Homeland Security and Using Contact Tracing to Reduce Pandemics
Similar to other pandemics, the COVID-19 pandemic has impacted citizens around the world in
profound ways and in some respects this pandemic have caused greater damage than any the world has ever seen. Because COVID-19 has impacted society in such a devastating way, it is more important than ever to recognize the benefits of “Contact Tracing” as part of the United States National Security Strategy (NSS). However, the use of Contact Tracing is not without some concerns such as weighing the “public good” versus the right to privacy and maintaining the confidentiality of medical records and adhering to HIPPA. Also, there are other serious issues as well to consider.
Coronaviruses (CoVs) are a big group of viruses that infect many mammals and birds. More specifically, COVID-19 is caused by a virus known as SARS coronavirus two that originated in bats and is the third coronavirus that has done this since 2002. SARS is the Severe Acute Respiratory Syndrome (SARS) CoV and originated in Guandgdong, China in 2002. The second coronavirus was Middle Eastern Respiratory Syndrome (MERS) CoV and it is believed to have originated in the Middle East in 2012. The third coronavirus is SARS-CoV-2 and according to researchers at Johns Hopkins University Bloomberg School of Public Health originated in Wuhan, China in 2019 (Gurley, 2020). The common signs and symptoms for COVID-19 include fever where the temperature is >100.4◦ F, tiredness or fatigue, chills,
muscle pain, cough, loss of taste or smell, difficulty breathing, headache, and sore throat (Gurley, 2020).
Importantly, symptoms are something that people report, but cannot be objectively measured. Nausea, loss of taste or smell, feeling tired are common examples of symptoms that cannot be measured objectively. Fever on the other hand can be a sign and a symptom as it is measurable. Unfortunately, fever, cough, and myalgia are nonspecific, but they are common in COVID-19 and other respiratory diseases (Gurley, 2020).
There are other signs and symptoms that indicate a disease (COVID-19) is progressing, and these include blue lips or face (this is indicative of a lack of oxygen), increased rate of breathing, shortness of breath, chest pain when breathing, waking up from sleep with shortness of breath, and new confusion or difficulty waking up (Gurley, 2020). When people experience any of these signs or symptoms, they should seek immediate medical assistance.
Contact tracing is “the practice of identifying and monitoring individuals who may have had contact with an infectious person as a means of controlling the spread of a communicable disease” (Merriam-Wester, n. d.). It is believed the first use of contact tracing is dated to the mid-19th Century in Europe and contact epidemiology “became a central public health strategy in the United States during the syphilis epidemic in the 1930s” (Gostin, 2008 p. 302). Kapa, Halamka, and Raskar (2020) state “the decision to deploy contact tracing at a regional, national, or global level needs to take into consideration a balance between individual data privacy and societal benefit” (p. 1). Also, contact tracing can be viewed from two distinct vantage points. The first utilizes user identification and emphasizes privacy. This is commonly used and involves a “central authority” who gathers data and responds to the results of that data through direct contact with the user (who is identifiable) or through a law enforcement agency. The second is where the user’s data is encrypted which prevents the “central authority” who never knows who the user is (Kapa, Halamka, and Raskar (2020). In today’s society, the second approach is likely the preferred path for those who may be infectious and does not trust the central authority. Therefore, “in scenario 2, no central authority or law enforcement body is aware of the identities of exposed individuals, but users can still be made aware of potential exposure and respond accordingly (pursuing testing or self-isolating) (pp. 1-2).
Contact Tracing Technology
Unfortunately, citizens in the United States may be opposed to any technology that tracs their movements such as the type used in China, the Republic of Korea, Singapore, or Europe even though many individuals may not realize they are tracked by Google, and other apps downloaded to their smartphones, even iPhones! China was the first to use advanced technology and it was the close contact detector. “Through the use of QR codes scanned by users and government identification numbers, the app integrates with the Ministry of Transport, China Railway, the Civil Aviation Administration, and the Chinese National Health Commission database” (Johns Hopkins, 2020, para. 3). In the Republic of Korea, location data is the primary contact tracing approach.
