COVID-19, Health, Tech, Top Stories

The Case for a Mandatory COVID-19 App

COVID-19 offers governments no attractive policy options. Those in power are in a no-win situation. The choice is not between good and bad, nor even between bad and worse, but between grim and catastrophic. On one hand, there is the “butcher’s bill” of death that results from inaction or inadequate action in the face of the virus. On the other, there is the “banker’s bill” of bail-out and bankruptcy that results from quarantine measures. The “butcher’s bill” that results from delay or inaction in the face of the virus is grim.

COVID-19 Total Deaths per million. (Source: Our World in Data May 4th)

The butcher bills fortnightly. Two weeks of inaction or delay in the face of COVID-19 can kill thousands. The banker moves at a more leisurely pace, billing quarterly. Most businesses can survive without revenue for a fortnight. Fewer can survive one quarter let alone three or four without income.

“Stay home: Save lives” is the message promoted by New Zealand’s prime minister Jacinda Ardern, the Western leader whose response to COVID-19 has been among the most successful. The secret of this success? Ardern also adopted an approach of “Go hard: Go early” and has consequently suffered far fewer fatalities per capita than countries that dithered or delayed imposing restrictions. But minimizing the butcher’s bill runs up the banker’s bill, and the banker’s bill is growing. As soon as the relevant offices emerge from lockdown, there will be insolvencies and liquidations. Some businesses will not re-open at all. The longer lockdown continues, the greater the number of businesses forced to close, and the more jobs lost. To avert widespread economic collapse, governments have been handing out wage subsidies and bail-outs to keep businesses afloat.

Extraordinary circumstances call for extraordinary policy measures. If there is a way to reduce both the butcher’s bill and the banker’s bill, then governments are justified in mandating it. Recently, an Oxford team published a paper in Science which found that the spread of COVID-19 was “too fast to be contained by manual contact tracing but could be controlled if this process was faster, more efficient and happened at scale.” The authors therefore make the case for a contact tracing app. Its main feature would be to store data on proximity contacts and sound an alarm if a contact has been tagged as testing positive. The authors argue such an app can “achieve epidemic control if used by enough people,” and that 60 percent take-up would be enough. That may be, but 100 percent would obviously be better. The functionality is shown in the figure below.

Taken from L. Ferretti et al., Science, 31st March, 2020

Their app design uses GPS and QR codes in places where GPS would be ineffective (such as underground train stations). Other proposed app designs rely on a Bluetooth “handshake” (automatic connection between devices which have Bluetooth detection enabled) rather than location data. In essence, a GPS and QR based solution works by tracking location. If two people are at the same location and one of them has tested positive for COVID-19, the app carried by the other can receive an alert based on a search of location history. With a Bluetooth solution, the app does not record where you are, it merely says one phone was within Bluetooth range of another. So, if a Bluetooth device finds itself in close proximity to a phone belonging to an infected person, an alert can be sent to the user who may have been exposed to them. The app does not need to identify the infected party, it need only say: “You have been close to someone who has tested for COVID-19. Call this number.”

China required installation of a plug-in to Alipay or WeChat. It provides a red/amber/green indicator function. To get into a high traffic public space (for instance, a shopping centre or a train station) it is necessary to present a phone displaying a green indicator. The Science paper provided a cautionary link to a New York Times article that reported complaints from people who did not know why their phone was showing red. The Chinese app may be badly designed but one would think a well-designed app would provide a number to call for information about what to do when an amber or red indicator is displayed. An adequately staffed response team would be an essential part of such an application.

An efficient app of this kind would enable a society to reopen businesses and return to something approaching normal economic life while keeping the risk of infection low. New COVID-19 infections could be targeted with technological precision rather than the blunt instrument of mass quarantine. The catch is that, if such an application is to work optimally, everyone must use it, at least in high-traffic areas, and this use will have to be enforced. Why trust, when you can verify? Many shops already screen their customers for tagged goods as an anti-shoplifting measure at their entrances and exits. What is so terrible about a phone-based screening at the entrance of a shopping mall? Given a choice between closing the mall to everyone or opening it and refusing entry to a few with an alert on their app, which is better?

