In the 1982
film, The Wrath of Khan, a character
called Spock enters a highly radioactive chamber to fix the ship's drive. Spock
risks his life to save the crew from danger as the ship, the Enterprise, is at
risk of exploding. In his last words, he says to another character Kirk,
"Don't grieve, Admiral. It is logical. The needs of the many
outweigh…" Kirk continues, "The needs of the few." Spock
replies, "Or the one." Choosing between the needs of the many versus
the needs of the few is the intrinsic ethical tension that Public Health
practitioners face daily. However, precautionary and preventative measures need
to be implemented to give civilization the best chance to "flatten the
curve" of the Novel Coronavirus Disease (COVID-19) pandemic. In Alberta,
the Public Health Act has given the Government of Alberta and the Chief Medical
Officer of Health far-reaching powers to proactively slow down the spread of
the virus. These powers may restrict individual liberties, such as limiting
travel and ordering the closure of non-essential businesses. Some groups
actively oppose public health guidance and city by-laws in the name of their "individual
rights and liberties," despite COVID-19 being the most defining global
health crisis of our time. The pandemic has shut down economic activity in
Alberta, leading to its most significant financial crisis since the Great
Depression. There is a need to reopen the economy; however, this needs to be
done safely as the second wave of COVID-19 could lead to many businesses being permanently
wiped out. The Alberta economy may never recover back to normal. There is a
need to have additional measures to control and further prevent the spread of
COVID-19. However, there may need to be trade-offs between public health and
privacy.
The
rapid spread of COVID-19 exceeds the capacity of many public health agencies in
performing traditional contact tracing, which had limitations in scalability,
notification delays, recall errors, and contact identification in public
spaces. Rapid contact tracing is the cornerstone of effective public health
response, as 50% of COVID-19 transmissions happen early in infection before
symptoms start and before test results can be acted upon. Mandating the
use of the ABTraceTogether app allows the minimum 80% of smartphone users to
have it installed, which enables the epidemic control to be more effective. ABTraceTogether
is a mobile app that is available on Apple or Android phones. ABTraceTogether
notifies users if they have been exposed to anyone positive for COVID-19, or if
the user has exposed others while protecting the user's privacy. The smartphone
application uses Bluetooth to accurately and efficiently identify contacts of a
confirmed COVID-19 case, just like a "digital handshake" that creates
an anonymous log. If a user is exposed to COVID-19 or is positive for COVID-19,
Alberta Health Services (AHS) will use the information from the app to contact
the user. AHS Contact Tracers will provide guidance and care the users need to
reduce the spread of COVID-19.
There are
reassurances that personal data is only stored on a user's phone for twenty-one
days in an encrypted format. However, there remains opposition to the
contact-tracing app citing "an extraordinary invasion of privacy." Jill
Clayton, Alberta Privacy Commissioner, has completed an independent review of
the privacy impact assessment (PIA) submitted by Alberta Health (AH) on July 9,
2020. In a LawBytes podcast, Commissioner Clayton praises how AH was
transparent with the deployment of the app and is cooperative with
recommendations. She continues to be concerned about the app in Apple devices
needing to run in the foreground and the device requiring to be unlocked, but
this is unfortunately out of AH's hands and is working with Apple towards a
solution. Clayton has accepted the PIA and recognizes that AH has made
reasonable efforts to protect privacy. AH has an existing policy including
prohibiting the use of information for secondary purposes (such as quarantine
enforcement), and there are plans to decommission the app.
If countries such as South Korea have
controlled their COVID-19 and have successfully reopened their economy using
contact-tracing apps, shouldn't this be a simple step that we, Albertans, need
to take to successfully revive our economy and have control over the spread of
COVID-19?
References
Armstrong, A. (2019, October 29). Spock's
Illogic: "The Needs of the Many Outweigh the Needs of the Few."
https://theobjectivestandard.com/2013/09/spocks-illogic-the-needs-of-the-many-outweigh-the-needs-of-the-few/.
Franklin, M. (2020, July 20). Group that
held rally in Calgary says masks are 'harmful.' Calgary CTV News.
https://calgary.ctvnews.ca/group-that-held-rally-in-calgary-says-masks-are-harmful-1.5030225.
Geist, M. (2020, July 20). The LawBytes
Podcast, Episode 60: Alberta Privacy Commissioner Jill Clayton on the
ABTraceTogether Contact Tracing App. https://www.michaelgeist.ca/2020/07/lawbytes-podcast-episode-60/.
Geppert, C. (2020, April 10). The Return of
the Plague: A Primer on Pandemic Ethics. Federal Practitioner. https://www.mdedge.com/fedprac/article/219909/health-policy/return-plague-primer-pandemic-ethics.
Government of Alberta. (2020a).
ABTraceTogether. https://www.alberta.ca/ab-trace-together.aspx
Johns Hopkins Coronavirus Resource Center.
COVID-19 Map. Johns Hopkins Coronavirus Resource Center.
https://coronavirus.jhu.edu/map.html.
Johnson, L. (2020, July 12). Second wave of
COVID-19 could push many off loan deferral cliff: economist. Edmonton Journal. https://edmontonjournal.com/news/local-news/second-wave-of-covid-19-could-push-many-off-loan-deferral-cliff-economist.
Kleinman, R. A., & Merkel, C. (2020).
Digital contact tracing for COVID-19. CMAJ, 192(24). https://doi.org/10.1503/cmaj.200922
Mertz, E. (2020, May 4). Alberta launches
ABTraceTogether app to improve contact tracing, fight COVID-19 spread.
https://globalnews.ca/news/6894997/covid-19-alberta-health-contact-tracing-app/
Murray, R. (2020, May 12). ABTraceTogether
- Addressing benefits and concerns of contact tracing. 106.5 Mountain FM. https://www.mountainfm.ca/2020/05/12/abtracetogether-addressing-benefits-and-concerns-of-contact-tracing/.
Parker, M. J., Fraser, C., Abeler-Dörner,
L., & Bonsall, D. (2020). Ethics of instantaneous contact tracing using
mobile phone apps in the control of the COVID-19 pandemic. Journal of
Medical Ethics.
Staples, D. (2020, May 12). How the
'horrible trade-off' to contain COVID-19 blew up Alberta's economy and its
finances. Edmonton Journal. https://edmontonjournal.com/business/energy/alberta-economic-impacts-covid-19-oil-price-collapse/
Urbaczewski, A., & Lee, Y. J. (2020).
Technology and Surveillance in Times of Crisis, and Beyond: Lessons from Mobile
Tracking Technology During the Covid-19 Outbreak. Available at SSRN 3614145.
United Nations Development Programme. (2020,
May 14). Coronavirus disease COVID-19 pandemic. https://www.undp.org/content/undp/en/home/coronavirus.html
Wells, N. (2020, May 2). 'Invasion of
privacy': Watchdogs concerned about apps tracking COVID-19 patients. CTV News.
https://www.ctvnews.ca/sci-tech/invasion-of-privacy-watchdogs-concerned-about-apps-tracking-covid-19-patients-1.4921995
Office of the Information and Privacy
Commissioner of Alberta. (2020, July). ABTraceTogether privacy impact
assessment review report. https://www.oipc.ab.ca/media/1089098/
Report_ABTraceTogether_PIA_Review_Jun2020.pdf
