Pandemic technology has been ignored by health experts. That’s why it needs to change.
Written by Susan Landau, a professor at Tufts University in cybersecurity and computer science Count people, a book on how and why contact tracking applications were created. She has also published an essay in Science last week argued that new technologies to support public health should be thoroughly tested in ways that could add to the injustices and inequalities already inherent in society.
“The pandemic will not be the last that people face,” Landau writes, urging society to “use and build tools and support health policies” that will protect people’s rights, health and safety and ensure a more equal level of health.
This interview is abbreviated and edited for clarity.
What did we learn after the distribution of Covid apps, especially about how they could work differently or better?
The technologists who worked on the programs were very attentive to talking to epidemiologists. They probably didn’t think enough about it: these programs would change whoever gets notified of the potential impact of Covid. They are going to change the delivery [public health] services. That kind of conversation didn’t happen.
For example, if I had received a notification of exposure last year, I would have called my doctor who would have said, “I want you to be tested for COVID.” Maybe I’ll isolate myself in my bedroom and my husband will bring me food. Maybe I wouldn’t go to the supermarket. But other than that, nothing will change for me. I don’t drive a bus. I am not a food service worker. For these people, getting an impact message is really different. You need to have social services to help them support what the health of the population knows.
In Switzerland, when you get a notice of exposure, and when the state says, “Yes, you need quarantine,” they ask, “What kind of work do you have? Can you work from home?” And if you say no, the state will come with certain financial support to stay at home.It is an investment of social infrastructure to support notification of impact.In most places this was not the case – for example, in the US.
Epidemiologists are studying how the disease spreads. Public health [experts] see how we take care of people and they play a different role.
Are there other ways to develop applications differently? What could make them more useful?
I think there are definitely arguments in favor of 10% of applications actually collecting location and being used only for medical purposes to understand the spread of the disease. When I spoke to epidemiologists back in May and June 2020, they said, “But if I can’t tell where it’s spreading, I’m losing what I need to know.” This is a management problem for Google and Apple.
There is also the question of how effective it is. This is due to the issue of equity. I live in a few rural areas, and the house closest to me is a few hundred feet away. I’m not going to receive a Bluetooth signal from someone else’s phone, which results in an impact notification. If my bedroom is opposite the bedroom of the next apartment, I could get a whole bunch of impact messages if the next sick person – the signal can pass through the wooden walls.
Why has privacy become so important to developers of contact tracking programs?
What you’ve been to is really revealing because it shows things like who you slept with, or stopping at a bar after work. It shows whether you go to church on Thursdays and seven, but never go to church at other times, and it turns out Alcoholics Anonymous meets then at church. It is obvious to human rights activists and journalists that tracking who they were with is very dangerous, as it reveals their sources. But even for the rest of us, with whom you spend time – the closeness of people – is a very personal matter.
“The end user is not an engineer … this is your uncle. This is your little sister. And you want to have people who understand how people use things. ”
Other countries use a protocol that includes more location tracking – such as Singapore.
Singapore said: “We are not going to use your data for other things.” They then modified it and used it for law enforcement purposes. And the app, which started as a voluntary one, is now needed to penetrate office buildings, schools, etc. There is nothing left as the government knows with whom to spend time.
I wonder what you think of some great lessons on creating social technologies in a crisis.
I work in cybersecurity, and in that area it took us a very long time to realize that on the other end there is a user, and the user is not an engineer sitting at Sun Microsystems or Google in the security group. This is your uncle. This is your little sister. And you want to have people who understand how people use things. But that’s not what engineers learn – it’s what healthcare people or social scientists do, and those people need to be an integral part of the decision.