tracing applications raise serious privacy and security concerns. Within Europe, two systems evolved: a centralised system, which calculates risk on a central server, and a decentralised system, which calculates risk on the users’ handset. This study examined both systems from a threat perspective to design a framework that enables privacy and security for contact tracing applications. Such a framework is helpful for App developers. The study found that even though both systems comply with the General Data Protection Regulation (GDPR), Europe’s privacy legislation, the centralised system suffers from severe risks against the threats identified. Experiments, research, and reviews tested the decentralised system in various settings but found that it performs better but still suffers from inherent shortcomings. User tracking and re-identification are possible, especially when users report themselves as infected. Based on these data, the study identified and validated a framework that enables privacy and security. The study also found that the current implementations using the decentralised Google/Apple API do not comply with the framework.
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14
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Köster AM, Bludau A, Devcic SK, Scheithauer S, Mardiko AA, Schaumann R. Infection surveillance measures during the COVID-19 pandemic in Germany. GMS HYGIENE AND INFECTION CONTROL 2021; 16:Doc27. [PMID: 34650903 PMCID: PMC8495235 DOI: 10.3205/dgkh000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction: To address the question as to which infection surveillance measures are used during the ongoing COVID-19 pandemic in Germany and how they differ from pre-existing approaches. Methods: In accordance with the systematic approach of a scoping review, a literature search was conducted in national and international medical literature databases using a search string. The search in the databases was limited to the period from 01.01.2000 to 15.11.2020 and has been subsequently completed by hand search until 08.03.2021. A hand search, even beyond 15.11.2020, seemed necessary and reasonable, since due to the dynamics of the ongoing COVID-19 pandemic, a large number of articles and regulations are being published very quickly at short notice. Results: The literature search resulted in the following number of hits in the databases listed below: PubMed: 165 articlesCochrane: 1 review and 35 studiesWeb of Science: 217 articlesRobert Koch Institute: 49 articles Thus, a total of 467 hits were identified, with a total of 124 hits being duplicates. From these, 138 articles were considered relevant to the COVID-19 infection surveillance situation in Germany based on established criteria. After reading the full texts, 92 articles and websites were ultimately included in the scoping review. Discussion: Many of the lessons learned from previous outbreaks seem to have been implemented in the infection surveillance measures during the ongoing COVID-19 pandemic in Germany. Most of the changes compared with previous measures were based on technological streamlining of existing procedures and changes and more inclusion of the population in different infection surveillance measures.
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Affiliation(s)
- Antonia Milena Köster
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Anna Bludau
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Sanja Katharina Devcic
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Simone Scheithauer
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Amelia Aquareta Mardiko
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Reiner Schaumann
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
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15
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Riza E, Kakalou E, Nitsa E, Hodges-Mameletzis I, Goggolidou P, Terzidis A, Cardoso E, Puchner KP, Solomos Z, Pikouli A, Stoupa EP, Kakalou C, Karamagioli E, Pikoulis E. Appraisal of a Contact Tracing Training Program for COVID-19 in Greece Focusing on Vulnerable Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9257. [PMID: 34501844 PMCID: PMC8431650 DOI: 10.3390/ijerph18179257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/15/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Contact tracing as an epidemiological strategy has repeatedly contributed to the containment of various past epidemics and succeeded in controlling the spread of disease in the community. Systematic training of contact tracers is crucial in ensuring the effectiveness of epidemic containment. METHODS An intensive training course was offered to 216 health and other professionals who work with vulnerable population groups, such as Roma, refugees, and migrants in Greece, by the scientific team of the postgraduate programme "Global Health-Disaster Medicine" of the Medical School, National and Kapodistrian University of Athens, with the support of the Swiss embassy in Greece. The course was delivered online due to the pandemic restriction measures and was comprised of 16 h over 2 days. The course curriculum was adapted in Greek using, upon agreement, a similar training course to what was developed by the Johns Hopkins University Bloomberg School of Public Health. Evaluation of the course was conducted in order to determine the short term satisfaction from participating in this training course. RESULTS A total of 70% of the course participants completed the evaluation questionnaires and all trainers gave feedback on the course. The training modules were ranked as extremely useful by the majority of the participants and over 50% of the participants specifically stated that the course content was directly related to their work with vulnerable groups. Content about the ethics of contact tracing and the effective communication skills presented were deemed most useful. CONCLUSION The course was well organised and provided the required skills for effective contact tracing. Many course participants intend to use some components in their work with vulnerable populations groups. Contact tracing efforts work best in a systematic and coordinated way and the provision of systematic and organised training can greatly increase its effectiveness.