In the figure above, if A is not carrying the right app, B and C will not get a test request. Making the app voluntary is like fighting a fire with a leaky bucket. If half or three-quarters of the population do not install it, it simply will not work. So, the moral argument is simple—making the app mandatory will maximize the precision of the government’s quarantine measures and minimize the need for mass lockdowns which are indiscriminate and economically ruinous. If it works, it can keep both the butcher’s bill and the banker’s bill down. Under these circumstances, making such an app mandatory is a fair and reasonable policy option for governments.

The case against such an app is mostly based on Big Brother arguments. People worry about the creation of a “surveillance state” and privacy violations. They argue that everyone should have the right to move freely from place to place and meet whoever they want without a government app tracing their location via GPS and their close contacts via Bluetooth. Opponents of a contact tracing app argue such apps will become normalized and one’s green/amber/red status will be a slippery slope towards something like China’s social credit system. Those tagged amber or red for whatever reason will be turned into social pariahs and excluded from all forms of normal social life. Such concerns strike me as exaggerated. Quarantine is a temporary medical measure.

There are legitimate doubts about the efficacy of such apps. As yet, they have not been tested properly in the West because downloads thus far have been voluntary. But suggestions that “there is no evidence” these apps work are premature. While the necessary experiments have not yet been conducted in open and democratic societies, they worked well in China where the government made adoption of these apps mandatory for anyone wishing to catch a train or enter a mall. Despite its immense population and high population density, China’s reported death rate per capita is now a fraction of that in the UK and the US. The Chinese Communist Party certainly operates an abysmal regime, but a policy initiative is not necessarily inadvisable simply because a one-party state adopts it. Even if the Chinese are massaging their numbers and under-reporting by one order of magnitude, Xi Jinping’s amended butcher’s bill of 30 fatalities per million still compares favourably with Donald Trump’s bill of 204 and Boris Johnson’s bill of 419.

Some critics may object that traditional human-centred contact tracing is better. A phone call from one person to another to quiz them about the last time they met a person can extract information that might contextualize a contact with an infected party and alter the consequent risk assessment. Contact tracing apps certainly cannot replace existing manual methods, but automation can assist and accelerate them. This is the main epidemiological argument made by the Oxford team. Contact tracing apps, targeted alerts, testing, and self-quarantine can help reduce the rate of COVID-19 infection at scale without continuing to subject the entire population to an indiscriminate, prohibitively expensive lockdown.

The Big Brother arguments suppose democratic governments will sink into authoritarian despotism due to location tracing and contact tracing. On this point it is worth being blunt. The organisations that really know exactly where we are and what we are thinking in real time are transnational firms like Google and Facebook, not democratic governments. More to the point, governments can already track mobiles—without any apps on them at all—using network triangulation. While this is tens of metres less accurate than GPS, governments have been able to track phones used by criminals and terrorists for over two decades. This is why drug dealers change their phones daily and terrorist leaders do not carry them at all.

The epidemiological arguments for an app centre on the functions of contact tracing and prevention. Prevention (on the Chinese model) requires a green light on the device based on lack of contact to get into high traffic public spaces. If most contacts don’t show on the app due to low take-up, the functions of prevention and contact tracing are compromised. The main argument against a voluntary app is lack of efficacy due to lack of take-up. Neither Singapore nor Australia has yet to achieve sufficient adoption (60 percent plus) for such an app to be effective. To encourage co-operation and to allay fears, it is critical people are told what the app does and why. In particular, they need to know there is a number to call if they get a red or amber indicator and they need to be provided with clear steps that enable them to get back to green. There should be bipartisan oversight and the app should be set up as a temporary measure for the purpose of combating COVID-19. A mandatory app deserves a rigorous trial in at least one large democratic state. This is a matter of epidemiological science not politics.

