Using Data to Fight COVID-19 - And Build Back Better Emmanuel Letouzé Maria Antonia Bravo - Vodafone Institute

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Using Data to Fight COVID-19 - And Build Back Better Emmanuel Letouzé Maria Antonia Bravo - Vodafone Institute
Emmanuel Letouzé    Maria Antonia Bravo
 Nuria Oliver        Natalie Shoup

Using Data to
Fight COVID-19
And Build Back Better
October 2020
Paper Series No. 2
   06                                                                                                18
                                                                                                     2. Four sets of
            Introduction                                                                             and concerns                         2
                                                                                                     raised by the use
                                                                                                     of digital data

Executive                                                                                            and technologies
Summary                                                                                              for COVID-19
                                                                                                     response efforts

            About this paper
                                                                               1. COVID-19
                                                                               digital initiatives

            T                                                                                                            27
                   his paper is the second in a Paper
                   Series published jointly by Data-Pop
                   Alliance and the Vodafone Institute
            for Society and Communications, following
            “Sharing Is Caring: Four Requirements for
            Four Key Requirements for Sustainable                                                                        3. Key recommen-
            Private Data Sharing and Use for Public                                                                      dations for a fairer
            Good, published in November 2019.11                                                                          post- COVID-19
                It was written by Emmanuel Letouzé,
            Nuria Oliver, María Antonia Bravo and
            Natalie Shoup. It benefited from comments
            and inputs from Inger Paus (Managing
            Director, Vodafone Institute for Society and
            Communications), Pedro Rente Lourenco

            (Lead Researcher and Data Scientist,
            Vodafone Group Big Data & AI), Matthew
            Allison (Senior Public Policy Manager,
            Data, Platforms & AI, Vodafone Group),
            Julia Ebert (Senior Research Manager,
            Vodafone Institute for Society and Com-
            munications) and Juan Camilo Mejía (Pro-                                                 Concluding
            gram and Research Manager, Data-Pop                                                      remarks

               The report was copy-edited by Carola
            Miras and Juan Camilo Mejía.

summary                                                                                                              3

           ince the start of the COVID-19 pan-     that the pandemic is more of a syndemic,
           demic in the first quarter of 2020,     which refers to a health issue that clusters
           numerous governments and public         along social lines.3 With COVID-19, it is as
   institutions around the globe have devel-       if the veil of feigned ignorance about the
   oped or promoted initiatives leveraging         features, drivers and effects of injustices,
   digital data and technology in support of       such as the indecent growth in income
   response efforts. Some have sought to           concentration and inequality, the differen-
   identify and predict hotspots, others to        tial impacts of environmental degradation
   evaluate the effectiveness of containment       and pollution, systemic racism and sexism,
   policies or to detect and trace the close       and even the risks posed to democracy
   contacts of infected individuals. As many       around the globe, including those fueled
   countries are still struggling with the first   by digital data and technology, had been
   wave of the disease and several are fearing     shredded in a few months.
   or already grappling with a second—often
   in tumultuous socio-political contexts—it is        In this context, digital data and tech-
   essential to take stock of the key features     nology serve as lenses on the world and
   and expected benefits of major initiatives      as levers of change, for good or bad.
   and summarize the main debates and              A decade into the “data revolution” and
   questions they have raised—about their          with a decade left to make progress
   usefulness, implications, limitations, risks    towards the Sustainable Development
   and requirements in the fight against the       Goals (SDGs), the current crisis provides
   pandemic, and beyond.                           a unique opportunity to ask how digital
                                                   data and technologies can truly and struc-
      The pandemic has also laid bare long-        turally improve our world by both fighting
   standing and deeply rooted structural fault     the pandemic and “building back better”.
   lines in our world. Far from hurting everyone   It is evident that reliable and timely data
   indiscriminately, the virus and its socioeco-   are of paramount importance to fight the
   nomic effects have affected disproportion-      pandemic. Yet, they are of no use if they
   ately poor people, people of color, women,      are concealed or manipulated for and
   people with disabilities, migrants, and peo-    by officials interested in scoring political
   ples governed by populists.                     points, drowned in an ocean of dubious
                                                   claims and rumors, or not effectively com-
      Some, such as the outgoing UN Special        municated and understood.
   Rapporteur on Extreme Poverty and
   Human Rights, even consider that COVID-   
   19 has “revealed a pandemic of poverty              19-has-revealed-a-pre-existing-pandemic-of-poverty-that-be-
   that benefits the rich”.2 Others have argued    3
Similarly, it is clear that more advanced    Social media companies and social plat-
initiatives leveraging digital data and          forms have a duty to the public to provide
technology that are at the core of this          safeguards from theories that weaken
paper—such as contact tracing applica-           trust in their governments and in science.
tions or hotspot detection algorithms—           Beyond citizens, the COVID-19 pandemic
can and must play a role in fighting the         has brought to light the evident lack of
pandemic. But these digital “solutions”          data and digital literacy among many
are not, as the saying goes, “silver bullets”    public officials and decision makers, with
that will solve our human-made problems          potentially devastating consequences.
by themselves. We are once again expe-           Education and the long-term collabora-
riencing the very real risk of jumping to        tion of a diverse set of experts in relevant
“technological solutionism” without under-       areas—such as data science, epidemi-
standing and addressing the key impli-           ology, anthropology, computer science,
cations—technological and scientific,            immunology, public health, economy
political, economic, ethical—of new data         and sociology—with public administra-
and technology.                                  tors must be ensured to assist in more
                                                 evidence and knowledge-driven decision
   Fundamentally, this crisis ought to be        making. These collaboration of a diverse
a moment in our lifetimes when we reas-          set of experts need to analyze the incen-
sess our ways of life, our incentives, our       tives and constraints of participants and
priorities, and push for real change with        work together to accomplish beneficial
some of the most powerful tools avail-           outcomes for all parties.
able: data and technology. We should
use this crisis as a testbed and catalizer          A third one is evidently high-quality
for how data and technology could help           data: to fuel better human systems to both
us set and achieve humanistic societal           fight the pandemic and build back better,
objectives, as underpinned by the SDGs           data are one of the most powerful tools at
and other frameworks—and not just serve          our disposal. Data must be allowed to be
the interests of surveillance agencies and       shared and analyzed in privacy-preserving,
large corporations. This paper there-            interoperable manners. Decision makers                       4
fore explores how data can help fight            and citizens should be both informed and
COVID-19 and how COVID-19 also pro-              involved in what data are being collected
vides an opportunity to better use data          and how; what they represent; how and
to build back better.                            why they are stored and potentially shared
                                                 in raw or transformed forms. Data regu-
                                                 lators and controllers have a key role to
To realise this                                  play in ensuring appropriate safeguards
                                                 with regards to privacy,
vision, four                                     consent and inclusion
                                                 of data subjects, and to        Social media companies
elements appear                                  help navigate the trade-
                                                 offs between emer-              and social platforms have
to be key:                                       gency situations and
                                                 long-term conditions.           a duty to the public to
    One is context: we need to have a
thorough understanding of the goals,                 A fourth one is com-        provide safeguards from
implications and the impact on citizens          munication and trust:
and society of decisions in the longer           a privacy-sensitive soci-       theories that weaken trust
term (from a science/technology, eco-            ety requires transpar-
nomic/commercial, social, political, legal       ency and confidence             in their governments and
and ethical point of view). It is also import-   in the use of the data
ant to understand the different technol-         collected. Honesty and          in science.
ogies being designed and used for real           transparency are key to
response, as well as the parameters and          building trust, in addition
risks, benefits, limitations and impact          to competence (i.e. efficiently carrying out
of each. Furthermore, it is crucial to be        the task at hand) and reliability (i.e. compe-
mindful of the fact that not all responses       tence sustained over time). The current sit-
can or must be digital, and that not all         uation has been enlightening for different
people will be able to access digital solu-      stakeholders, showing that even though
tions. This means that solutions have to be      data could be the solution to some reali-
thought in a holistic way so that everyone       ties, there are many different groups that
is included.                                     are inevitably less connected and there-
                                                 fore not accounted for. This reality means
   Another is education: citizens should         that data and technology may have con-
be provided with clear, precise, under-          tributed to spreading—just as much as
standable information. Huge amounts of           to curbing—the pandemic, and this fact
dis- and mis- information are being pro-         must be acknowledged, communicated
duced about and around the pandemic,             and addressed. What can and cannot be
which makes it difficult for the non-expert      achieved by these technologies must be
to discern the differences between facts,        communicated transparently so that citi-
hoaxes and everything in between, which          zens and societies can effectively use and
feed on and fuel political polarisation.         accept them when they are deployed.
   Once these various digital technologies                                Develop “data literate” human and
are fully understood, it is important to crit-                            data systems. A major challenge
ically interrogate the wider implications                                 and objective over the coming years
beyond immediate pandemic response.                                 will be to actively strengthen “data liter-
Such implications should lead to a set of                           acy” among both governmental agencies
guiding principles impacting how each                               and citizens—defined as “the desire and
of them is designed, developed and                                  ability to constructively engage in society
deployed.                                                           through and about data”.5 This will mean
                                                                    building data skills and culture through
                                                                    capacity building support in order to
With this in mind,                                                  base discussions and decisions on facts.
                                                                    Building a data culture and systems of
we put forth                                                        interoperability is also key yet it is missing:
                                                                    it should work across distributed networks
six main                                                            and systems thereby ensuring usability
                                                                    between different apps within or across
recommendations:                                                    different countries.

