Digital Contact Tracing for Pandemic Response
Jeffrey P. Kahn · Johns Hopkins University Press eBooks · 2020
Digital technologies are being developed and promoted to support the public health response to the COVID-19 pandemic, with discussion and implementation planning in the United States by localities, states, institutions, and employers.Key decision makers and stakeholders-including government officials, institutional leaders, employers, digital technology developers, and the public-require clear and well-supported guidance to inform the deployment and use of these technologies as well as of the data they collect, store, and share.While technology-based approaches are currently unable to provide solutions on their own, experiences in other countries indicate that they could be used successfully in conjunction with traditional and novel public health methods.This report reflects a rapid research and expert consensus group effort led by the Berman Institute of Bioethics and the Center for Health Se- curity at Johns Hopkins University.It draws on experts from both inside and outside Johns Hopkins in bioethics, health security, public health, technology development, engineering, public policy, and law.The report highlights issues that must be addressed and provides recommendations for the use of digital technologies as part of contact tracing.The analysis offered here is focused on answering the following questions:• Can digital contact tracing technologies (DCTT) be effective as part of public health responses to the pandemic, and if so, to what degree, for which specific types of functions, with what confidence, and with what requirements?• How can these technologies serve the interests of public health while respecting other individual and collective interests, such as ensuring equitable distribution of benefits and burdens and limiting infringement on privacy and other civil liberties?x Preface• What are the ethical, legal, policy, and governance guardrails currently in place around such technologies and what else is needed?• What additional guardrails are required to ensure that the goals of public health in using these technologies are achievable in ways that are ethically and legally sound?To answer these questions, the report examines some core aspects of digital technologies applied to contact tracing, focusing on:• the value of and basic methods for traditional public health surveillance and contact tracing,• candidate technological products to enhance public health surveillance and contact tracing, how they work, and their comparative value for public health,• core ethical, legal, and governance considerations, and how they relate to relevant features of candidate technological solutions, and• what is needed to move forward responsibly with the use of digital technology in support of public health surveillance, acknowledging gaps in our current understanding.The project involved in-depth analysis by a dedicated team of faculty, postdoctoral fellows, and research staff working over the course of only a few weeks but with great intensity, drafting a report in collaboration with 26 total contributors writing, commenting, and revising through multiple drafts, with the penultimate draft "pressure-tested" by review and discussion at a virtual workshop of invited experts and stakeholders held on May 13, 2020, and the final version completed on May 21, 2020.The report and analysis builds on the excellent work of others in some parts of this territory, while focusing on the gaps in analysis and areas that have not been sufficiently addressed.The goal is to offer comprehensive guidance to relevant stakeholders to advance public health response during the COVID-19 pandemic.Given the rapidly evolving territory into which DCTT is being introduced, this report will, by necessity, be something of a living document, updated as often as information dictates in order to continue to offer leading-edge analysis and guidance.Versions will be noted in the digital and print editions.xi Efforts like this project require teams and even small armies to be carried out successfully, and this was no exception, except that it was many fewer people working many more hours than could reasonably be expected of them.From the initial kernel of an idea to the publication of this report in book form, this project took just over a month total.That seems impossible, even as I know it is accurate, and it speaks to the incredible commitment, hard work, research skills, and analytic acumen of our colleagues at Johns Hopkins-the core team are deservedly listed as lead authors of this report.None of this would have been possible without the support-moral and financial-and encouragement of Johns Hopkins University President Ronald J. Daniels, who was the first to suggest the idea to me of taking on this topic.He provided not only support and encouragement but the imprimatur of his office, including help, guidance, and counsel from Prof. Lainie Rutkow, senior advisor to the president.Lainie played a more integral role than that description captures, reflected in part by her inclusion among the report's contributors, but she deserves special acknowledgement for shepherding us through to the end.I mentioned that this was a team effort, and every team requires an effective leader.My colleague Prof.Joseph Ali stepped into that role as we undertook the project, and then he worked seven days a week along with the rest of the core research and writing team, always unfailingly positive and deeply engaged in the work.He, along with Prof. Anne Barnhill, Alan Regenberg, Amelia Hood, and Drs.Katelyn Esmonde, Brian Hutler, and Crystal Watson, all deserve special thanks for doing so much in so little time,