The Oxford team suggested people should be “democratically entitled” to decide whether or not to carry such an app. Frankly, this is timid. There is no “democratic” right to opt out of quarantine measures. The death rate in Europe is appalling. Even so, if people would rather stay in lockdown than install a contact tracing app, they can remain free to do so. During a pandemic, people should not have unfettered rights to be asymptomatic super-spreaders. Nor should they have rights to move around as normal without observing reasonable quarantine restrictions and checks. A few counter-pandemic bytes will not tip democracies into dictatorships, and when nations are able to emerge permanently from lockdown, the app can be shut down. Such a measure could save lives and save jobs. And this is self-evidently better than saving lives and killing jobs.

 

Sean Welsh holds a PhD from the Department of Philosophy at the University of Canterbury in New Zealand. He is the author of Ethics and Security Automata, a research monograph on machine ethics. Follow him on Twitter @sean_welsh77.

Comments

  1. I disagree with this post in every detail, including the basic assessment. It’s very spastic and full of do what I say or everyone is going to die poor and hungry. It’s long on panicked hyperbole and short on rational analysis. But rather than try to pick it apart I will focus on just two things:

    The organisations that really know exactly where we are and what we are thinking in real time are transnational firms like Google and Facebook, not democratic governments.

    I don’t use Google and Facebook. I made a conscious decision to do all I could to deny them access to my data back in 2009, when I first realized the extent to which they’d made themselves unwelcome guests on my computers. If they are tracking me, they are doing so illegally and I want them prosecuted for that. I do use an Apple iPhone and I know they are tracking me, but there’s nothing I can do about that. Any other smartphone I might use would expose me to Google, and I’m sorry: Google is evil. But back to Apple: if I ever find out Apple is sharing my data with third parties without my permission I will do all I can to hold them to account for that crime. I’ve been using iPhones for about a decade and as far as I can tell, that hasn’t happened yet. All that said, I really don’t understand this logic. If somebody had their home robbed, would you tell them they are missing the point and shouldn’t bother going to the police because the thieves already have all their stuff?

    More to the point, governments can already track mobiles—without any apps on them at all—using network triangulation.

    The US government needs a warrant to do that. I live in the US. If I find out the US government is tracking my iPhone without a warrant, I will do all I can to hold the officials responsible to account for their criminal abuse of power. I will also do what I can to hold the company I get cell service from responsible for turning over my data to the US government without my permission when the government did not present them with a warrant.

  2. I don’t really consider “we should trust the government” to be a no-brainer. I estimate 100% of Democrats in the US don’t trust the executive branch because of Trump being President, and 100% of Republicans also don’t trust the executive branch because when Obama was President he sent the FBI and the CIA after Trump with the intent of undoing an election, and did so using this same tech we are currently discussing.

    On a related note:

    Tawakkol Karman is Yemeni Muslim Brotherhood. This is not in dispute. She is a member of a Muslim Brotherhood political party. Seeing as how Facebook has just partnered with the Muslim Brotherhood, which is the parent organization of Al Qaida, Hamas, ISIS and a hundred other Sunni jihadist groups, how confident are we that Facebook is not sharing our data with terrorists who want to literally murder us? Even if not, Facebook has put some of the worst bigots who ever lived in charge of policing our speech on its platform. How much should we trust Facebook? I don’t know about anyone else, but I really don’t want the Muslim Brotherhood to be able to find out everywhere I’ve been for the last month, and everyone I’ve talked to, and everything I’ve said, and everything they’ve said, with the click of a button. That really doesn’t seem like a nice feature, to me. I don’t want it. That’s why I don’t use Facebook.

  3. The Big Brother arguments suppose democratic governments will sink into authoritarian despotism

    You mean like closing the economy and halting all production of the many things we needed more of? Or the declaration that some people are essential while others are presumably unimportant/disposable? Or the misinformation about wearings masks to slow the spread and instead just wait until you are in the hospital? Or that you only test those who are already clearly sick rather than finding those who are spreading but aren’t yet sick? Or that you can’t make a test because the CDC/FDA block you? Or that most are not entirely dependent on government handouts paid for by increased debt for the future?