1                                                                   5
    Think and act boldly and decisively                                   Test and scale sustainable busi-
    —now. This may be a once-in-our-                                      ness models. Now is also a good
    lifetime opportunity for deep, ambitious                              time to think broadly and boldly
and long-term thinking, especially to fight                         about sustainable business models for
deep-rooted inequalities and excesses                               private-public data sharing and use.
fueled by complacency and greed that                                Today’s data boom and raised visibility of
have been exposed and exacerbated by                                digital solutions are great incentives for the
the pandemic. Now is the time to design,                            private sector to allocate more resources
deploy, test and scale digital data and                             into data sharing for the public interest, to
technology approaches to enable long-                               formalize public-private-people partner-
term positive social transformation.                                ships (PPPP) and develop and test “free-

                                                                    mium models” that would ensure financial
      Only deploy data and technology                               sustainability. At a European level, research
      that are fit for purpose. Despite                             funding should be devoted to foster PPPP
      its promise, technology is no silver                          Data4Good research consortia within the
bullet. Its strengths and limitations should                        next EU Horizon 2027 program.

be acknowledged. How to balance dig-
ital and non-digital technology solutions                                  Consider and use regulation as
is of paramount importance. Furthermore,                                   an enabler. Regulations must sup-
technological solutions should be thought                                  port enabling principles such as
of as enablers, integrated with existing                            (1) encouraging data sharing through
structures when they perform well, such                             voluntary, market-driven mechanisms; (2)
as public health systems. They should                               sharing only under legally compliant, eth-
also have clearly stated rationale and                              ical and socially acceptable scenarios, in
purpose and be systematically evalu-                                line with the principles of trustworthiness
ated. Given the already staggering digital                          and privacy-by-design; (3) data for good
divide, omnipresent structural inequities                           initiatives should be subject to fair remu-
and biases, we need inclusive solutions                             neration, thereby creating the conditions
so that large segments of the population                            for products and services; (4) technol-
are not left by the wayside.                                        ogies should be fit for purpose and with