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Affiliation(s)
- Elena Riza
- Department of Hygiene, Epidemiology & Medical Statistics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; (E.R.); (E.N.)
| | - Eleni Kakalou
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | - Evangelia Nitsa
- Department of Hygiene, Epidemiology & Medical Statistics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; (E.R.); (E.N.)
| | - Ioannis Hodges-Mameletzis
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | - Paraskevi Goggolidou
- Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton WV1 1LY, UK;
| | - Agis Terzidis
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | - Eleni Cardoso
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | - Karl Philipp Puchner
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | | | - Anastasia Pikouli
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | - Eleni-Panagiota Stoupa
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | - Christina Kakalou
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | - Evika Karamagioli
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
| | - Emmanouil Pikoulis
- Postgraduate Programme “Global Health-Disaster Medicine”, Medical School National and Kapodistrian University of Athens, Dilou 1 Street, 11527 Athens, Greece; (E.K.); (I.H.-M.); (A.T.); (E.C.); (K.P.P.); (A.P.); (E.-P.S.); (C.K.); (E.P.)
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16
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Do you have COVID-19? How to increase the use of diagnostic and contact tracing apps. PLoS One 2021; 16:e0253490. [PMID: 34324504 PMCID: PMC8321141 DOI: 10.1371/journal.pone.0253490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/06/2021] [Indexed: 12/02/2022] Open
Abstract
Diagnostic and contact tracing apps are a needed weapon to contain contagion during a pandemic. We study how the content of the messages used to promote the apps influence adoption by running a survey experiment on approximately 23,000 Mexican adults. Respondents were randomly assigned to one of three different prompts, or a control condition, before stating their willingness to adopt a diagnostic app and contact tracing app. The prompt emphasizing government efforts to ensure data privacy, which has been one of the most common strategies, reduced willingness to adopt the apps by about 4 pp and 3 pp, respectively. An effective app promotion policy must understand individuals’ reservations and be wary of unintended reactions to naïve reassurances.
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17
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Kolasa K, Mazzi F, Leszczuk-Czubkowska E, Zrubka Z, Péntek M. State of the Art in Adoption of Contact Tracing Apps and Recommendations Regarding Privacy Protection and Public Health: Systematic Review. JMIR Mhealth Uhealth 2021; 9:e23250. [PMID: 34033581 PMCID: PMC8195202 DOI: 10.2196/23250] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/30/2020] [Accepted: 02/22/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, contact tracing apps have received a lot of public attention. The ongoing debate highlights the challenges of the adoption of data-driven innovation. We reflect on how to ensure an appropriate level of protection of individual data and how to maximize public health benefits that can be derived from the collected data. OBJECTIVE The aim of the study was to analyze available COVID-19 contact tracing apps and verify to what extent public health interests and data privacy standards can be fulfilled simultaneously in the process of the adoption of digital health technologies. METHODS A systematic review of PubMed and MEDLINE databases, as well as grey literature, was performed to identify available contact tracing apps. Two checklists were developed to evaluate (1) the apps' compliance with data privacy standards and (2) their fulfillment of public health interests. Based on both checklists, a scorecard with a selected set of minimum requirements was created with the goal of estimating whether the balance between the objective of data privacy and public health interests can be achieved in order to ensure the broad adoption of digital technologies. RESULTS Overall, 21 contact tracing apps were reviewed. In total, 11 criteria were defined to assess the usefulness of each digital technology for public health interests. The most frequently installed features related to contact alerting and governmental accountability. The least frequently installed feature was the availability of a system of medical or organizational support. Only 1 app out of 21 (5%) provided a threshold for the population coverage needed for the digital solution to be effective. In total, 12 criteria were used to assess the compliance of contact tracing apps with data privacy regulations. Explicit user consent, voluntary use, and anonymization techniques were among the most frequently fulfilled criteria. The least often implemented criteria were provisions of information about personal data breaches and data gathered from children. The balance between standards of data protection and public health benefits was achieved best by the COVIDSafe app and worst by the Alipay Health Code app. CONCLUSIONS Contact tracing apps with high levels of compliance with standards of data privacy tend to fulfill public health interests to a limited extent. Simultaneously, digital technologies with a lower level of data privacy protection allow for the collection of more data. Overall, this review shows that a consistent number of apps appear to comply with standards of data privacy, while their usefulness from a public health perspective can still be maximized.
