Monday, August 3, 2020

ABTraceTogether: Mandatory Tracing Prevents the Spread of COVID-19


              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

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