                                                                    a human(ity)-centric perspective. Let us
      Place people at the center and “in                            not forget that that technological break-
      the loop” at all times. Privacy and                           throughs throughout history are often pre-
      human rights should be core consid-                           cipitated by a crisis, and then adapted
erations. Simulations of unintended con-                            and reused elsewhere, both for good and
sequences from ethical and human rights                             bad. Good harmonization of regulation is
perspectives should be performed and                                key to ensure that initiatives can be scaled
potential risks minimized before imple-                             up quickly, as appropriate, and sustained
menting and deploying any technology.                               over time.
Social and behavioral responses to dig-
ital technology interventions need to be                                The COVID-19 pandemic—or syn-
anticipated and embedded in the design                              demic—presents a historic opportunity
of tools and apps. This requires large-                             for all parts of societies—the private and
scale public consultations, digital public                          public sectors in collaboration—to organ-
spaces such as “online parks”4, critical                            ise themselves and collectively build back
governance and accountability mecha-                                better following a human-centric approach
nisms, on line portals and local forums to                          to, and use of, digital data and technology.
ensure that citizens are informed and can                           Let us not miss it.
actively participate in outcomes.
                                                                        Questions and comments about this
                                                                    paper can be sent to eletouze@datapop
    online-parks/                                                   5   Data-Pop Alliance Data Literacy White Paper, 2015
Introduction                                                                                                                                                                   6

        ver the past few months, many gov-                        to optimise this significant potential for    of this crisis safeguard fundamental rights
        ernments and public institutions                          change. A key question posed is how dig-      and promote a renewed human-centric
        around the globe have developed                           ital data and technologies can truly and      vision rather than a techno-solutionist
or deployed initiatives leveraging digi-                          structurally improve our world by both        approach that may enhance the very con-
tal technologies and privately held data                          fighting the pandemic and “building back      ditions that contributed to the magnitude
in support of COVID-19 response efforts.                          better”, i.e. not satisfying ourselves with   of the pandemic’s impact, such as struc-
Some resources aim to identify potential                          returning to business as usual, but rather    tural inequalities. As we unpack these
hotspots or demonstrate the effectiveness                         capitalizing on this dramatic event and       questions in a dire and urgent context, it
of containment policies, while others seek                        allowing novel, ambitious projects and        is essential not to lose sight of the trade-
to trace infected individuals’ close con-                         ideas not only to emerge but also to garner   offs and risks that putting our trust in tech-
tacts, amongst others. The usefulness and                         public support—pending the development        nologies may entail, and how these tools
implications of these initiatives—notably                         of a vaccine or other effective treatment.    could be leveraged to improve tomorrow’s
but not only contact tracing applications—                                                                      world.
have been widely debated. Meanwhile,                                 What makes infectious diseases
many countries are still struggling with the                      unique is that they thrive on human inter-       With these points in mind, this paper is
first wave and several are in the midst of a                      action. In doing so they serve as a litmus    structured as follows:
second—often in tumultuous socio-political                        test, revealing how societies function,
contexts.                                                         rendering visible the world’s inner work-        Section I describes initiatives that use
                                                                  ings and flaws. Thus, while data and tech-    digital technologies and privately held data
    Concomitantly, structural fault lines                         nology are seen as increasingly relevant      as part of pandemic response strategies,
around the world have been laid bare in all                       for pandemic response strategies, crises      unpacking how these initiatives work and
available data: far from hurting everyone                         offer an opportunity to step back, examine    providing examples from several regions.
indiscriminately, the COVID-19 crisis and                         and hopefully improve our current systems     Section II summarizes key questions and
its effects have disproportionately affected                      and societies. While there is no doubt that   concerns these initiatives have raised
people governed by populists, the poor,                           using data has significant potential for      across four main domains: technological
people of color, women, persons with dis-                         fighting COVID-19, challenges and ques-       and scientific, commercial and economic,
abilities, migrants and children. Some con-                       tions about the requirements and long-        ethical and legal, and political spheres.7
sider that COVID-19 has also “revealed                            term applicability of digital technologies    Section III discusses recommendations to
a pandemic of poverty that benefits the                           must be identified and addressed.             meet the challenges of today and tomor-
rich”.6                                                                                                         row by leveraging data and tech in the
                                                                     Assessing the effectiveness, security,     fight against COVID-19 and potentially
   This historical context provides a                             privacy, ethical and trust implications of    other pandemics, as well as the scourge
unique, perhaps once-in-a lifetime, oppor-                        these digital responses to the crisis is      of global poverty and inequality.
tunity to reconsider our life styles and                          indispensable to combat the epidemic
                                                                  and overcome it rapidly. However, it          7   Based on the taxonomy proposed in the publication Sharing
                                                                                                                    is Caring: Four Requirements for Sustainable Private Data
6       is equally essential to ensure that the           Sharing and Use for Public Good co-developed and published
                                                                  longer-term impacts of the models, proto-         by Data-Pop Alliance and the Vodafone Institute in November
                                                                                                                    2019. See
    nefits-the-rich                                               cols and applications created in the midst        quirements-for-sustainable-private-data-sharing/

