The United States, by most measures, drastically underperformed in its efforts to contain and treat the novel coronavirus epidemic at its outset. How it manages the pandemic’s next phase will determine how soon the country will be able to resume social and economic activity. Technology has been crucial to such efforts abroad, and the same will be true in the United States—the Senate signaled as much on April 9, when it held a hearing called “Enlisting Big Data in the Fight Against Coronavirus.” But the use of digital tools for public health purposes raises complex questions that U.S. policymakers are not yet prepared to address.
The countries in Asia that have competently managed their outbreaks have relied on digital surveillance technology to help track, contain, and manage the disease. Google and Apple recently announced that they have put their rivalry aside to collaborate on an app that would track the interactions of infected patients, among those who choose to participate. The app uses anonymous Bluetooth signals to alert users if their phones have been near the phones of infected people. But the United States will not be able to avail itself of such digital tools unless it can also adopt careful and well-coordinated policies to deploy them effectively and to regulate them. Unfortunately, the current moment is one of particular incoherence in U.S. governance. Washington has already missed the opportunity to use digital tools that could have saved lives in the early months of the crisis. Now it stands poised to miss a chance to use them to save more lives as well as the economy—unless it can learn from the choices that other countries have made.
NOT JUST FOR AUTOCRACIES
In pre-pandemic times, experts debated whether digital technologies offered an advantage to authoritarian governments. China had built a comprehensive domestic surveillance system and started exporting related technology elsewhere. Analysts worried that “digital authoritarianism” would enable popular repression and strengthen illiberal regimes. The early weeks of the pandemic complicated this picture by showing that digital surveillance could also save lives and keep economies functioning.
The countries that have best contained COVID-19, the disease caused by the new coronavirus—including South Korea, Taiwan, and Singapore—do not all share the same political system. But they have one thing in common: all have contained their outbreaks by relying on digital technology, even at considerable expense to individual privacy rights. The successful countries in this pandemic have used digital surveillance to identify patients, sort the sick from the healthy, limit the virus’s spread, and carefully resume some social and economic activity.
South Korea and Singapore have collected data on every known case of COVID-19, posting anonymous but data-rich national dashboards. Citizens can use this information to avoid locations where infected people have been and general areas that have high rates of infection. South Korea’s dashboard even has a function that helps users to find supplies, such as masks. The two countries rely heavily on digital platforms for contact tracing, and they use surveillance camera footage, geolocation data, and sometimes even credit card receipts to determine who may be at risk once an infected person has been identified.
Hong Kong, Taiwan, Thailand, and Australia have monitored incoming travelers to contain the virus’s spread, and Taiwan has combined its national health-care and customs data to sort its population into high- and low-risk groups. South Korea, Hong Kong, and Taiwan have also used location trackers to enforce mandatory quarantines for the sick and restrict their contact with the healthy. Technologically savvy countries outside of Asia will soon face the choice of whether and how to adopt similar approaches.
The United States is still in the early weeks of its pandemic response, but it is the world’s leader in confirmed cases. The moment for initial containment has passed, but a vaccine is 12 to 18 months away, and the federal administration is impatient to unfreeze the economy. Officials at all levels must now contemplate the next phase of the crisis, in which digital technology will play a role in stopping second and even third waves of infection after the initial peak.
BEST AND WORST PRACTICES
Public health and national prosperity will require the United States to resume some social and economic function, to the extent that is possible without setting off significant secondary outbreaks. Indeed, countries that appeared to have the virus under control, including Singapore, Taiwan, and Hong Kong, are all seeing signs of second waves. The same may befall the United States. But Washington remains the world’s technology leader, and it might reasonably rely on cutting-edge platforms as it attempts the pandemic high-wire act of restarting the economy without inducing a new spike.
