With my final academic oriented post, I will attempt to unpack the ethical implications of the use of digital surveillance and contact tracing in democratic societies compared to other political systems under the assumption that the latter is likely to pay less attention to the delicate balance between collective benefit and individual rights. I have my opinions based on what I have read in the media but being a data junkie, before coming to any conclusions, I would like to see what the evidence says.
Intro
Globally, new policies have emerged from the COVID-19 response to make it easier for public health agencies and governments to collect information to track the spread of the virus and contain its spread. Software developers have also played an important role in COVID-19 prevention efforts and many have developed and launched mobile contact tracing Apps to support Ministries of Health track people with COVID and their contacts in an attempt to mitigate its spread. Information technology and big data have been central to COVID contract tracing initiatives across the globe. By default, this requires the collection of personal information and enabling of location services.
From a public health perspective, these systems were initiated to protect the greater good and to essentially save lives. For me, as a public health professional, the benefits were clear and as I mentioned in my recent post, Public Health Data for the Greater Good, the fundamental principle of public health response during infectious disease outbreaks is to protect the masses from becoming infected – and to ultimately save as many lives as possible. If policies or mandates need to be enacted to protect the greater good, revoking certain civil liberties may be necessary for public safety. For example, mask mandates were one of the most effective ways to ensure masking was adopted as quickly as possible to protect those who were the most at risk. Personally, I believe that wearing a mask to protect oneself and others should not even be up for debate. It is a simple measure that can have a significant public health impact (Wang, Y. et al., 2020). When it comes to contact tracing however, the issue has been less unambiguous and there have clearly been tensions between the individual right to personal privacy and the collective benefit (O’Connor et al, 2021).
Privacy as a legal right is globally recognized in the Universal Declaration of Human Rights (1948) and in many (but not all) national frameworks worldwide (O’Connor et al, 2021). In my previous post, we saw how in the US, personal and location data could be accessed through a geofence warrant issued by law enforcement or immigration authorities but that legal firewalls had the potential to protect people from this invasion of privacy, at least in New York.
Potential benefits of digital contact tracing
Typically contact tracing is a critical element of infectious disease control. The idea is to identify infected individuals and inform those they have been in contact with of their potential risk for infection. This requires a meticulous process of tracing each person the infected person has been in contact with and involves them retracing their steps over a specific period (Lucivero et al, 2020). Digital contact tracing has several advantages to the traditional method, particularly in the context of the COVID-19 pandemic. Digital contact tracing systems were able to replace or complement the arduous, labour intensive process of tracing and calling contacts, requiring a large workforce of skilled contact tracers. These digital systems are also more accurate given the unreliability of human recall especially in the context of COVID where evidence suggested that one could transmit the disease asymptomatically several days to weeks prior to having symptoms (Lucivero et al, 2020). Thus, in several countries, digital contact tracing Apps or wearables were rolled out to complement and sometimes replace manual contact tracing in an effort to contain the spread of the virus as quickly and efficiently as possible. In the Americas and Europe, digital contact tracing was implemented in Norway, the UK, Germany, Austria, Estonia, Switzerland, Poland, Italy, the US, Canada, Mexico and others (Yang, C., 2022). In Asia and Pacific, Apps and wearables were initiated in Singapore, China, South Korea, Thailand, India, and Fiji among others.
However, the implementation of contact tracing Apps is not as straightforward as it may appear. According to Yang, C. (2022) “The sociotechnical context surrounding the development and implementation of these apps is diverse with regards to who operates the system (actors), the historical and cultural context related to information practices, and the existing principles of information transmission guiding their deployment (legal and regulatory frameworks” (p5).
Private sector involvement and public trust across the Globe
In April of 2020, in an attempt to support governments create digital tracing apps, Apple and Google developed a new technology that could support third-party apps which became known as “Exposure Notification” (Akinbi et al., 2021; Veal In Taylor et al. 2020). Although both companies claimed that “user privacy and security [were] at the core of design” (Akinbi et al., 2021, p2), privacy issues related to contact tracing apps have been called into question worldwide. The prevailing skepticism is based on the idea that these systems could also be used by governments for unwarranted discrimination and non-Covid surveillance activities or that data could be provided to third parties (Akinbi et al., 2021). This has led to trust issues in some places, and a reluctance to download them, particularly where the Apps were not mandatory such as in North America and most countries across Europe. Non-compliance is counterproductive to the aim of the App as for contact tracing to be effective, 80% of the smart phone owning population needs to download and use them (Edwards In Taylor et al., 2020). Support for and intent to use contact tracing apps varies from country to country but even when the intent is there, this doesn’t always translate into action (Akinbi et al., 2021).