digital initiatives
           he way that data and technologies      smartphones has also emerged not only
           are leveraged and positioned in the    as a promising and rich source providing
           COVID-19 response presents a real      the public with information about the virus,
   opportunity for greater visibility, collabo-   but also as a critical source of information
   ration and evidence of impact for digital      for decision makers and authorities.
   solutions. However, it also harbors sig-
   nificant risks given the speed with which         The COVID-19 context has also opened
   governments and companies are obliged          discussions on using data collected by
   to react and make decisions about data         additional technologies such as smart-
   use, privacy, oversight and accountabil-       phone apps (e.g. Facebook, Google
   ity in developing and implementing these       Maps), search engines (e.g. Google
   solutions. The scope of data considered in     searches) or social media platforms (e.g.
   this paper centers mainly on that gener-       Twitter feeds), facial recognition sys-
   ated and/or enabled by interactions with,      tems, satellite and surveillance devices,
   or between, mobile phones (both feature        bank and credit card transactions, public
   phones and smartphones): a highly sensi-       transportation systems, electronic health
   tive issue with almost all publics.            records and funeral homes to aid gov-
                                                  ernments in their responses to contain
       Digital technologies based on the          the spread of the virus. In this context,
   analysis of large-scale human behavioral       expectations as to what technologies and
   data are being touted for their prospec-       applications can really do to enable better
   tive usefulness to combat the pandemic.        responses and policies remain high. How-
   Given the ubiquity of cell phones, mobile      ever, given that these applications fre-
   phone network data has been one of the         quently rely on collecting, sharing, storing
   first sources of privately-held data that      and analyzing personal, and often quite
   many countries—both developed and              sensitive data, it is critical to assess the
   developing—have turned to in COVID-19          possible unintended consequences that
   response efforts. Moreover, data captur-       may arise from sharing and using such
   ing the interactions with, and between,        data.
A. Types and                                   Box 1. Location and proximity
taxonomies of                                  data: how mobile devices can
privately held                                 be used to infer your position8
data sources                                      GPS: Mobile devices can determine their location using the
                                               global positioning system (GPS) through the device’s GPS chip
   The functions and promise of many of        which receives signals from satellites orbiting the earth. Accuracy
the mobile phone applications evoked           of GPS signals is variable and tends to be less so in urban areas or
above for combating the spread of COVID-       indoors. GPS signals are detected primarily through the device’s
19 are grounded in their ability to make use   operating system or through mobile applications where the user is
of mobile data in order to map hotspots of     asked to opt-in to sharing their location. They can also be detected
infection, determine changes in mobility       by wearable devices or navigation systems to provide location
patterns, or track contacts between at-risk    data. When analyzed individually, GPS location data is subject to
or infected individuals. The ubiquitous        privacy regulations, given its sensitive nature.                                                              8
nature of our mobile devices and the fact
that human mobility is one of the key fac-         Base transmitter stations (BTS): BTS—or cell towers—facil-
tors in the spread of an infectious disease    itate signal reception of cell phones and other wireless devices.
make these devices a formidable tool to        Thus, carriers are able to know where devices are, based on which
understand and measure our movements.          tower they connect to for services as well as the signal strength of
                                               the connection. Given that each tower has a unique ID, from the
   The most widely used types of loca-         tower ID and the signal strength one can infer a device’s location.
tion and proximity data collected by cell      BTS location information is useful for inferring aggregate mobility
phones in the context of the pandemic are      patterns but not highly accurate in location tracking of individuals,
summarized in Box 1. Each of them has its      as their spatial granularity depends on the density of cell towers
strengths and weaknesses, with varying         in a region. For instance, two devices connected to the same rural
degrees of privacy implications.               BTS could in fact be kilometers apart.

   Given that location and proximity data         Wi-Fi: Wi-Fi signals tend to provide more accurate indoor
can be key sources of information for          location data and can often generate more granular data. Mobile
understanding the spread of a pandemic,        devices can scan for nearby Wi-Fi networks and crowdsource
analyzing how digital technologies and         location. Nearby networks or “access points” can include any
applications can be used to safely collect     Wi-Fi signals in the vicinity, such as that in cafes and shops or
and harness data, and studying the ways        neighbors’ homes.
they are being used—or proposed—is
key to gage the opportunities and risks           Bluetooth: Bluetooth technology is common in portable
of these solutions for COVID-19 response       devices and can be thought of as a beacon that broadcasts one-
efforts.                                       way signals which other devices can pick up (think of connecting
                                               your phone to wireless headphones) when enabled. This occurs
                                               through bursts of information packets dispersed into the electro-
B. Technologies,                               magnetic spectrum, which other Bluetooth-enabled devices then
                                               detect. No direct connection has to be established, as devices
applications and                               exchange identifiers. Bluetooth can be used to infer location or
                                               proximity. In the case of location, a registered device in a known
uses                                           location can infer the locations of other devices that are visible
                                               to it via Bluetooth with a certain signal strength. In the case of
    In this paper we consider technological    proximity, Bluetooth-based signals can be sent to other devices
tools developed from the application of        within a certain range to collect proximity data rather than absolute
scientific knowledge to raw materials for      location. Bluetooth-based proximity information is generally more
practical purposes, i.e. digital technolo-     privacy preserving than absolute (e.g. GPS, Wi-Fi) location data.
gies. Several applications have been iden-
tified below within the scope of pandemic         Many devices use a combination of GPS with other forms of
containment using combinations of tech-        location signals such as Wi-Fi and Bluetooth to improve the preci-
nologies and the different data sources        sion of the devices’ location.
detailed above.
                                               8; https://theintercept.
These include:                                 websites can also be a tool for citizens to

                                               access reliable, trustworthy information
      Self-assessment /                        regarding symptoms and next steps to
      symptom tracking                         take when experiencing them.
      Self-assessment and symptom track-
ing websites or apps allow users to report         While these applications do not nec-
their symptoms and get instant feedback        essarily require personal data in order to
on their assessed risk through interactive     fulfill their promise, they do often collect
forms and surveys. In many markets with        information from users, including home
low smartphone penetration, symptom            address, phone number and location.
tracking messages can be displayed via         These apps have been deployed widely
a USSD menu (the user opens a menu             by local and national governments in, for
and picks from a range of options) which       example, Afghanistan, Colombia, Kenya,
enable two-way flash messages. These           Singapore and Turkey. A recent study
types of applications can help govern-         by Zoe Global, Massachusetts General
ments to better handle citizen demand          Hospital and King’s College, which
for trustworthy feedback and information       tracked self-assessment applications in
when faced with symptoms and to moni-          Sweden, the UK and the US found that
tor disease outbreaks. This in turn enables    these apps could be “remarkably effective
a better use of resources and medical          in predicting coronavirus infections”.9 Nev-
services: to an extent, these apps and         ertheless, while self-reporting apps can be
websites relieve some of the strain put on     very useful there are caveats to consider,
hospitals and facilities as self-screening     such as a high variance in self-reporting
can help rule out infection and reduce the     or misreporting due to a misperception
need for patients to seek a formal diagno-     of users’ own realities. Awareness of the
sis. It can also suggest containment and       human factor in these types of applica-
control measures to individuals at risk.       tions is important.
Given the large amounts of misinformation
surrounding COVID-19, these apps and               ptoms-app.html?auth=login-email&login=email

                                               Impact Assessment Determine wheth-
                                               er—and how—various interventions affect
                                               the spread of COVID-19 and identify ob-
                                               stacles hampering achievement of objec-
                                               tives of particular interventions.

