Digital Technology Is the Key to Effective and Humane Pandemic Preparedness
As the world slowly recovers from the catastrophic consequences of the Covid-19 crisis, we are confronted with the reality of the economic impact, death tolls, and fragility of health systems globally.
Scientists believe that future pandemics are inevitable and will occur more frequently due to climate change, population growth, and the interconnectedness of the world. We need our governments, policymakers, and organizations like the WHO to focus on enduring and effective pandemic preparedness.
Growing distrust of government and authorities and the mental health toll resulting from extended lockdowns and restrictions will require pandemic preparedness to focus not only on disease control but also on ensuring the protection of individual freedoms.
This is where technology could play a critical role: it can help mitigate a health crisis while allowing for more humane management of future pandemics.
Bill Gates called for a huge global effort to prepare for the next pandemic. The Microsoft founder said research and development budgets should focus on weaknesses exposed by the rapid spread of Covid-19 around the world.
In a 2014 TED Talk, Gates even warned that the world was not ready for a pandemic: “It’ll take tens of billions in research and development,” he said, “and probably about a billion a year for a pandemic task force at the WHO [World Health Organization] level.”
Although many governments have invested in pandemic preparedness, it hasn’t been at the level necessary or in line with Gates’ estimates, and relatively little money has been directed to technology-based solutions.
Covid-19 has impacted many different aspects of society, from economics and politics to considering the rights of individuals’ need for data privacy, with the broader impact of individual human rights. These are important considerations that should influence the way that we manage the Covid-19 outbreak and future pandemics.
It is critical to address the role of digital solutions in pandemic preparedness and how governments and organizations may leverage the available innovative technologies to:
1) Protect the privacy and security of personal data
2) Respond in a more equitable way by ensuring that vulnerable communities are not left behind with respect to healthcare acess and vaccinations
3) Agree on urgent standards necessary to retain individual freedoms
Governments Bested by Covid-19
Covid-19 is the most significant public health crisis in modern-day history, ravaging the world’s population, with detrimental economic consequences, hundreds of millions of people infected, and devastatingly high death tolls.
Let’s recap on the global experience: many governments reacted somewhat slowly in implementing restrictions and measures, including social distancing, the wearing of face masks, stay-at-home orders, lockdowns, travel bans, and business closures.
Subsequently, hospitals were overwhelmed with patients and stretched beyond their capacity. As the pandemic went on, we saw shortages of health workers and life-saving equipment. Globally, health workers suffer from fatigue and stress-related burnout, hence further exposing the weaknesses and vulnerabilities in already fragile health systems. And many of these challenges continue today as we move into the third year of the pandemic.
As vaccines became available, the emphasis shifted towards immunization of populations, targeting priority groups to reduce the secondary transmission of infection and accelerate post-pandemic recovery.
However, the universal immunization of populations continues to face tremendous challenges with response efforts to the pandemic by most accounts being slow, inadequate, and at times influenced by political agendas and nationalism, leading to delays in setting clear standards and globally coordinated actions.
Leaders are faced with challenges including inequitable vaccination distribution, coping with weak health systems, the shortage of health professionals, and a lack of public awareness and trust in imposed restrictions and mandates.
Why is the Public Distrustful of Authorities?
Some governments have had greater success than others in dealing with the Covid-19 pandemic and one key factor is whether citizens trust their leaders, as well as whether those leaders are competent and effective at managing and communicating their pandemic health strategies.
This can be seen with the tentative adoption of contact tracing applications. Contact tracing apps were rapidly developed as a tool used by governments to identify and monitor individuals who have been in contact with an infected person, designed to limit the spread of Covid-19 disease. Amnesty International Security Lab and privacy advocates expressed concerns about whether governments could use and abuse these tracking apps for mass surveillance of all citizens, with concerning human rights implications.
Big tech companies such as Apple and Google quickly created privacy-by-design frameworks for contact tracing solutions, using these advanced technologies for disease detection and tracking, which raised further concerns voiced by academic institutions over compromising the privacy or anonymity of the users’ information.