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Affiliation(s)
- Katarzyna Kolasa
- Division of Health Economics and Healthcare Management, Kozminski University, Warsaw, Poland
| | - Francesca Mazzi
- Queen Mary University of London, London, United Kingdom
- Maastricht University, Maastricht, Netherlands
| | | | - Zsombor Zrubka
- Health Economics Research Center, Óbuda University, Budapest, Hungary
- Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | - Márta Péntek
- Health Economics Research Center, Óbuda University, Budapest, Hungary
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18
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Lucivero F, Marelli L, Hangel N, Zimmermann BM, Prainsack B, Galasso I, Horn R, Kieslich K, Lanzing M, Lievevrouw E, Ongolly F, Samuel G, Sharon T, Siffels L, Stendahl E, Van Hoyweghen I. Normative positions towards COVID-19 contact-tracing apps: findings from a large-scale qualitative study in nine European countries. CRITICAL PUBLIC HEALTH 2021; 32:5-18. [PMID: 37377839 PMCID: PMC10292825 DOI: 10.1080/09581596.2021.1925634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
Mobile applications for digital contact tracing have been developed and introduced around the world in response to the COVID-19 pandemic. Proposed as a tool to support 'traditional' forms of contact-tracing carried out to monitor contagion, these apps have triggered an intense debate with respect to their legal and ethical permissibility, social desirability and general feasibility. Based on a large-scale study including qualitative data from 349 interviews conducted in nine European countries (Austria, Belgium, France, Germany, Ireland, Italy, the Netherlands, German-speaking Switzerland, the United Kingdom), this paper shows that the binary framing often found in surveys and polls, which contrasts privacy concerns with the usefulness of these interventions for public health, does not capture the depth, breadth, and nuances of people's positions towards COVID-19 contact-tracing apps. The paper provides a detailed account of how people arrive at certain normative positions by analysing the argumentative patterns, tropes and (moral) repertoires underpinning people's perspectives on digital contact-tracing. Specifically, we identified a spectrum comprising five normative positions towards the use of COVID-19 contact-tracing apps: opposition, scepticism of feasibility, pondered deliberation, resignation, and support. We describe these stances and analyse the diversity of assumptions and values that underlie the normative orientations of our interviewees. We conclude by arguing that policy attempts to develop and implement these and other digital responses to the pandemic should move beyond the reiteration of binary framings, and instead cater to the variety of values, concerns and expectations that citizens voice in discussions about these types of public health interventions.
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Affiliation(s)
- Federica Lucivero
- Ethox and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Luca Marelli
- Centre for Sociological Research, KU Leuven, Leuven, Belgium
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Nora Hangel
- Institute of History and Ethics in Medicine, Technical University of Munich, Munchen, Germany
| | | | - Barbara Prainsack
- Department of Political Science, University of Vienna, Veinna, Austria
| | - Ilaria Galasso
- College of Business, University College Dublin, Dublin, Ireland
| | - Ruth Horn
- Ethox Centre, University of Oxford, Oxford, UK
| | | | - Marjolein Lanzing
- Department of Philosophy, Universiteit van Amsterdam, Amsterdam, The Netherlands
| | | | | | - Gabrielle Samuel
- Department of Global Health and Social Medicine, King's College London andClinical Ethics and Law, University of Southampton, Southampton, UK
| | - Tamar Sharon
- Hub and Department of Ethics and Political Philosophy, Radboud University, Nijmegen, The Netherlands
| | - Lotje Siffels
- Philosophical Ethics and Political Philosophy, Radboud Universiteit, Nijmegen, Netherlands
| | - Emma Stendahl
- College of Business, University College Dublin, Dublin, Ireland
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19
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Hohman M, McMaster F, Woodruff SI. Contact Tracing for COVID-19: The Use of Motivational Interviewing and the Role of Social Work. CLINICAL SOCIAL WORK JOURNAL 2021; 49:419-428. [PMID: 33776159 PMCID: PMC7982339 DOI: 10.1007/s10615-021-00802-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 05/11/2023]
Abstract
One method in mitigating the impact of COVID-19 is that of contact tracing. It is estimated that in the US, 35,000-100,000 contact tracers will be hired (and trained) to talk to recently-infected individuals, understand who they have exposed to the virus, and encourage those exposed to self-quarantine. The Center for Disease Control recommends the use of motivational interviewing (MI) by contact tracers to encourage compliance with contact tracing/quarantine. Contact tracers need to sensitively communicate with COVID-19-exposed individuals who may also be experiencing other issues caused by the pandemic, such as anxiety, depression, grief, anger, intimate partner violence, health problems, food insecurity, and/or unemployment. Social workers are particularly prepared to address the mental health and other psychosocial problems that may be encountered in the tracing process. This article describes contact tracing, its use in other diseases, the role of MI, psychosocial issues that contact tracers may encounter, and how social work can respond to these needs. A sample dialogue of contact tracing using MI is presented with a discussion of the content and skills used in the process.