                                               Prediction Leverage real-time popula-
                                               tion counts and mobility data to enable
                                               new predictive capabilies to assess future
                                               risks, needs and opportunities.

                                               Cause and Effect Identify key drivers and
                                               consequences of implementing measures
                                               to contain the spread of COVID-19. Estab-
                                               lish variables with incidence on a problem.

                                               Situational Awareness Better under-
                                               stand COVID-19 trends and geographic

      Centralized / Decentralized                    Epidemiological
      Contact Tracing
                                                     Surveillance and
      Social Media Analysis /                        Enforcement
      Citizen Surveys
                                                     Self Assessmnt /
      Flows Modelling /                              Symptom Tracking
      Mobility Mapping

Figure 1. Purpose and applications of digital technologies for
COVID-19 response and recovery efforts
Source: Data-Pop Alliance, 2020
       Contact tracing applications
       Contact tracing is a central techni-
       que often applied in epidemiology
that has gained widespread attention
amid COVID-19 response efforts. The
objective here is to quickly identify poten-
tially at-risk individuals who have been in
close contact with a recently diagnosed
positive case of an infectious disease
requiring compulsory reporting, as is the
case for SARS-CoV-2. Once these people
have been identified, the main goal is to        Box 2. CoronaMadrid10                                                   10
quickly test and isolate those with a con-
firmed coronavirus infection so as to break      and COVID-19 CDMX11
the chain of transmission.
                                                    In early March, the autonomous community of Madrid in Spain
     Traditional contact tracing involves        released CoronaMadrid, a self-assessment application available
carrying out epidemiological interviews          for Android and Apple phones, as well as in web form. One of
(typically performed over the phone) to          the main objectives with this application was to reduce traffic and
collect relevant data about the symptoms,        demand on mobile hotlines, while allowing officials to continue
mobility and social behavior of patients.        providing instructions and recommendations to citizens. Individ-
Personal information is commonly col-            uals are only prompted to use this application if they experience
lected in these interviews, including the        symptoms. Users can opt-in to share their locations to provide
phone numbers of all the people with             public health organizations with more precise information to inform
whom the patient has been in close con-          their responses. Users must share their phone numbers.
tact within the past N days (for COVID-19
the latest recommendation is 48 hours).             Conversely, the tool created by the government of Mexico City in
Traditional contact tracing has four intrin-     March is a uniquely web-based form. It requires users to share per-
sic limitations where digital tools might        sonal information such as their cell phone number and complete
help. First, it relies on the patient’s mem-     address. After assessing symptoms, the tool will classify individuals
ory. Second, all the close contacts need         according to their risk factor and recommend a series of actions
to be known to the patient such that (s)he       to take. The privacy notice for this tool establishes that the data
can share their contact information with         collected may be used by judicial and administrative, federal and
the contact tracer. Third, it does not work      local authorities.
well across borders. Fourth, it is expen-
sive, human-resource intensive and time          10
consuming. Despite these limitations, it is      11
an effective tool to help contain the spread
of an infectious disease, assuming the
contact tracing teams are properly scaled
to the incidence of the disease and the
information they collect is in digital form,
ideally using state-of-the-art tools, so that
it is readily available for analysis and deci-
sion making.

    Since the outbreak of COVID-19 has
exceeded the capacity of most manual
contact tracing teams worldwide, public
officials in many countries are turning to
smartphones as a key tool to complement
these existing initiatives. Thus, we are
witnessing the emergence of dozens of
smartphone-based contact tracing apps
globally. If indeed smartphone apps were
able to passively record close contacts
between individuals, they could automat-
ically generate the necessary contact
traces, such that at-risk individuals who                              Centralized            Decentralized
had been in close contact with an infected                             A central system       John and Jane’s
person could be notified, tested, and                                  generates a series     phones generate
isolated if positive. This process would                               of user-specific       a series of user-
enable the transmission chain to be bro-                               anonymous IDs          specific, anonymous
ken and prevent community transmission                                 and sends them to      IDs.
of the disease.                                                        John and Jane’s
   Contact tracing applications rely
on proximity technology and/or loca-                                                          1 John and Jane
tion traces to identify potential contacts                                                    don’t know each
between individuals. First efforts on this                                                    other but chat for
front—such as those deployed in China                                                         10 minutes in a
or South Korea—leverage the GPS loca-                                                         park.
tion alone or in combination with other
data, such as credit card transactions
or visual surveillance camera footage.
These applications infer close contacts if                                                    2 Their
individuals have been within a radius of                                                      smartphones
1.5-2 meters of each other and for at least                                                   exchange their
15 minutes. However, limitations associ-                                                      anonymous
ated with GPS—including imprecisions in                                                       ephemeral
indoor (e.g. buildings) and transport (e.g.                                                   identities over
subway, planes) environments, as well pri-                                                    Bluetooth LE.
vacy concerns, have led technologists and
governments to turn towards Bluetooth as                                                      3 A few days later      11
the main sensor to detect close contacts                                                      John tests positive
between individuals via smartphone apps.                                                      for COVID-19
                                                                                              and, via the
   Bluetooth-based contact tracing apps                                                       app, consents to
enable devices to share “digital hand-                                                        sharing his status
shakes” by sharing encrypted, unique                                                          as well as his test
identifiers (referred to in the literature as                                                 results.
tokens, beacons, pseudonyms, temporary
exposure keys (TEKs) or temporary con-
tact numbers (TCNs) to record contacts
that last “longer than a few minutes”12 and
located within a 1.5-2m radius.