These concerns of compromising individual privacy through contract tracing apps have been more broadly raised worldwide. In Singapore, the Ministry of Home Affairs confirmed that contact tracing data could actually be accessed by the Singapore police for criminal searches, with a minister revealing that such data had, in fact, already been used in a murder investigation. These revelations triggered public anger and criticism because people felt they’d been subjected to misinformation.
Governments Choosing to Mandate Vaccines
The right to choose to be vaccinated against Covid-19 has sparked significant debate and controversy. A vaccine mandate is a law that requires you to be vaccinated to do certain activities like working, traveling, going to a restaurant, or attending a concert. While governments cannot physically force people to be vaccinated, businesses, schools, healthcare facilities can legally stop people from entering buildings or using their services if they have not been vaccinated.
Mandating vaccines is not only a political decision but also a public health matter in which governments are required to consider the impact on the wider population and the entire healthcare system. Due to the high transmission rate and severity of Covid-19 disease, strong laws and vaccine mandates have been put in place in an attempt to limit the public health impact of the virus.
Each government is forced to consider not only the health of the individual but also the health of the greater public, influenced by pre-existing health inequalities. A short supply of vaccines globally and the emergence of new more transmissible strains, such as the Omicron variant, have also to be considered. Vaccine availability needs to be urgently addressed by governments, particularly for developing countries, indigenous populations, and the unhoused, in addition to undocumented people who may have a difficult time accessing vaccines, if we are to break the vicious cycle of the pandemic.
Employers mandating vaccines face their own challenges for managing employees’ Covid-19 vaccination compliance. First, workers feel forced or ostracized from workplaces if they refuse the vaccination. Second, current technologies potentially compromise the security and privacy of the employees’ personal information, with personal Covid-19 data managed and stored on ill-equipped software tools with barely rudimentary security measures in place.
Take the hypothetical example of Tony: he is a maintenance worker at a big global company, frequently traveling to different worksites to perform his job. From a public health and safety perspective, it would be wise to monitor Tony’s movements. As a contractual worker, he is in the high-risk category of spreading Covid-19 as he travels to different work sites daily.
Tony is nervous and hesitant about the Covid-19 vaccine and chooses not to be vaccinated. He also does not want to carry a government-issued Covid-19 proof of vaccination certificate due to privacy concerns arising from having a pre-existing health condition. The choice to not be vaccinated now matters to Tony—his ability to work in certain organizations requiring proof of vaccination status will be limited. Tony cannot work at his company if he is not vaccinated. His personal freedom is compromised, as is his employment opportunities in places where vaccination is mandatory.
In the US, vaccine mandates remain a controversial topic, with President Biden’s plans for businesses to mandate vaccines temporarily blocked through the US appeals court. Education and sporting institutions passed vaccine mandates in New York requiring residents and professional athletes to be vaccinated with at least one shot to enter indoor gyms to practice or play in public venues, including the Barclays Centre. It is this mandate that has kept high-profile players like Kyrie Irving benched, after his refusal to be vaccinated.
France’s vaccine mandates have introduced a Covid-19 health pass from July to access indoor public activities including restaurants, bars, theatres, venues, cinemas, places of worship, and sporting events. Laws imposed for the mandatory vaccination of healthcare workers in September saw 230,000 people marching across France to protest measures meant to counter the spread of Covid-19.
France is not the only country to turn to health passes. Denmark pioneered their health passes with little resistance and Italy introduced green passes recently.
In Perth, Western Australia (WA), strict border closures and mandatory restrictions stay in place until the state reaches a 90 percent double-dose vaccination rate for people aged 12 and above, while other Australian states have taken a different approach. Each jurisdiction is therefore making its own rules, based on very different experiences of Covid-19 in each state of Australia.
Protecting Individuals’ Privacy, Fostering Inclusion & Personal Freedom
The Covid-19 pandemic has given us a unique opportunity to reflect on what we can do better as we move forward in our planning for future pandemics.
For organizations like the WHO and governments, this may include setting up regulatory frameworks and policies, as well as leveraging available digital technologies to make innovation the cornerstone of their approach. Efforts need to be steered to design technology solutions that at their core protect the rights and privacy of every individual, and reduce health inequalities and discrimination of vulnerable populations.