The Corona Map and Corona 100m apps use date from government information systems, including those from the Korea Centers for Disease Control, to send push notifications if the user has been within a certain distance of a person known to be infected. (Johns Hopkins, 2020, para. 4).
The Republic of Korea system provides the recipient of push data with detailed information about the person the user was exposed to, the age, sex, and location of the exposure. The system uses GPS data, history, and surveillance cameras to provide the detailed information.
Singapore takes a much different approach as they use “Bluetooth signaling between devices to detect users in close proximity” (para 5). All the data is stored on the user’s device who can send the data to the Ministry of Health. This system does not collect any location data. According to the study by Johns Hopkins, the information collected by the app is deleted automatically after 21 days. Currently, there is an effort under way in Europe to develop what is known as the GDPR-compliant platform “to enable contact tracing using an approach that enables full anonymity; this system is known as the Pan European Privacy-Preserving Proximity Tracing (PEPP-PT) (para. 6). The European system is similar to that of Singapore and uses Bluetooth rather than geolocators.
In the United States there are several systems under development. The first is COVID-19 Watch. This system is being developed by Stanford University and uses Bluetooth. The data is voluntary and are anonymized. Additionally, “Bluetooth signaling: (2) heatmaps based on anonymized GPS data on locations of highest concentrations of cases to identify high-risk areas for transmission; and (3) generation of risk reduction strategies for health practitioners based on the data” (para. 8). COEpi: Community Epidemiology in Action is another Bluetooth, voluntary technology which allows for self-reporting. There is very little known about this system or the administrators of the company.
The Massachusetts Institute of Technology (MIT) developed Project Safe Paths. This project involves participant experts from the United States, Canada, Germany, India, Italy, the United Kingdom, and Vietnam. The system is an open-source technology and uses smartphone technology applications and a web application known as the PrivateKit appl. Currently there are projections for at least two more versions which will include log location history, personal location history with infected people, and in V. 3 the ability to match one’s location history with encrypted anonymous redacted infected patient trace files provided by government officials (MIT, 2020).
21-century technology has progressed to the point where at least on the issue of pandemics, contact tracing can be quicker and much more efficient. One can only imagine how many lives would have been saved by the use of technology and contact tracing. The Smallpox epidemic (1633-1634), Yellow fever (1793), three waves of Cholera 1832-1866, Scarlet fever (1858), Typhoid Mary (1906-1907), H1N1 Flu (1918), Diphtheria (1921-1925), Polio (1916-1955), H2N2 Flu (1957), Measles Second outbreak (1981-1991), Contaminated Water in Milwaukee (1993), Whooping cough (2010, 2014), HIV and AIDS (1980s to the present), and COVID-19 (2019-) could all have been less deadly through the use of contact tracing. However, in the United States there are concerns that many people have related to confidentiality, privacy, and the possibility the law enforcement or social services could remove family members who have nowhere to go or anyone to take care of them. Each jurisdiction (state) has their own guidelines and protocols which could result in such actions.
Gostin, L. O. (2008). Public health law: Power, duty, restraint. Berkeley, CA: University of California Press
Gurley, E. (2020). COVID-19 Contact Tracing. Johns Hopkins University School Bloomberg School of Public Health. Retrieved from:
Johns Hopkins. (2020 April 8). Review of mobile application technology to enhance contact tracing Capacity of COVID-19. Bloomberg School of Public Health Center for Health Security.
Retrieved from: https://www.mayoclinicproceedings.org/article/S0025-6196(20)30424-9/pdf
Kapa, S., Halamka, J., and Raskar, R. (2020). Contact tracing to manage COVID-19 – Balancing personal privacy and public health. Retrieved from: https://www.mayoclinicproceedings.org/article/S0025-6196(20)30424-9/pdf
Merriam-Webster. (2020). Contact tracing.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/contact%20tracing
MIT. (2020). Project Safe Paths. Massachusetts Institute of Technology. Retrieved from: https://www.media.mit.edu/projects/safepaths/overview/
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