   The success of these apps depends
on many factors, including high adop-
tion rates and tight integration with public
health systems, such that both doctors and                             4 John’s phone         4 John’s phone
infected individuals can report positive                               sends the              sends his own
cases and at-risk individuals can be duly                              anonymous              anonymous
notified. Unlike manual contact tracing,                               identifiers of         identifiers (or a key
these applications record contacts that a                              people he has          that can derive
person may not remember or know they                                   met to a central       them) to a central
have come in close proximity with. How-                                database.              database.
ever, these applications are not exempt
from their own limitations and challenges,                             5 The central          5 Jane’s phone
including difficulties in reliably detecting                           database               downloads the
close contacts via Bluetooth, battery con-                             matches                entire central
sumption, trolling and hacking scenarios,13                            the reported           database
human-centric challenges,14 privacy and                                identifiers to         and checks
security risks and low adoption rates, par-                            John’s contacts        for matching
ticularly within the most vulnerable groups                            and sends them         identifiers.
(e.g. the elderly, low socioeconomic levels                            an alert.
and skeptics).
                                                                                              6 Jane’s phone
12                                alerts her that
   coronavirus-tracing-apps-need-to-succeed/                                                  someone she
13 In the UK, for example, hackers successfully launched
   phishing attacks with the National Health Service’s app.
                                                                                              met has tested
   A phishing message redirected victims to a fake website whe-                               positive.
   re they were asked to type in their personal details; www.itwire.
14 The app’s design needs to be based on how people can,
   need and want to perform tasks, rather than expecting users to
                                                                       Figure 2. Centralized vs.decentralized
   adjust and accommodate their behaviors to the product.              contact tracing app-based models
+50 % more movement than usual

   Feb. 16                    Feb. 23                   March 1                    March 8                  March 15        March 22   March 29

                                                                                                                         March 19
-50 % less movement than usual

                                                                                                  March 16

-100 %
Average change for                 wealthiest and              poorest

Figure 3. “Location Data Says It All: Staying at Home During Coronavirus Is a Luxury”
Source: NY Times, 3 April 2020,

      Modelling and mapping
      population flows                                               Box 3. Bluetooth-based
      Mapping flows, or mobility of peo-                                                                                                          12
ple over time and space, has been one of                             contract tracing app models
the more common applications of private
data for social good initiatives in the recent                       The debate over app-based contact tracing models centers fore-
past. Mobile phones can often act as indi-                           most on what data is captured so as to ensure that only strictly
cators of human mobility and give insights                           relevant information is collected. Second, there are debates over
into behavior. Aggregated and anonymi-                               where this data should be stored. Concerns also exist around the
zed location data can be sourced from                                aggregation of data, underlying privacy configurations and who
various technologies such as GPS, mobile                             should have access to this data—including public authorities. For
cell towers, Wi-Fi networks, Bluetooth con-                          the apps that exchange tokens via Bluetooth, two main architec-
nections, surveillance video, credit card                            tures have been proposed: centralized and decentralized. In both
records and wearables, as well as many                               cases, the token exchange takes place locally in the phones. The
other devices and apps. In the case of                               main difference stems from (1) who provides the phones with the
COVID-19 responses, the analysis of these                            initial seed used to generate such tokens, and (2) what information
data enhances findings by identifying risk                           the phones send to a centralized server when their user is tested
and potential hotspots, assessing public                             positive for coronavirus.
responses and the effectiveness of social
contact and mobility contention policies,                               In the centralized model, the initial seed to generate the to-
and detecting where more resources may                               kens is given by a trusted, centralized server typically controlled
need to be channeled. Moreover, human                                by administrators or public health authorities. Moreover, when an
mobility is a valuable input to computa-                             individual tests positive and upon recording this event in the appli-
tional epidemiological models. While the                             cation, their phone sends all tokens of the devices it has had close
aim of flow modelling is descriptive, its use                        contact with (e.g. over the preceding 14 days) to a centralized
can cross the line and be used as a tool                             server. The central server matches the tokens and alerts users to
for control by authoritarian governments—                            a potential contact. Resulting aggregated, anonymized data can
and, even more surprisingly, by others                               help experts fine tune the risk calculation to determine whom to
perceived to be considerably less so—by                              send a notification to and also allows administrations to detect
applying stringent enforcement policies.                             infection patterns in society, which is crucial input when designing
                                                                     policies and measures aimed to curb the spread of a disease.
    These analyses can also simply shed
light on the effects and effectiveness of                                In the decentralized model, the initial seed to generate the
containment measures, especially across                              tokens is given by the operating system (in the case of the Apple/
different demographics, potentially pointing                         Google API) or by the app itself. When an individual tests positive,
to enabling and constraining factors. For                            upon recording this event in their phone, their app only sends to
example, a US study revealed that, when                              the central server their list of tokens. All the phones running the
on March 16th people were asked to stay                              app periodically poll the central server for the list of tokens of pos-
at home, those living in richer areas had                            itively diagnosed individuals. Given that the phones have the list
already reduced their mobility by nearly                             of contact traces, they locally check if there is a match between
half whereas people in poorer areas did not                          their contact traces and the list of tokens associated with recently
substantially reduce theirs until three days                         diagnosed individuals. If a match is found, the app triggers a noti-
later, suggesting structural impediments                             fication with indications of what to do next. In this case, no central
for the latter to staying at home and limiting                       authority has visibility on how many users have been notified for
their exposure to the virus.                                         each registered positive case.
Box 4. Debate over contact
                                                                   tracing apps: moving from
                                                                   centralized to decentralized
    Descriptive tools such as flow mapping
are used to look at people’s movement                              approaches
patterns locally to gage risks or potential
hotspots, as well as to assess how people                              Early on, the general public in several European countries
are responding to the virus and response                           showed support for centralized models using pseudonymized
measures to inform public response. In the                         proximity data. For example, the Pan-European Privacy Preserving
Valencian region of Spain, a team of                               Proximity Tracing (PEPP-PT) initiative developed an open protocol,
experts has been working closely with                              defining standards for tracing apps built on it and uses a blend
the president of the region on a variety                           of centralized and decentralized methods.18 The UK and France
of data-driven tasks related to COVID-19,                          have also developed their own centralized apps, with France
including quantifying and modeling human                           being the first to launch its voluntary app StopCovid, using a pro-                                 13
mobility captured by the mobile network                            tocol known as Robert to complement existing manual contact
infrastructure. In a pioneering collabora-                         tracing. While the data protection authority, CNIL, has not raised
tion between the Spanish National Office                           any major flags, concerns are being voiced over the use of pseud-
of Statistics and the three largest telecom-                       onymized data which necessitates a certain level of trust that the
munication companies in Spain, experts                             government is indeed respecting the limitations around data col-
have been able to assess the success of                            lection it has detailed.19 Supporters of these models ensure that
containment measures and their impact                              fully privacy-preserving techniques are in place, along with ready-
on the spread of the pandemic, estimating                          to-use, well-tested, properly assessed mechanisms, and support
that over 40,000 lives were saved in the                           for interoperability.
                                                                      Other countries, like the US, quickly turned to decentralized
   In many countries, pre-existing tools                           models, using e.g. the Apple/Google API that combines Bluetooth,
designed to look at flows of people for                            cryptography and location tracking. The debate between cen-
applications in the public transport or tour-                      tralized and decentralized contact tracing models has continued
ism sectors have also been adapted to                              within and across countries and, as response efforts develop, more
the current COVID-19 context. In Austria,                          countries, including Germany, are choosing to pursue decentral-
for example, Invenium, an existing col-                            ized models, mainly due to fears of function creep.20
laboration between A1 Telekom Austria
Group and a local university, developed a                              Researchers at MIT have created Private Kit: Safe Paths,21 a
motion analysis application that was used                          free and open-source application that uses both Bluetooth and
to model human mobility flows for applica-                         GPS tracking based on the decentralized model. One key feature
tions in traffic congestion or tourism sites                       is its interoperable standards to ensure usability between differ-
to assess the effectiveness of response                            ent apps within or across different countries based on an open
measures to reduce movement and social                             source Temporary Contact Number protocol to ensure interopera-
contact.16 The COVID-19 Community                                  bility. Decentralized Privacy-Preserving Proximity Tracing (DP-3T),
Mobility Maps generated by Google are                              developed by researchers in France, Germany, the Netherlands
based on users’ aggregated location data                           and Switzerland, creates a virus contraction risk score gener-
and reflect community-level behavior such                          ated from an algorithm running on the user’s data locally on their
as travel, for example, to grocery stores,                         device. Decentralized apps are the subject of criticism particularly
parks and public transport centers.17 Many                         with respect to making it more difficult for health authorities to have
of these mappings of concentration and                             the necessary data regarding how many close contacts receive
movements of people use aggregated and                             a notification for each positive case; agility and practicality rely
anonymized data, further calibrating policy                        on cryptography which is complex and requires challenging and
response and containment measures such                             frequent updates of parameters, especially at the scale that would
as social distancing and contact tracing.                          be needed to be effective in this epidemiological response.22