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Affiliation(s)
- Melinda Hohman
- School of Social Work, San Diego State University, San Diego, CA USA
- 24645 Kings Pointe, Laguna Niguel, CA 92677 USA
| | | | - Susan I. Woodruff
- School of Social Work, San Diego State University, San Diego, CA USA
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20
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Gómez-Ramírez O, Iyamu I, Ablona A, Watt S, Xu AXT, Chang HJ, Gilbert M. On the imperative of thinking through the ethical, health equity, and social justice possibilities and limits of digital technologies in public health. Canadian Journal of Public Health 2021; 112:412-416. [PMID: 33725332 PMCID: PMC7962628 DOI: 10.17269/s41997-021-00487-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/28/2021] [Indexed: 11/24/2022]
Abstract
The COVID-19 pandemic has demonstrated both the positive and negative use, usefulness, and impact of digital technologies in public health. Digitalization can help advance and sustain the core functions of public health, including health promotion and prevention, epidemiological surveillance, and response to emergent health issues. Digital technologies are thus—in some areas of public discourse—presented as being both necessary and inevitable requirements to address routine and emergency public health issues. However, the circumstances, ways, and extent to which they apply remain a subject of critical reflection and empirical investigation. In this commentary, we argue that we must think through the use of digital technologies in public health and that their usefulness must be assessed in relation to their short- and long-term ethical, health equity, and social justice implications. Neither a sense of digital technological optimism and determinism nor the demands of addressing pressing public health issues should override critical assessment before development and implementation. The urgency of addressing public health emergencies such as the ongoing COVID-19 pandemic requires prompt and effective action, including action facilitated by digital technologies. Nevertheless, a sense of urgency cannot be an excuse or a substitute for a critical assessment of the tools employed.
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Affiliation(s)
- Oralia Gómez-Ramírez
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada. .,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. .,CIHR Canadian HIV Trials Network, Vancouver, BC, Canada.
| | - Ihoghosa Iyamu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Aidan Ablona
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Sarah Watt
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Alice X T Xu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Hsiu-Ju Chang
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Mark Gilbert
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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21
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Zimmermann BM, Fiske A, Prainsack B, Hangel N, McLennan S, Buyx A. Early Perceptions of COVID-19 Contact Tracing Apps in German-Speaking Countries: Comparative Mixed Methods Study. J Med Internet Res 2021; 23:e25525. [PMID: 33503000 PMCID: PMC7872326 DOI: 10.2196/25525] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/17/2020] [Accepted: 01/09/2021] [Indexed: 01/07/2023] Open
Abstract
Background The main German-speaking countries (Germany, Austria, and Switzerland) have implemented digital contact tracing apps to assist the authorities with COVID-19 containment strategies. Low user rates for these apps can affect contact tracing and, thus, its usefulness in controlling the spread of the novel coronavirus. Objective This study aimed to assess the early perceptions of people living in the German-speaking countries and compare them with the frames portrayed in the newspapers during the first wave of the COVID-19 pandemic. Methods We conducted qualitative interviews with 159 participants of the SolPan project. Of those, 110 participants discussed contact tracing apps and were included in this study. We analyzed articles regarding contact tracing apps from 12 newspapers in the German-speaking countries. Results Study participants perceived and newspaper coverage in all German-speaking countries framed contact tracing apps as governmental surveillance tools and embedded them in a broader context of technological surveillance. Participants identified trust in authorities, respect of individual privacy, voluntariness, and temporary use of contact tracing apps as prerequisites for democratic compatibility. Newspapers commonly referenced the use of such apps in Asian countries, emphasizing the differences in privacy regulation among these countries. Conclusions The uptake of digital contact tracing apps in German-speaking countries may be undermined due to privacy risks that are not compensated by potential benefits and are rooted in a deeper skepticism towards digital tools. When authorities plan to implement new digital tools and practices in the future, they should be very transparent and proactive in communicating their objectives and the role of the technology—and how it differs from other, possibly similar, tools. It is also important to publicly address ethical, legal, and social issues related to such technologies prior to their launch.