Another picture emerges in countries, particularly in East Asia, where the use of digital contact tracing apps were made mandatory. Contrary to what was reported in the media, in some countries, such as South Korea, public support was high. In South Korea, the evidence suggests that the Corona 100 App along with other measures that had been put in place, were well received by the public and were effective in mitigating the spread of the virus (Zastrow, 2020). In Hong Kong, the government made it mandatory to download the StayHomeSafe App and provided bracelets with electronic trackers which would send a warning to the authorities should someone who was supposed to be isolating violate quarantine requirements. According to Akinbi et al. (2021), these apps were effective and widely accepted despite the awareness that governments in these contexts, compromised the privacy of individuals for public safety. Yang C. (2022) argues that the binary perspective of surveillance verses privacy oversimplifies the complexities of Asian society and the common Western myth that in East Asian societies, privacy is of little concern due to “lack of emphasis in authoritarian regimes or even in democracies, due to relatively little history of strong privacy rights” (Edwards In Taylor et al., 2020, p42). However, Edwards (In Taylor et al., 2020) believes that this perception is erroneous, and that the acceptability of contact tracing Apps was in fact based on a “higher degree of trust in, and appetite for, technological solutions” (p42).
In other contexts however, public support is less clear, and in countries, such as Mexico, where tracking technology was used prior to the pandemic to track scientists, human rights defenders, political dissidents, journalists, and members of civil society organisations (CSOs), COVID-19 contact tracing apps brought about fear and concern among the general public, particularly those that have been historically vulnerable and where accountability mechanisms are absent (Cruz-Santiago In Taylor et al., 2020). In this case, technology cannot be separated from the political and given that it was the same or very similar technologies that were used to silence journalists and political dissidents, it became challenging to justify that the benefits outweighed the risks.
I would like to conclude my post by discussing China, given that this was the first country to introduce the mandatory contact tracing app, Health Code, and the fact that China has been subject to a significant amount of media attention since the onset of the pandemic (Wang In Taylor et al., 2020). Admittedly, I expected to uncover a plethora of stories relevant to human rights violations, and although these do exist, I was also surprised to learn that there were some positive stories as well. For example, Wang (In Taylor et al., 2020) highlights a general willingness of Chinese citizens to “abandon some fundamental rights” (p117) as part of the rhetoric of Chinese collectivism. In this sense, digital technologies played an important role in improving public trust in the government. Wang (In Taylor et al., 2020) suggests that “in this particular case, most Chinese people might consider individual rights as a worthwhile trade-off for the state’s interests because the state has been conceptualised as a collective community where all lives are bound and intertwined in the pandemic” (p118).
In addition, a survey which looked at user acceptance of contact tracing Apps (CTAs) in China, Germany and the US, showed that acceptance was highest in China with 80% of Chinese respondents saying they either strongly or somewhat supported CTAs (Kostka & Habich-Sobiegalla, 2022). Interestingly, only 39% and 41% of respondents in the US and Germany respectively supported these Apps (Kostka & Habich-Sobiegalla, 2022). Admittedly I was surprised by the overwhelming support reported in China and immediately assumed that people may not have been responding truthfully to the questions in the survey. The authors also made note of this in the study limitations section and state that “China’s authoritarian political context might make it difficult for people to express dissent from technologies that are officially endorsed by the government” and the “possibility of preference falsification as some more cautious respondents may have given false answers due to concerns about reprisals from the state” (Kostka & Habich-Sobiegalla, 2022, p17).
My skepticism is based on the fact that the media has portrayed a completely different picture of the situation in China and according to Human Rights Watch, the high levels of censorship and propaganda that preceded the pandemic was maintained and even exacerbated during COVID times. For example, they report that any criticism of the government on social media during the pandemic was scrubbed by authorities and foreign journalists and the World Health Organisation (WHO) were kicked out of the country (Wang, 2021). While it was difficult to find academic sources which focused on the darker side of China’s approach, media content was easy to source. Although the accounts stray away from contact tracing Apps specifically, I felt that it was still important to highlight that there are several stories of suffering, starvation and neglect due to China’s Zero-Covid policy that have been circulated via traditional and new media. Finally, Teng Biao, a visiting professor at the Pozen Centre for Human Rights at the University of Chicago remarks: “Under the political system in China, which is highlighted by an unrealistic and irrational goal of a political party, it is hard to avoid human rights violations at such a massive scale” (In Yang, W., 2022).