  4. The case against such an app is mostly based on Big Brother arguments. People worry about the creation of a “surveillance state” and privacy violations. They argue that everyone should have the right to move freely from place to place and meet whoever they want without a government app tracing their location via GPS and their close contacts via Bluetooth.

    There is something monstrous about this Sean Welsh. Putting scare quotes around “surveillance state” as if only a foolish person would fear such a thing. Deriding people who believe they have a right to move freely about without their government spying on them.

    Only a Stalinist, or someone very much like one, could love the case that Mr. Welsh is making.

    I would sooner see a massive uptick in COVID-19 deaths - and take my chances with the rest - than see such a plan come to fruition in the US. I would sooner see bloody revolution in the streets than allow the American government to have this much power. Power once wielded, never voluntarily given up.

  5. “when nations are able to emerge permanently from lockdown, the app can be shut down“

    It can be, but it won’t. And the next time, the removal of freedoms will be even greater.

  6. Colour me unconvinced.

    New Zealand is also a smattering of hillside cottages compared to the US and Europe. And Ardern is an authoritarian. She needs little convincing to restrict people’s freedom, this is not to be celebrated.

    When you set up your argument such that there is heavy death on one side and economic destruction on the other, and the only way out is to let the government track everywhere we go, this “fair and reasonable” solution feels more like a gun to our heads. I don’t like it.

    I don’t think we need to speculate about where our governments might take us with this precedent and infrastructure. There are unlimited possibilities. For the sanctity of our democracies we shouldn’t open that door. Even if your friendly authoritarian Arderns or Trudeaus aren’t going to persecute anyone with them now, doesn’t mean they or someone else won’t in the future. This simply isn’t worth the risk.

    How could a single living human believe the Chinese numbers aren’t entirely bogus? One order of magnitude off? Ha! That is how much this disease spreads in one week. China has been reporting no new homegrown cases for months now. But I suppose when you’re advocating for authoritarian measures, you’ve got to make the world’s worst autocracy sound good.

    I’m glad it was noted that the US is doing better than most of Europe, but it doesn’t hurt to point out the US fared as well as Germany if you don’t count New York, where incompetent Democrats sent covid+ elderly back to their nursing homes and only started disinfecting their overcrowded trains this week.

    So it’s not enough that governments have given up on their responsibility to protect consumers, they need to get in on the tracking game, too? If I don’t want to be tracked by Google, there are steps I can take. If I don’t want to download the government’s tracking app, what are my recourses, except prison?

    This is the attitude of someone with too much faith in government. There will not be sufficient oversight and the tracking will not go away.

    Maybe if we had kept government lean and transparent, reasonable people could have faith such an emergency measure would not be used to further entrench government in our personal lives. Instead, we have governments always looking for new ways to meddle, getting their hands all over our education, media, health care, energy, retirement, housing, with evermore regulations. There is no reason to believe government will pull back this time when it never has before. So now we have to hold the line.

  7. That’s the argument the author makes, which assumes that all public places belong to the government. Shouldn’t it be individual owners who should have the power to exclude anyone for any reason, including whether or not they have a particular app?

    If my grocer doesn’t want my business, I’ll go elsewhere. It’s only when the government mandates that all grocery stores must comply that we have a problem.

  8. The big danger that I think everyone realizes, is that whatever happens will be here for good. According to the world economic forum, there have been pandemics in 1918, 1957, 1968, 1981, 2002, 2009, 2014 , 2015, and 2019. Maybe fighting the flu will be the perpetual war used to enslave us all as in 1984.

  9. This article reminds me of an old saying: “The road to hell is paved with good intentions”.

    What could possibly be wrong with copying the methods of an authoritarian surveillance state? Freedom and voluntariness are overrated anyway, just ask the CPC leadership.

