Where, Who, When, Why, Whom – This is a set of questions that human contact tracers will ask everyone who has been diagnosed with any contagious disease. They will seek the information directly from the individuals to determine who they came in contact with, and when and where did these interactions take place? This is known as contact tracing, a technology used by government health agencies to identify people who may have been exposed to infectious diseases, either through direct contact with someone or through anyone who has been in close proximity to them. Its aim is to diminish the spread of an epidemic or pandemic by identifying the points of transmission and slowing community spread. Contact tracing has been a pillar for the control of infectious diseases in public health for decades. For example, smallpox has been eradicated not only by vaccination but by exhaustive contact tracing to find all infected people.
The manual contact tracing sounds simple but is overwhelmingly complex and resource consuming. What if patients can’t recall all of their movements? What about people who might have been unknowingly exposed to the infected individual? Moreover, it is an inefficient method for addressing infectious diseases in areas of high prevalence where cases start to climb with individuals having hundreds of potential contacts. This is where modern technology plays a role by providing innovative approaches to increase contact tracing capabilities.
As the Covid-19 pandemic continues, technicians everywhere are rushing to build applications, services, and systems for contact tracing. The cumbersome process that once relied on an individual’s inaccurate memory has entered the digital era and our smartphones are all set to play a significant role in navigating our way out of the pandemics. All thanks to advanced analytics, technologists have found ways to quickly identify people who have been exposed to an infectious disease so that they can self-isolate themselves, seek treatment, and impede the spread of infection.
Analytics help in determining who might be directly linked to a patient by combining distinct data sources into a single repository to know how wide their geographical territory might be. But that’s easier said than done. For instance, if anyone gets infected, that person is contacted through text, email, or phone and is asked to log in to contact tracing applications. It asks for personal information including places you visited recently, international travel history, etc.
The app identifies a person’s contacts by tracking the phone’s movements using GPS or triangulation from nearby towers and looking for other phones that have spent time in the same location. Alternatively, systems also use “proximity tracking” in which phones swap encrypted tokens with any other nearby phones over Bluetooth. Contact tracing technology is also being used to influence public health policies through the study of contamination chains.
Aarogya Setu, India’s primary contact tracking technology uses the phone’s Bluetooth and GPS capabilities. Access to Bluetooth is key for this app to establish the records of all other users that it detected nearby. When users with installed apps come in each other’s Bluetooth range – even if these people are strangers who just happened to sit on adjacent subway seats, the app collects information. The app could alert others as soon as any of them tests positive for an infection and in the process allows the government to trace potential cases. It also uses a GPS log of all the places that the device had been at 15 minutes intervals. Many food delivery services have already mandated its use for their delivery personnel and other organizations are planning to do the same.
Global operators, Google and Apple usually never come together but they are working collectively on an application programming interface (API) and some other fundamental technologies that other apps can plug into. They have done the groundwork to introduce a Coronavirus Disease 2019 tracking technology, relying on Bluetooth Low Energy (BLE) wireless radio signals to make sure that contact tracing applications can coordinate with each other across Android and iOS. If anyone tests positive for an infection, they would tell the app and this software would let all the phones nearby use Bluetooth data to notify people of potential exposure, which could be used by millions of people almost immediately.
Everybody expects these apps to follow ethical and privacy constraints, for instance, only the necessary information will be collected and would be used only to protect public health. But how private is this technology? Are citizens’ rights being safeguarded? Contact tracing technologies gather data such as name, address, phone number, email address, health conditions, etc. which come under-protected data according to existing laws.
But data privacy laws only govern and do not prohibit such information gathering for contact tracing. This level of intrusion in citizens’ life varies from country to country with citizens of different countries being subjected to varying levels of surveillance and transparency. China’s system, for example, sucks up data including citizens’ identity, location, and even online payment history so that local police can watch for those who break quarantine rules. This widespread use of automated GPS tracking restricts movements and raises privacy concerns.
Challenges can also arise due to issues of medical privacy and confidentiality. Though public health teams typically disclose the minimum amount of information it is possible that infected individuals’ right to medical confidentiality might be breached. As a result, governments are instead developing apps that use Bluetooth radio signals where each phone generates a random numerical ID that is broadcasted to nearby phones. It is easier to anonymize and generally considered better for privacy.
Relying mainly on the user’s choice to make informed decisions on whether to use the service or not, is not enough. The success of contact tracing technology depends on how well-equipped masses are with the applications. It might also happen that people who are infected are reluctant to download such applications and the users can even refuse to comply with self-isolation measures, inevitably, demanding the introduction of tougher measures. With only 3.2 billion people having access to smartphones across the globe, and the rise in cases even after adopting the contact tracing technology casts doubts on its effectiveness which is yet to be proved.
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Currently pursuing Economics (Hons.) from SRCC, Simran is an avid reader and is always on a lookout for some ‘real’ knowledge. She is a proud member of BTS Army and has an innate obsession for Sundays. She often finds herself stuck in the rat race and struggles to have a consensus between her heart and mind.