Evidence of the public’s growing distrust in governments, big tech companies, and organizations means that solutions that were intended to help are being scrutinized or rejected by the masses when there is a choice to do so. Contact tracing solutions intended to detect and reduce the spread and evolution of the disease and its variants, along with authenticated “vaccination certificates” and “digital passports” are at the very least viewed with suspicion, indicating the urgent need for governments to strategize and create forward plans for safer systems.
As vaccination rates increase in the developed economies and mandates are gradually relaxed allowing a return to freedom of movement for the majority, it is important to be aware of the groups of people who will have less freedom and empowerment. This includes people immunocompromised and those from disadvantaged and vulnerable communities, as well as countries where vaccination rates remain low due to the inability to access vaccines and booster shots, or those at most risk of counterfeit vaccines.
Moreover, Covid-19 does not respect borders, there are risks associated with variants and mutations which means that we are not truly safe until everyone is vaccinated.
How Can Tech Make Things Easier?
Governments face enormous technology challenges in ensuring the safe return to “normal.” Economic reopening strategies, reopening workplaces, the increase in international travel, and preventing further waves of infections are amongst the many challenges governments need to contend with.
Implementing technological solutions (health certificates, digital passports, or any highly secure health document that gives Covid-19 test or vaccination proof) could serve as the basis for a certificate that liberates individuals from the most restrictive government regulations.
Blockchain technology offers one such digital technology solution. Blockchain-enabled decentralized platforms are able to manage data storage of Covid-19 vaccination certificates and vaccination record management, ensuring this data is immutable and guided by the strictest privacy standards of GDPR and HIPAA.
Blockchain’s ability to keep an incorruptible, decentralized, and transparent log of all personal data makes it a suitable technology to store sensitive health data in a secure, protected way, while also ensuring the identity of any individual remains private.
The decentralized nature of the technology also allows individuals to choose how they share or conceal private information with their doctors, governments and researchers, quickly and safely. Individuals could be incentivized to share this data with authorities to support public health campaigns, the tracking of new pandemics, and assisting pragmatic vaccination clinical trials designs, helping to generate innovative new treatment approaches—if they choose to do so.
Additionally, AI health monitoring technologies could be helpful in detecting the spread of Covid-19 as seen with the company Bluedot to detect the world’s most dangerous diseases. The AI-based “chatbot” technology developed by Microsoft addresses rising patients’ concerns and can screen patients for Covid-19 symptoms and/or exposure by asking a series of questions based on the latest Centers for Disease Control & Prevention (CDC) guidelines.
Future Considerations: Healthcare Technology to Combat a Pandemic
Technology solutions need to protect all citizens and not further discriminate against marginalized communities. Governments need to foster an ecosystem of digital inclusion and healthcare data literacy for disadvantaged and vulnerable folks. Therefore, providing access to resources and digital apps remains a high-level priority.
Addressing the significant trust issues in healthcare is imperative for governments, notably regarding access and management of health data. While there seems to be broad support for Covid-19 health status certificates worldwide offering the potential of a safe return to normal, there is an increased risk of cybersecurity threats to healthcare provider systems and universities in the midst of a pandemic. Breaches of the healthcare system’s cybersecurity may expose personal information or data that will negatively impact both patients and the healthcare institutions, with potentially life-threatening consequences. It will also further erode trust and risk more civil disobedience.
Given the sensitive nature of health data, governments need to access top data security and privacy experts to develop a robust framework and policies that go beyond where we are today, protecting the rights of their citizens and finding better ways to make people’s personal data as secure and private as possible.
Designing privacy-preserving data access control (P2DAC) mechanisms that are anti-fraud and trustworthy ensure an individual’s personal health is protected and de-identified.
Data privacy must be placed at the center of the design, development, implementation, and evaluation of digital technology solutions, independent of the type of architecture or technology chosen. A data privacy-centric approach should encompass data privacy by design and by default.
Overall, digital technologies adopted during the current pandemic will have a lasting impact on our societies. They will shape how we respond to data privacy and human rights within digital solution frameworks; therefore, it is important for policymakers and governments to consider the impact on individuals and societies to ensure they do not exacerbate or create further inequality.
There is also a need to test the robustness of these digital solutions and work with citizens, governments, and organizations to pioneer solutions that simultaneously benefit individuals and economies while improving public health outcomes globally.