Pandemic tech has left to public health experts. Here’s why that needs to change.
Susan Landau, a Tufts University professor of cybersecurity and computer science, is the author of Counting the People, a book on how and why tracking apps are built. He also published a essay on Science last week arguing that new technology to support public health needs to be scrutinized more closely for ways that can increase the inequality and inequality already embedded in society.
“The pandemic is not the last thing people will face,” Landau wrote, calling for societies to “use and build tools and support health care policy” that will protect rights, health, and safety of the people and become a greater justification for health care.
This conversation was conditioned and edited for clarity.
What do we learn from the launch of covid apps, especially how they can be different or better?
The technologists working on the apps have carefully thought about making sure to talk to epidemiologists. What they probably haven’t thought about enough is: These apps will change who is informed about the possibility of being exposed to covid. They will change the delivery of [public health] services. That’s the conversation that didn’t happen.
For example, if I received a notice of exposure last year, I would call my doctor, who would say, “I want you to get tested for covid.” Maybe I’ll sacrifice myself in my room, and give me food to my husband. Maybe I won’t go to the supermarket. But for others, not much will change for me. I will not drive. I am not a food service worker. For people, getting an exposure notice is very different. You need to have social services to help them support, which is something public health is aware of.
In Switzerland, if you get a notice of exposure, and if the state says “Yes, you have to quarantine,” they will ask, “What is your job? Can you work from home?” And if you do said no, the state will come in with financial support to keep you home.That puts in place social infrastructures to support disclosure notice.Most places do not – for example the US.
Epidemiologists studied how the disease spread. Public health [experts] see how we take care of people, and they play a different role.
Are there other ways that apps can be designed differently? What could have made them so useful?
I think there is specific controversy for having 10% of apps actually collect the location, to be used only for medical purposes to understand the spread of the disease. If I spoke to epidemiologists in May and June 2020, they would say, “But if I can’t tell where it’s spreading, I’m missing out on what I need to know.” That’s a management issue for Google and Apple.
There is also the issue of how effective it is. That’s tied to the issue of equity. I live in a fairly urban area, and the nearest house to mine is hundreds of feet away. I will not pick up a Bluetooth signal from someone else’s phone that results in an exposure notification. If my bedroom bed is right in the apartment room next to the apartment, I can get a full exposure notifications if the neighbor person is sick – the signal can go through the wooden walls.
Why has privacy become more important to developers of tracking apps?
Where you’re really revealing really is because it shows things like who you’re sleeping with, or when you stop at the bar after work. It shows if you go to church every Thursday at seven but you don’t always go to church anytime, and it happens that Alcoholics Anonymous has been meeting at church before. For human rights workers and journalists, it is obvious that tracking down who they are with is very risky, because it reveals their background. But even for the rest of us, who you spend time with – being close to people – is a private matter.
“The end user is not an engineer… your uncle. It’s your sister. And you want to have people who understand how people use things. ”
Other countries use a protocol that includes multiple location tracking – for example Singapore.
Singapore said, “We will not use your data for other purposes.” Then they changed it, and they use it for law enforcement purposes. And the app, which started as a volunteer, is now required to access office buildings, schools, and more. There is no option even for the government to know who you are spending time with.
I’m amazed at your thoughts on some even more lessons for building public technology in a crisis.
I work in cybersecurity, and in the field we take a long time to find out that there is a user on the other end, and the user is not an engineer sitting at Sun Microsystems or Google in the security group. Tito nimo. It’s your sister. And you want to have people who understand how people use things. But it’s not something engineers are trained to do – it’s something that people in public health or social media do, and those people have to be a key part of the solution.