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Affiliation(s)
- Bettina Maria Zimmermann
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany.,Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Amelia Fiske
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria
| | - Nora Hangel
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany
| | - Stuart McLennan
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany.,Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Alena Buyx
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany
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22
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Noda H. Progress of public health policy regarding global infectious diseases over the past decade in Japan. J Infect Chemother 2021; 27:555-561. [PMID: 33472748 PMCID: PMC7833483 DOI: 10.1016/j.jiac.2020.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/06/2020] [Accepted: 12/24/2020] [Indexed: 11/17/2022]
Abstract
This article aims to examine progress of public health policy regarding global infectious diseases over the past decade in Japan. A narrative review was conducted, overviewing items of the Infectious Disease Committee and the Tuberculosis Committee of the Ministry of Health, Labour and Welfare between 2010 and 2019. The mean value of items discussed in each meeting were 9.7 items. Among these items, these committees have discussed about countermeasures in terms of reduced burden of indigenous infectious diseases such as measles, rubella and pertussis, and increased risk of imported infectious diseases such as Ebola virus disease, Middle East Respiratory Syndrome, plague, avian influenza, pandemic influenza and tuberculosis. These changes regarding infectious diseases lead to loss of target population, difficulty of early detection, and market failure in old and new antibiotics and others, which requires challenge to scattered at-risk targets, effort to training and awareness, and creation of novel public health policy for research and development as well as production and supply. Over the past decade, public health policy regarding global infectious diseases have been one of the key targets under the triangle of global infectious disease, and recent experience of Coronavirus disease 2019 will further prioritize it in Japan. However, the principles of public health policy are globally vulnerable in the Post-Corona era, which can lead to the collapse of democratic way. To combat global infectious diseases without going off the road, we need to learn about the past history of public health policy.
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Affiliation(s)
- Hiroyuki Noda
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan; Cabinet Secretariat, Tokyo, Japan.
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23
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Dave R, Gupta R. Mandating the Use of Proximity Tracking Apps During Coronavirus Disease 2019: Ethical Justifications. Front Med (Lausanne) 2020; 7:590265. [PMID: 33344477 PMCID: PMC7738463 DOI: 10.3389/fmed.2020.590265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/02/2020] [Indexed: 01/07/2023] Open
Abstract
The rise of the coronavirus disease 2019 (COVID-19) in a digital world has expectedly called upon technologies, such as wearables and mobile devices, to work in conjunction with public health interventions to tackle the pandemic. One significant example of this integration is the deployment of proximity tracking apps on smartphones to enhance traditional contact tracing methods. Many countries have adopted proximity tracking apps; however, there is a large degree of global differentiation in the voluntariness of the apps. Further, the concept of a mandatory policy—forcing individuals to use the apps—has been met with ethical concerns (e.g., privacy and liberty). While ethical considerations surrounding deployment have been put forth, such as by the World Health Organization, ethical justifications for a mandatory policy are lacking. Here, we use the Faden–Shebaya framework, which was formed to justify public health interventions, to determine if the compulsory use of proximity tracking apps is ethically appropriate. We show that while theoretically justified, due to the current state of proximity tracking applications and societal factors, it is difficult to defend a mandatory policy in practice.
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Affiliation(s)
- Riya Dave
- Cognitive and Behavioural Neuroscience Laboratory, Department of Humanities and Social Sciences, Indian Institute of Technology Bombay, Mumbai, India
| | - Rashmi Gupta
- Cognitive and Behavioural Neuroscience Laboratory, Department of Humanities and Social Sciences, Indian Institute of Technology Bombay, Mumbai, India
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24
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Martinez-Martin N. Big Data, Corporate Surveillance and Public Health. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2020; 20:79-81. [PMID: 33016833 PMCID: PMC7546577 DOI: 10.1080/15265161.2020.1806394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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25
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Abstract
Digital contact tracing, in combination with widespread testing, has been a focal point for many plans to “reopen” economies while containing the spread of Covid‐19. Most digital contact tracing projects in the United States and Europe have prioritized privacy protections in the form of local storage of data on smartphones and the deidentification of information. However, in the prioritization of privacy in this narrow form, there is not sufficient attention given to weighing ethical trade‐offs within the context of a public health pandemic or to the need to evaluate safety and effectiveness of software‐based technology applied to public health.
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