Conclusion and reflections
The answer to my original question on the ethical implications of the use of digital CTAs in democratic societies compared to other political systems is clearly complex and context dependent. To assume that non-democratic societies have compromised individual rights at the expense of the collective benefit and democratic ones have focused more on preserving individual rights is clearly an oversimplification. Any attempts to answer this question requires a more thorough analysis of the historical and cultural context of each country. However, through writing this blog, I uncovered some interesting insights which challenged my own biases and tendency to oversimplify and compartmentalise issues. It also became clear that digital contact tracing is not the magic bullet it was initially touted to be. For it to be effective, it required a significant number of people to download and use the Apps, which varied across contexts, and essentially failed to achieve its goal in countries where it was voluntary. In countries where it was mandatory, issues of privacy and ethics were highlighted but not unique to these contexts. Personally, I think the technology has significant potential for future public health emergencies if due considerations are paid to protecting people’s privacy and ensuring data is not misused.
As I reflect on this post and the other blog posts I have written over the course of this assignment, I have been forced to confront (as mentioned above) my own biases. I feel that being challenged is a critical element of learning and a significant driver of self-improvement, both from an academic and personal perspective. In this sense, this exercise, which involved not only writing our own group blog posts but also reading the work of others, has compelled me to explore and discuss the topic of Information Communication Technologies (ICTs), New Media and Development not only in terms of how ICTs can be instrumental to change but also the limitations of ICTs, the inequalities they have the potential to exacerbate and the ethical considerations they raise. Discussions made it even clearer that these opposing elements are not mutually exclusive and the importance of understanding the grey areas. On the tech side of things, I found the exercise to be useful in terms of learning how to use the blog platform, WordPress, which I found to be quite user friendly. I also appreciated the informal nature of the blog posts which forced me to reflect on my own writing style and eliminate the jargon and acronyms which I often tend to use without thinking. This latter point is something I want to incorporate into my own work, and I plan to take these learnings forward by making a conscious effort to make my professional writing more accessible and easier to read and to always be mindful of the intended audience.
References
Akinbi, A., Forshaw, M. & Blinkhorn, V. Contact tracing apps for the COVID-19 pandemic: a systematic literature review of challenges and future directions for neo-liberal societies. Health Inf Sci Syst 9, 18 (2021). https://doi.org/10.1007/s13755-021-00147-7
Kostka, G., & Habich-Sobiegalla, S. (2022). In times of crisis: Public perceptions toward COVID-19 contact tracing apps in China, Germany, and the United States. New Media & Society, 0(0). https://doi.org/10.1177/14614448221083285
Lucivero, F., Hallowell, N., Johnson, S., Prainsack, B., Samuel, G., & Sharon, T. (2020). COVID-19 and Contact Tracing Apps: Ethical Challenges for a Social Experiment on a Global Scale. Journal of bioethical inquiry, 17(4), 835–839. https://doi.org/10.1007/s11673-020-10016-9
Taylor, L., Sharma, G., Martin, A., & Jameson, S. (Eds.) (2020). Data justice and COVID-19: Global perspectives. Meatspace Press. https://meatspacepress.com/go/data-justice-and-covid-19-internet-archive/
Universal Declaration of Human Rights. Article 12. 1948.
Wang, Y (January 26, 2021). China’s Covid Success Story is Also a Human Rights Tragedy. China’s Official Covid Rates Are Down. But Has That Come at the Cost of Human Rights? Human Rights Watch. Accessed November 6, 2022. https://www.hrw.org/news/2021/01/26/chinas-covid-success-story-also-human-rights-tragedy?
Wang, Y., Tian, H., Zhang, L., Zhang, M., Guo, D., Wu, W., Zhang, X., Kan, G. L., Jia, L., Huo, D., Liu, B., Wang, X., Sun, Y., Wang, Q., Yang, P., & MacIntyre, C. R. (2020). Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: A cohort study in Beijing, China. BMJ Global Health, 5(5), e002794. https://doi.org/10.1136/bmjgh-2020-002794
Yang, C. (2022). Digital contact tracing in the pandemic cities: Problematizing the regime of traceability in South Korea. Big Data & Society, 9(1). https://doi.org/10.1177/20539517221089294
Yang, W. (2022, April 26). How public anger over Shanghai lockdown threatens China’s zero-Covid campaign – Despite government efforts to censor information as Shanghai’s lockdown enters a fourth week, some citizens are finding ways to broadcast human rights violations by the authorities. The Independent (London, England). https://infoweb-newsbank-com.proxy.mau.se/apps/news/document-view?p=AWNB&docref=news/189A0AE18813BFC0. Accessed on November 6, 2022.
Zastrow M. (2020). South Korea is reporting intimate details of COVID-19 cases: has it helped? Nature. https://www.nature.com/articles/d41586-020-00740-y.