15   19
   prensa?id=858477                                                20
16      contacts-tracing/
   telecoms/european-mobile-operators-share-data-for-corona-       21
   virus-fight-idUSKBN2152C2                                       22
17                           succeed/
Figure 4.


Predicted baseline

mobility patterns

for 28 January to

18 February 2020.
Individual prob-                       FI                                                             RO
ability of moving                    ES
between the top                                                                                        SI
20 European
                                     EL                                                                TR
countries with the                                                                                      UK
greatest outward

Source: https://science.

      Surveillance and enforcement
      In general, tools for surveillance and                      Box 5. Applying research on
      quarantine enforcement analyze
sensitive personal data. More granular,                           malaria-related mobility
often pseudonymized (but in the case of
COVID-19 also increasingly sensitive)                             flows to COVID-19: the case
data sources have emerged to monitor                                                                                                                                14
people’s movements with a view to con-                            of Mozambique23
taining the spread of the disease. This
exceptional circumstance has led many                                Novel mobility analyses by mobile networks have proven
governments to consider loosening or                              themselves useful for mapping the spread of many diseases. A part-
sacrificing individual privacy during the                         nership was established between Vodafone, the University
response period for the sake of curbing                           of Southampton, the Clinton Health Access Initiative and the
contagion and saving lives. Facial rec-                           National Malaria Control Program; it was backed by the Bill and
ognition systems, mobile tracking apps,                           Melinda Gates Foundation. Together they analyzed mobility flows
wearables, geolocation, credit card and                           in Mozambique, a country where malaria poses a great burden
financial transactions and transport data                         on the economy and the general well-being of the population.
are being used for real-time monitoring of                        By examining aggregated and anonymized population flows and
compliance with response policies.                                malaria incidence in the country, the analysis allowed a better
                                                                  prioritization of resources and geographically stratified actions
    Examples of crisis response involving                         by providing malaria “sinks” and “sources” – thus showing how
both new technologies and sensitive per-                          the disease moves across the country with population flows. The
sonal data along with emergency public                            lessons learned from this analysis were then quickly applied to
health policies and law enforcement mea-                          COVID-19 and, by leveraging the global reach of Vodafone’s
sures can be seen in several countries                            mobile networks, mobility insights were extracted. They were used
globally. Apps deployed in China, such                            not only for tracking how populations were responding to govern-
as Alipay Health Code, are grounded in                            ment measures, but were also fed into an epidemiological model
technology for symptom tracking, assign-                          on the effects of travel restrictions and lockdown behaviors during
ing a color-coded QR code to the user                             the spread of the disease.
indicating their risk level.24 This tool goes
beyond self-assessment as all citizens                            23
are required to use it and personal data is
sent to law enforcement bodies to enforce
quarantine measures based on an individ-
ual’s risk level. Amongst others, this app
has been criticized for its lack of auditabil-
ity as the rules behind the assignment of
risk are not widely known. Though appar-
ently not compulsory, access to many ser-
vices and activities in China is dependent
on receiving a green code.25

