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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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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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Tretter M. How is "solidarity" understood in discussions about contact tracing apps? An overview. Front Public Health 2022; 10:859831. [PMID: 35937216 PMCID: PMC9355132 DOI: 10.3389/fpubh.2022.859831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Background In the context of the COVID-19 pandemic, there is much discussion about contact tracing apps, their use to contain the spread of the virus as well as the ethical, legal, and social aspects of their development, implementation, acceptance, and use. In these discussions, authors frequently mention "solidarity" when making key points in arguments. At the same time, authors rarely specify how they understand "solidarity". This lack of specification about how they understand "solidarity" can lead to misunderstandings in discussions. Objective To prevent such misunderstandings, it is important to specify how one understands "solidarity" when mentioning it in the discussions on contact tracing apps. Therefore, the aim of this paper is to elaborate how "solidarity" is understood in the context of contact tracing apps, i.e., how different authors understand "solidarity" when using it in discussions about these apps. Methods In order to find out how different authors understand "solidarity" when discussing contact tracing apps, I conduct a literature review. I collect papers from several databases, inductively work out central differences and similarities between the different uses of "solidarity", and use them to code and analyze relevant passages. Results In the final sample, five different understandings of "solidarity" in the context of contact tracing apps can be identified. These understandings differ in how different authors (1) imagine the basic concept of solidarity, i.e., what "solidarity" refers to, (2) how they temporally relate solidarity to contact tracing apps, and (3) how they perceive the causal interactions between solidarity and contact tracing apps, i.e., the different ways in which solidarity and contact tracing apps influence each other. Conclusions The five understandings of "solidarity" in the context of contact tracing apps presented here can serve as guidance for how "solidarity" can be understood in discussions-thus contributing to a better mutual understanding and preventing communicative misunderstandings.
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Affiliation(s)
- Max Tretter
- Department of Systematic Theology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Osmanlliu E, Rafie E, Bédard S, Paquette J, Gore G, Pomey MP. Considerations for the Design and Implementation of COVID-19 Contact Tracing Apps: Scoping Review. JMIR Mhealth Uhealth 2021; 9:e27102. [PMID: 34038376 PMCID: PMC8191727 DOI: 10.2196/27102] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/14/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Given the magnitude and speed of SARS-CoV-2 transmission, achieving timely and effective manual contact tracing has been a challenging task. Early in the pandemic, contact tracing apps generated substantial enthusiasm due to their potential for automating tracing and reducing transmission rates while enabling targeted confinement strategies. However, although surveys demonstrate public interest in using such apps, their actual uptake remains limited. Their social acceptability is challenged by issues around privacy, fairness, and effectiveness, among other concerns. OBJECTIVE This study aims to examine the extent to which design and implementation considerations for contact tracing apps are detailed in the available literature, focusing on aspects related to participatory and responsible eHealth innovation, and synthesize recommendations that support the development of successful COVID-19 contact tracing apps and related eHealth technologies. METHODS Searches were performed on five databases, and articles were selected based on eligibility criteria. Papers pertaining to the design, implementation, or acceptability of contact tracing apps were included. Articles published since 2019, written in English or French, and for which the full articles were available were considered eligible for analysis. To assess the scope of the knowledge found in the current literature, we used three complementary frameworks: (1) the Holistic Framework to Improve the Uptake and Impact of eHealth Technologies, (2) the Montreal model, and (3) the Responsible Innovation in Health Assessment Tool. RESULTS A total of 63 articles qualified for the final analysis. Less than half of the selected articles cited the need for a participatory process (n=25, 40%), which nonetheless was the most frequently referenced item of the Framework to Improve the Uptake and Impact of eHealth Technologies. Regarding the Montreal model, stakeholder consultation was the most frequently described level of engagement in the development of contact tracing apps (n=24, 38%), while collaboration and partnership were cited the least (n=2, 3%). As for the Responsible Innovation in Health framework, all the articles (n=63, 100%) addressed population health, whereas only 2% (n=1) covered environmental considerations. CONCLUSIONS Most studies lacked fundamental aspects of eHealth development and implementation. Our results demonstrate that stakeholders of COVID-19 contact tracing apps lack important information to be able to critically appraise this eHealth innovation. This may have contributed to the modest uptake of contact tracing apps worldwide. We make evidence-informed recommendations regarding data management, communication, stakeholder engagement, user experience, and implementation strategies for the successful and responsible development of contact tracing apps.
