Digital tools against COVID-19: Framing the ethical challenges and how to address them

Data collection and processing via digital public health technologies are being promoted worldwide by governments and private companies as strategic remedies for mitigating the COVID-19 pandemic and loosening lockdown measures. However, the ethical and legal boundaries of deploying digital tools for disease surveillance and control purposes are unclear, and a rapidly evolving debate has emerged globally around the promises and risks of mobilizing digital tools for public health. To help scientists and policymakers navigate technological and ethical uncertainty, we present a typology of the primary digital public health applications currently in use. Namely: proximity and contact tracing, symptom monitoring, quarantine control, and flow modeling. For each, we discuss context-specific risks, cross-sectional issues, and ethical concerns. Finally, in recognition of the need for practical guidance, we propose a navigation aid for policymakers made up of ten steps for the ethical use of digital public health tools.

[1]  P. Quinn Crisis Communication in Public Health Emergencies: The Limits of ‘Legal Control’ and the Risks for Harmful Outcomes in a Digital Age , 2018, Life Sciences, Society and Policy.

[2]  B. Parry Domesticating biosurveillance: 'containment' and the politics of bioinformation. , 2012, Health & place.

[3]  Mike Catchpole,et al.  Preventing the next 'SARS' - European healthcare workers' attitudes towards monitoring their health for the surveillance of newly emerging infections: qualitative study , 2011, BMC public health.

[4]  P. Tambyah,et al.  The ethics of responding to a novel pandemic. , 2011, Annals of the Academy of Medicine, Singapore.

[5]  S. Coughlin How Many Principles for Public Health Ethics? , 2008, The open public health journal.

[6]  Online Symptom Checker Applications: Syndromic Surveillance for International Health , 2018, Ochsner Journal.

[7]  Markus K. Labude,et al.  Cross-Sectoral Big Data , 2019, Asian Bioethics Review.

[8]  Marcello Ienca,et al.  On the responsible use of digital data to tackle the COVID-19 pandemic , 2020, Nature Medicine.

[9]  K. Servick Cellphone tracking could help stem the spread of coronavirus. Is privacy the price? , 2020 .

[10]  Alex Pentland,et al.  COVID-19 Contact Tracing Privacy Principles , 2020 .

[11]  Public Health Strategies for Pandemic Influenza , 2006 .

[12]  Markus K. Labude,et al.  An Ethics Framework for Big Data in Health and Research , 2019, Asian Bioethics Review.

[13]  Scott S.D. Mitchell,et al.  "Warning! You're entering a sick zone" , 2019, Online Inf. Rev..

[14]  R. Coker,et al.  Pandemic influenza control in Europe and the constraints resulting from incoherent public health laws , 2010, BMC public health.

[15]  A. Chughtai,et al.  Utility and potential of rapid epidemic intelligence from internet-based sources. , 2017, International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases.

[16]  Hyunghoon Cho,et al.  Contact Tracing Mobile Apps for COVID-19: Privacy Considerations and Related Trade-offs , 2020, ArXiv.

[17]  Paul Lukowicz,et al.  Participatory Disease Surveillance Systems: Ethical Framework , 2019, Journal of medical Internet research.

[18]  L. Gostin,et al.  Public Health Ethics: Mapping the Terrain , 2002, The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics.

[19]  Hannah van Kolfschooten EU Coordination of Serious Cross-Border Threats to Health: The Implications for Protection of Informed Consent in National Pandemic Policies , 2019, European Journal of Risk Regulation.

[20]  R. Brook,et al.  Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing. , 2020, JAMA.

[21]  S. L. Roberts Big Data, Algorithmic Governmentality and the Regulation of Pandemic Risk , 2019, European Journal of Risk Regulation.

[22]  Lisa M. Lee,et al.  Ethical justification for conducting public health surveillance without patient consent. , 2012, American journal of public health.

[23]  Urs Gasser,et al.  Practical approaches to big data privacy over time , 2018 .

[24]  Chiara Garattini,et al.  Big Data Analytics, Infectious Diseases and Associated Ethical Impacts , 2017, Philosophy & Technology.

[25]  Alessandro Blasimme,et al.  Health Research with Big Data: Time for Systemic Oversight , 2018, Journal of Law, Medicine & Ethics.

[26]  Lucie Abeler-Dörner,et al.  Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing , 2020, Science.