   Taiwan was one of the first countries
to lead the development of technologies
for quarantine enforcement using mobile

data, implementing a “digital fence”.26 This
integrates location data from cell phones
to trigger an alert system if anyone moves
too far from their home and issues a fine
for breaking quarantine restrictions.27                         Box 6. Trade-offs in quick
Hong Kong has introduced wearables in
order to enforce the 14-day quarantine for                      containment and digital rights
anyone arriving at the airport: an electronic
tracker wristband, paired with a mobile                             In Israel, the response efforts went beyond introducing new
app used to calibrate the wristband, using                      technologies using sensitive personal data; the authorities also
geo­fencing technology.28 In the case of the                    implemented an emergency law passed to specifically track
tracker wristband, the technology is said to                    infected individuals and their contacts in order to enforce individ-
preserve privacy as it does not track indi-                     ual quarantine measures. Importantly, there were time limitations                                    15
viduals’ exact location, but simply signals                     involved in the implementation of this technology set out in the law,
whether an individual is inside or outside                      initially to thirty days. As of September, the security service pro-
of their home.                                                  gram used for contact tracing was still in place.30 However, other
                                                                key questions such as who has access to this data for analysis,
   There has been mixed public percep-                          what other types of analysis may be performed and when the data
tion of the development and use of these                        will be deleted have not been specified. Digital rights advocates
applications. China, which has seen                             have pushed back on these measures, warning of the risks not
breaches of data collected for the COVID-                       only of mass surveillance but also of targeted law enforcement
19 response entailing negative conse-                           action, as there are fears of a slippery slope as these methods
quences such as discrimination or stigma,                       unfold.
has strengthened public debate around
privacy in the country.29 Similar concerns                          South Korea has gone even further. It has not only used sen-
and debates have been raised about pri-                         sitive personal data from mobile phone tracking, credit card
vacy and digital rights globally, such as                       transactions, as well as face-to-face interview data with patients,
the examples detailed in Box 6.                                 but used this information to publish a publicly available map to
                                                                allow citizens to verify their potential contacts and the patterns of
    Transparency in the design and use of                       those infected as well. While the data does not include personal
many of these apps across several coun-                         identifiers, there is a high potential for re-identification of individ-
tries has been called into question as                          uals due to the granularity of location data, mobility patterns and
there is often a lack of clear data privacy                     even personal descriptions of those infected. Though the trans-
policies, communication with the public,                        parency and openness of the government has allegedly increased
or limitations on who has access, for what                      trust in its containment efforts, the fear of social stigmatisation is
purpose and for how long. Complicating                          high, given the amount of information usually released about con-
this is the ambiguity in legal and regula-                      firmed patients.
tory frameworks on data protection and
privacy that has given some governments                            India has become the only democratic nation in the world to
ground to implement measures that may                           require a majority of its citizens to download and use its tracking
infringe on digital and human rights in                         app, Aarogya Setu, with threats of fines, losing jobs, or jail if non-
cases of emergency, with unclear limita-                        compliant. While official policy maintains that the application is
tions on these provisions. It is not impossi-                   voluntary, all government employees, many large private compa-
ble to imagine that certain abusive policies                    nies, landlords and even city governments are mandating its use.
may linger long after any justification for                     The technology underpinning the application differs from many
them has disappeared.                                           others as it allows for enforcement as well, in that it goes beyond
                                                                exposure notifications from proximity data to assigning color-coded
                                                                risk badges, similar to China’s Alipay Health Code app. Other con-
26 This recent AI&I exchange with Audrey Tang, Taiwan’s         cerns have been raised about the lack of legal frameworks around
   Digital Minister can be accessed here:      data privacy and lack of transparency around data access or use
                                                                from the app as the developers’ profiles are not fully disclosed to
   monitors-55000-under-coronavirus-quarantine/                 the public and include many private companies.31
   for-coronavirus-quarantine/                                  30
29 Tracing.Testing.Tweaking. Approaches to data-driven             phones/
   Covid-19 management in China (Meric paper)                   31
      Epidemiological modelling
      Both metapopulation and individual                                         1M
      computational epidemiological mod-                                        100K
els benefit from high quality, real-time data
about the number of people infected, hos-                                        100
pitalized or in intensive care. Moreover,

                                                                                                                                                            2 cycles
human mobility (computed from, for exam-                                               3 weeks
ple, the mobile network infrastructure) and
quarantine information enable building                                           1M
more accurate models and predictions.                                           100K
Having an underlying model enables run-
ning it under different scenarios—such as                                        100
different social contention, mobility and
contact tracing situations—to assess the                                               4 weeks
impact that different non-pharmaceutical
interventions (NPIs) might have on the
incidence and spread of the disease.                                             1M
    Other technologies such as smart
thermometers and AI-based diagnostic                                             100
tools have been providing different ways

                                                                                                                                                            3 cycles
to map and predict the evolution and                                                   3 weeks
spread of the virus. Data from smart ther-
mometers were used in the US to create                                           1M
HealthWeather, a map which visualizes                                           100K
seasonal illness linked to fever, based on
aggregated, anonymized data from the                                             100
thermometers and mobile applications.32
In the fight against COVID-19, the benefits                                            4 weeks
of real-time data drew attention to similar                                                                                                                            16
sources of data such as wearable fitness
and health devices, encouraging users to                                         1M
synchronize their existing devices to spe-                                      100K
cific apps such as MyDataHelps to pool
data. However, concerns were raised                                              100
around the accuracy of these efforts as

                                                                                                                                                            4 cycles
they are based on information about the                                                3 weeks
behavior of flu-like illnesses, as well as the
representativeness of these initiatives as                                       1M
their data collection appears to be biased                                      100K
towards people who have access to wear-
                                                              Number infected

able devices.                                                                    100
   Real-time modelling, and therefore real-                                            4 weeks
time data access, are critical to enable                                                         1      2         3          4          5          6
timely response policies particularly in the
case of outbreaks. Data access is also key                                       Time since beginning of simulation in month
to accelerate scientific research in order
to better diagnose, treat and develop vac-                           Asynchronous NPIs           Synchronized NPIs
cines.                                                            (non-pharmaceutical interventions)

32        Figure 5. Cases over time, when lockdowns are synchronized
                                                                  or unsynchronized across all European countries.
   a3ec-70d7479d83f0_story.html                                   Source: (N. W. Ruktanonchai, 2020)
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