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Affiliation(s)
- Esli Osmanlliu
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Edmond Rafie
- Research Centre of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Sylvain Bédard
- Centre d'excellence sur le partenariat avec les patients et le public, Montreal, QC, Canada
| | - Jesseca Paquette
- Research Centre of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Genevieve Gore
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada
| | - Marie-Pascale Pomey
- Research Centre of the University of Montreal Hospital Centre, Montreal, QC, Canada
- Centre d'excellence sur le partenariat avec les patients et le public, Montreal, QC, Canada
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montreal, Montreal, QC, Canada
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Cortés U, Cortés A, Garcia-Gasulla D, Pérez-Arnal R, Álvarez-Napagao S, Àlvarez E. The ethical use of high-performance computing and artificial intelligence: fighting COVID-19 at Barcelona Supercomputing Center. AI AND ETHICS 2021; 2:325-340. [PMID: 34790948 PMCID: PMC8101339 DOI: 10.1007/s43681-021-00056-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/15/2021] [Indexed: 10/24/2022]
Abstract
The COVID-19 pandemic has created an extraordinary medical, economic and humanitarian emergency. Artificial intelligence, in combination with other digital technologies, is being used as a tool to support the fight against the viral pandemic that has affected the entire world since the beginning of 2020. Barcelona Supercomputing Center collaborates in the battle against the coronavirus in different areas: the application of bioinformatics for the research on the virus and its possible treatments, the use of artificial intelligence, natural language processing and big data techniques to analyse the spread and impact of the pandemic, and the use of the MareNostrum 4 supercomputer to enable massive analysis on COVID-19 data. Many of these activities have included the use of personal and sensitive data of citizens, which, even during a pandemic, should be treated and handled with care. In this work we discuss our approach based on an ethical, transparent and fair use of this information, an approach aligned with the guidelines proposed by the European Union.
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Affiliation(s)
- Ulises Cortés
- Universitat Politècnica de Catalunya, Edifici Omega 205, Jordi Girona 29, 08034 Barcelona, Spain
- Barcelona Supercomputing Center, Edifici Omega 201, Jordi Girona 1 and 3, 08034 Barcelona, Spain
| | - Atia Cortés
- Barcelona Supercomputing Center, Edifici Omega 201, Jordi Girona 1 and 3, 08034 Barcelona, Spain
| | - Dario Garcia-Gasulla
- Barcelona Supercomputing Center, Edifici Omega 201, Jordi Girona 1 and 3, 08034 Barcelona, Spain
| | - Raquel Pérez-Arnal
- Barcelona Supercomputing Center, Edifici Omega 201, Jordi Girona 1 and 3, 08034 Barcelona, Spain
| | - Sergio Álvarez-Napagao
- Barcelona Supercomputing Center, Edifici Omega 201, Jordi Girona 1 and 3, 08034 Barcelona, Spain
| | - Enric Àlvarez
- Universitat Politècnica de Catalunya, Edifici Omega 205, Jordi Girona 29, 08034 Barcelona, Spain
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Ranisch R, Nijsingh N, Ballantyne A, van Bergen A, Buyx A, Friedrich O, Hendl T, Marckmann G, Munthe C, Wild V. Digital contact tracing and exposure notification: ethical guidance for trustworthy pandemic management. ETHICS AND INFORMATION TECHNOLOGY 2020; 23:285-294. [PMID: 33106749 PMCID: PMC7577205 DOI: 10.1007/s10676-020-09566-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
There is growing interest in contact tracing apps (CT apps) for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. We will discuss some trade-offs that arise from this perspective. We then suggest that public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely undermine public trust, and as such, risk impeding general effectiveness.
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Affiliation(s)
- Robert Ranisch
- International Center for Ethics in the Sciences and Humanities, University of Tübingen, Tübingen, Germany
| | - Niels Nijsingh
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Angela Ballantyne
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore
| | - Anne van Bergen
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Alena Buyx
- Institute for History and Ethics in Medicine, Technical University Munich, Munich, Germany
| | | | - Tereza Hendl
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Georg Marckmann
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christian Munthe
- Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden
| | - Verina Wild
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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