The United States can take lessons, both cautionary and salutary, from the experiences of other countries that have brought digital solutions to bear on the pandemic problem. Consider China. The government used the same digital surveillance tools to track and contain infections that it did to control the narrative about the virus’s origins. Back in February, the body that regulates cyberspace in China issued guidelines for protecting personal information while using big data to fight the virus. The policy restricted the scope of the data to be collected and limited its use to epidemic control. But China’s system offers little oversight or recourse for contestation. The new tools can be abused, particularly if they remain in place when the pandemic passes or if the government co-opts them for purposes of authoritarian control. Moreover, China’s health apps use opaque algorithms that obscure the sources of their data and the means by which they draw conclusions.
Even democracies have prioritized national health over adherence to privacy regulations—in some cases, with scanty public debate. South Korea’s government has drawn on a public interest exception to its strict privacy rules in order to collect and use personal data without consent during the crisis. In Singapore and Hong Kong, data privacy commissions ruled that personal health information can be used for contact tracing and other response measures—in the case of Singapore, without consent.
Washington should be working to fast-track the technology necessary for managing the pandemic while at the same time developing the principles that will minimize the risks of abuse. Other democracies are grappling with this tradeoff. The European Union, for example, had recently set out strict rules governing the use of artificial intelligence and data. But because responding to the pandemic, and particularly developing a vaccine, calls for greater access to data, Europe has indicated that it will reexamine those precepts. At the same time, European researchers are developing a contact-tracing system that does not store or exchange personal information.
In the United States, the technology sector has advanced well ahead of the policy debate. The Google-Apple solution is slated to roll out in May, and the Massachusetts Institute of Technology has built a virus-response app based on “differential privacy,” meaning that the app shares information by scrambling data so that individuals cannot be identified. But unless these piecemeal efforts come under a broader policy governing the use of digital platforms, they will do little to curb the further spread of the virus now and, perhaps more important, to stop a second wave. For these solutions to work, federal, state, and local governments need to implement them everywhere and in lockstep—together with widespread testing, so that there is data to feed into the apps. Without a coordinated policy approach, the adoption of such platforms will be uneven, and even the savviest states will struggle to recoup safety and prosperity if the virus continues to spread elsewhere in the country. Absent a coherent policy, technological solutions to the pandemic crisis will not be effective, no matter how innovative they are.
PRIVACY BY DESIGN
With the virus moving at breakneck speed, the United States’ window to devise a digital pandemic policy may be closing. Those who craft this policy must disentangle the risks from the benefits of using certain kinds of data to develop effective tools. They should strive to address the potential for discrimination against marginalized groups and to erect guardrails limiting who can access the data, for what purpose, and for how long that data can be retained. If policymakers bring these concerns to a close collaboration with technical experts, solutions can be embedded into the technology as it develops—in what is known as “privacy by design.”
That technological capability is outstripping the public policy debate in the United States is not altogether surprising. Americans have grown accustomed to Apple, Facebook, and Google using their data for commercial purposes. They may be far more skeptical about allowing federal or state governments to access that data, even if the nation’s health is at stake. Moreover, neither citizens nor policymakers yet know just what tools are under development or what data they will draw on. Americans have long proven willing to share location data, but they may feel differently when that information is combined with medical data.
Now is the time for Americans to grapple openly with the concessions that the country’s health and economic recovery may require. The chance to adopt tools that might save both lives and jobs could swiftly pass. But if the United States takes up such technologies without a national debate, and without articulating the principles under which they will operate, even the best instruments are likely to be politicized and rendered ineffective.
The stakes of getting this right are hard to overstate. If the United States fails to harness its innovative capacity in the interest of pandemic management, it will suffer many additional months of economic and social paralysis. State and local authorities could lift stay-at-home orders only to confront new outbreaks, resulting in repeated lockdowns and a protracted economic plunge. U.S. competence in this next phase of pandemic management could make the difference between a moderate, U-shaped economic recovery and an L-shaped future in which the economy stalls out. Moreover, as China resumes business as usual, and Asia’s middle powers seek to keep their economies on course, U.S. ineptitude will risk accelerating adverse international trends. The pandemic has already heightened perceptions of U.S. decline and accelerated China’s sprint for global leadership. If the United States bypasses new technologies for managing the pandemic—and sidesteps the debates that come with them—it will show itself, once more, a still-mighty power performing vastly beneath its capabilities.