How A Coronavirus ‘Data Vault’ Could Help Re-Open The Economy In Four Weeks
This story was originally published on Forbes on 30 March 2020 and can be accessed here:
A secure Coronavirus Data Vault could help accelerate the re-opening of the economy
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Yesterday, President Trump extended Social Distancing Guidelines in the US by a further two weeks until 30th April. This is in line with other countries who are now tightening their physical distancing measures.
The juggling act has always been one of balancing public health risks due to COVID-19, with further health risks due to extended closure of the economy. There is then the challenge of how to re-open the economy in a way that does not compound the COVID-19 health challenges.
Many countries are several weeks ahead of the US, such as China CI , Hong Kong, South Korea, Singapore, UK, Italy. Lessons from there show what has worked, what hasn’t and what new ideas need to be explored.
With a vaccine (and sufficient production) being over a year away, it is important to re-open the economy in a way that minimizes public health risks, and likely entails a prolonged period of opening and closing down certain regions.
This will force a debate around the trade-off between public health safety and that of civil liberties and data privacy. Yet again, some creative options are possible.
Reducing leakages during ‘Stay-at-Home’ measures
Italian soldiers patrol by a check-point at the entrance of the small town of Vo Vecchio, situated in the red zone of the COVID-19 the novel coronavirus outbreak, northern Italy, on February 24, 2020.
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There are lessons from the town of Vò in Italy, Hong Kong, and other regions that tried re-opening smaller regions where COVID-19 incidences had subsided. To date, only South Korea and China have appeared to have strong success in consistently reducing cases.
Even with the strictest Stay-at-Home measures, full isolation is not possible, as there is a need for the continued delivery of groceries, medical supplies, critical utility workers, among others. This could amount to something like 10% of residents moving in and out of a ring-fenced location.
However, an evaluation of ‘Stay-At-Home’ measures have shown that in many countries, at least a quarter were travelling more than 300m (the usual distance for walking a dog, exercise or groceries). This then allowed the Coronavirus to spread back into these communities that had been previously isolated.
Hence, countries are evaluating a three-step approach on how to safely re-open their economies.
The Three-Step Process
Three steps are needed in order to safely open certain regions that have been cleared of COVID-19.
- Testing (both those with symptoms as well as randomized testing of those without symptoms)
- Contact Tracking
- Isolating cases in Recovery Facilities
Randomized Testing
A registered nurse puts a nasal swab into a tube held by another nurse in Pennsylvania State, USA on Friday March 27, 2020.
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To date, several countries have only tested those who have shown symptoms.
However, given that the virus takes 10–14 days to demonstrate visible symptoms, randomized testing may be required of residents who appear asymptomatic.
The testing of NBA Basketball Players revealed how prevalent the disease could have been, especially among those who never reveal any symptoms but are still carriers.
Widespread testing, particularly using rapid testing (rather than waiting several days for results), appears to be a strong lever to help monitor and control the spread.
Contact Tracking
Singapore officials demonstrate new contact-tracing smarthphone app called TraceTogether, as a preventive measure against the COVID-19 coronavirus in Singapore on March 20, 2020.
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In parallel, it is critical that there is a form of contact tracking to see which individuals could have been exposed, once an individual has been tested positive.
However, such a system needs to be backwards-looking, given that it takes 14 days for symptoms to appear.
Some countries have explored tracking cell phone movement, however, this has proven unpopular in Germany and controversial in Israel.
There have been hard fought battles around privacy over the past five years, such as the EU’s GDPR and California’s Consumer Privacy Act data standards. Many commentators are now warning about the civil liberty risks of taking a knee-jerk reaction to rolling back such legislation in times of crisis.
The Data Vault idea
Trust is key to ensure COVID-19 data is responsibly handled.
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One option is whether to place such data can be placed in a secure ‘Data Vault.’ This data would be owned by individual citizens. However, should a patient test positive, this data could be anonymized and those who were potentially exposed be alerted.
This would give a rapid way of tracking the potential exposure footprint and quickly tightening these locations down. Other design parameters to consider include:
- Trusted Governance. Who can be the trusted governance board that would oversee such a system. This cannot be just the private sector alone, given some of the privacy concerns around tracking by large Silicon Valley companies like Facebook and Google GOOGL . Similarly, a Government tracking system would be seen as a significant infringement upon civil liberties, particularly the involved of law enforcement. A third option could be to utilize trusted civil society organizations, such as civil liberties groups, trusted healthcare professionals, citizen representatives and certain philanthropies.
- Operational robustness. The infamous launch of the Healthcare.gov Portal under President Barack Obama, reminded us that major technological launches need strong private sector expertise to ensure operational robustness at scale, especially if major health and economic decisions depend on them.
- Linkage to Policy Levers. Such an app cannot operate in isolation without accompanying rapid policy responses, across states and regions. This includes the ability to track and order regional shutdowns at very short notice — often less than 24 hours. It will also force an unprecedented level of collaboration, and force a creative thinking around HIPAA Healthcare Record regulations in the US, so such policies can operate across State lines.
- Access to Recovery Facilities. Part of the solution is to isolate those who may potentially be infected. This means keeping them in residential facilities (which could be secure, converted hotels). This means that those not at serious risk could be in low risk facilities, and those at higher risk (elderly or with underlying health issues) could have much more sophisticated medical support.
- Encouraging Testing. One of the concerns has been excessive disclosure of private information may discourage those with symptoms to avoid testing. This is where the critical debate of how much information needs to be stored in such a ‘Data Vault.’
- Tragedy of the Commons. It is also critical to assess how the population could adopt this — it is an ‘all or nothing’ approach, as the entire population needs to adopt in order for this to be effective. We have seen how COVID-19 apps are now the most popular downloads in the App Store. A variety of options around ‘Opt-in’ vs ‘Opt-out’ may need to be explored, with an accompanying set of incentives. This worked in smaller locations in Singapore, and it will be interesting to see what may be possible in the US. Already, several voluntary efforts have begun with an Apple-CDC Partnership, a WHO ‘Waze-like’ app, MIT spinout Safepaths and MedShr medical diagnostic app, LetsBeatCOVID.net.
COVID-19 Passports
Another novel idea being explored is that of COVID-19 ‘Passports.’
Although in the early stages, there is significant work being undertaken to try and understand which individuals may have been exposed to COVID-19, but now have sufficient antibodies for a few months.
This means that they may not suffer the symptoms of COVID-19, whilst they may still be higher-risk carriers.
However, this could allow such individuals who are temporarily less vulnerable to symptoms, to return back to work in critical areas such as front-line medical workers, transport workers, grocery delivery workers.
Blockchain-based approach
One of the obvious questions is whether distributed ledger technologies such as Blockchain, could be used to build such a trusted system, and ensure the right permissioning for health organizations to access individual data.
With each week that ‘Stay-at-Home’ measures are in place costing the US economy an estimated $50 billion, all measures that could accelerate a safe return for the economy should be explored.
This would be an unprecedented effort, and would open up the way for the new exponential organizations we need for the 21st Century.