    Unfortunately, it was to be expected that the practical usefulness of Chinese methods in controlling their population would finally arouse the desire among parts of the Western establishment to gradually introduce them in our societies as well. Authoritarian characters with a strong belief in the nanny state are particularly susceptible to this. And this pandemic now offers them a great opportunity to promote their aims.

    The Oxford team suggested people should be “democratically entitled” to decide whether or not to carry such an app. Frankly, this is timid. There is no “democratic” right to opt out of quarantine measures. (…) During a pandemic, people should not have unfettered rights to be asymptomatic super-spreaders. Nor should they have rights to move around as normal without observing reasonable quarantine restrictions and checks.

    “Unfettered rights” are certainly something that people cannot be entrusted with - just ask any would-be dictator. As for the "reasonable quarantine restrictions and checks ": The author may have noticed that, in order for the measures advocated by him to be effective, it would be necessary to prohibit the use of public transport, going shopping or even meeting friends and family without constantly carrying a monitoring smartphone. Even George Orwell would have thought that was over the top!

    Opponents of a contact tracing app argue such apps will become normalized and one’s green/amber/red status will be a slippery slope towards something like China’s social credit system. (…) Such concerns strike me as exaggerated. Quarantine is a temporary medical measure.

    “A temporary measure” - you bet! Why abandon this system once it is in place when it can be so useful in so many other ways?

    Remember the drastic measures taken after 9/11, invading our privacy, most of which have become part of a new normality? Covid-19 will certainly not be the last crisis we will see - and each time there will be people crying out for more and more surveillance and coercion, and wanting to restrict our freedoms for the common good. That they could succeed seems almost more worrying than the crisis they claim to be fighting.

  10. Admittedly I only scanned this long orwellian piece, but I have to wonder about the purpose of such an app. Isn’t it largely to notify someone that they’ve been in contact with an infected person? So that they’ll be more cautious and get tested? But isn’t that right where we are? Wouldn’t a better goal be (until we get a vaccine) to test everyone, all of us, everywhere, for the infection and/or antibodies? I don’t think you’d have any problems getting people on board for that. I’d do it in a heartbeat.

    As for the big brother app, it implies that owning a smart phone would also be mandatory.

    Fuck that.

    p.s. Belgium called. They want their number of deaths per million crown back.

  11. Where in the article do you find good intentions?

    This article is a case for abolishing graduate philosophy education.

  12. I’m not sure what to think of this guy. If he held a PhD in Computer Science, Data Systems, or Information Technology I’d write him off as a textbook technocrat. But nah, turns out he’s a philosophy wonk who thinks he knows a thing or two about machines.

    As an actual software developer that actually builds shit, as opposed to dreaming up digital sky-castles, I can think of 100 ways this app and its attendant infrastructure would be guaranteed to go sideways. And through no malicious intent…that’s the scary part. It’ll go sideways simply because it exists.

  13. The moment you make it mandatory for me to download a tracking app onto my phone is the moment I will go full Hillary Clinton on it; hammer, bleachbit, THE WORKS!

    Meantime it is nice and safe in its Faraday pouch thank you very much.

  14. From the article: “New COVID-19 infections could be targeted with technological precision rather than the blunt instrument of mass quarantine.”

    How I read it: “Would you like your liberties to die by razor blade, or by sledge hammer?”

    I probably sound crazy, but this stuff just makes my skin crawl.

  15. 1). Nobody used this slogan.

    2). What am I “denying”?

    3). In your repulsive, offensive, and empty accusations, you failed to address my argument. So I’ll repeat it: there’s many technologies to explore for fighting this virus that do not include handing over my personal data to the government. Let’s focus on that.

    Please, enlighten this ignorant prick, dear Mr immunologist–economist–big data expert S.B.
    Tell me why it is a good idea to transfer my personal location data to the government. Hint: “they already know your cloud password” doesn’t do the job.

    Forgive me my sarcasm, but I’m allergic to anything that steers away from substantive, argument-based discussion. It’s toxic, unnecessarily humiliating, and reduces the quality of the debate.

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