With the outbreak of the novel coronavirus, contact tracing apps have emerged as the best examples of digital epidemiology, a nascent field where digital data is used to understand patterns of disease, and chart out interventions to prevent it.
The story so far
Aarogya Setu, the Indian government’s COVID-19 contract tracing mobile application, is being used by over 13 crore people. On the app’s home page, a quote by Prime Minister Narendra Modi appears, where he insists that “as more and more people use it, its effectiveness will increase”. The app tracks the interaction of its users through Bluetooth and a location-generated social graph. If a user tests positive for COVID-19, other app users who may have been in his/her close proximity, knowingly or unknowingly, are alerted and guided on self-isolation and steps to be taken if they develop symptoms. While government employees have been asked to use the app, it was also made mandatory for rail and air travellers.
Cybersecurity experts and activists have dubbed Aarogya Setu a government surveillance tool. In response to one such petition, highlighting the violation of the right to privacy, the Centre has told the Karnataka High Court that it is not mandatory for rail and air travellers to download the app. Multiple COVID-19 trackers like Aarogya Setu have been launched across the world.
What has led to the growth of digital epidemiology?
The traditional form of epidemiology, considered a basis of public health, consists of studying various factors (age, gender, location and other determinants) of the general population to study disease patterns, spread, incidence, and prevalence. Traditional epidemiologists say it is a field founded on the pillars of science and is thus extremely robust. Data is mostly collected by field staff through house-to-house surveys and from hospital records. Digital epidemiology, as the term suggests, uses digital data to study the same factors.
Swiss epidemiologist Marcel Salathé, director of the Digital Epidemiology Lab in Lausanne, defines the field in a more nuanced manner. He says, “Epidemiology that uses data that was generated outside the public health system, i.e. with data that was not generated with the primary purpose of doing epidemiology.” In an article published in a peer-reviewed journal in January 2018, Mr. Salathé says that the field of digital epidemiology is new, but has been growing rapidly owing to the increasing amounts of data generated on the internet, especially on social media.
What are good examples of digital epidemiology?
In an email response to The Hindu , Mr. Salathé said Twitter data mining has been one of the best uses of digital epidemiology in his view. Also, systems like Healthmap are good examples. “In 2020, the digital contact tracing apps will certainly become the best examples of digital epidemiology,” he says.
An article published in October 2018 in a Korean journal, Healthcare Informatics Research, listed Google Flu Trends as one of the early examples of digital epidemiology, wherein researchers from Google and U.S. Centers for Disease Control and Prevention published a method to estimate flu activity by region using search engine queries. The article also cites the use of Twitter to track level of disease activity and concern about the influenza H1N1 pandemic in 2011, and an attempt by the Boston Children’s Hospital to estimate the level of influenza-like illnesses, “in near-real-time, in the U.S. by monitoring the rate of influenza-related Wikipedia article views on a daily basis”.
What are the privacy issues involved?
According to Mr. Salathé, digital epidemiology has an important role to play in preventing disease outbreaks. He says one of the big advantages of digital speed is it is fast and will be a key contributor in keeping outbreaks under control. But, data privacy is an element of huge concern. COVID-19 trackers like Aarogya Setu, which collect contact network information and location information, can be privacy-intrusive, he says. N.S. Nappinai, Supreme Court advocate and founder of Cyber Sathi, says the privacy mandate under the law (Information Technology Act) as it stands today, is specific to body corporates. “Having said that, the Puttaswamy judgement makes it clear that data principles of privacy and consent are equally applicable for the government,” she says, adding that for the use of Aarogya Setu, the government should be transparent about where the data is going, what are they using it for and how one can be assured that it will be deleted when all this is over. “The app should be consent-based. But it seems that a lot of organisations have made it mandatory. Then how is it consent?” she says.
