contact tracing
The company behind the crime-fighting app Citizen is now part of Los Angeles County's contract-tracing effort to stem the spread of the novel coronavirus.
County officials announced on Wednesday they will partner with the New York-based company and use its app Citizen SafePass. The bluetooth technology tracks people's movement and identifies those that may have been exposed to the virus, alerting them of danger.
"The information gathered through the SafePass app will help us learn more about the virus and how it is spreading through our communities and the county," said L.A. County Supervisor Kathryn Barger. "In collecting information, everyone's identity remains anonymous and all data is encrypted to ensure privacy and security."
Contact-tracing technology has long been seen as a way to speed up the laborious task of calling individuals who might have been exposed to the virus. Right now, the county employs 2,600 contact tracers to reach out to a web of nearly a quarter million individuals that either have the virus or have potentially been exposed.
But cities have struggled with how to do it correctly as questions of privacy continue to hover over the use of such technologies.
In announcing the partnership, Citizen CEO Andrew Frame said the company "will never share data with any authorities without the user opting in."
Photo by engin akyurt on Unsplash
Using Bluetooth to run contact tracing apps isn't new. Apple and Google teamed up to launch such an app in May. Other developers have pitched GPS-enabled apps that rely on monitoring a user's every move.
Citizen's app does both, combining bluetooth and GPS location-tracking to inform users if they've recently crossed paths with someone who later tests positive for COVID. When the app notifies you of the discovery, they'll send you a map of where the interaction happened.
That removes some of the anonymity, said Angel S. Diaz, an attorney specializing in liberty and national security at the Brennan Center for Justice. Diaz analyzed the app with a Coin Desk reporter back when it was being pitched to officials in New York in May.
"It's hard to anonymize data fully," he told dot.LA "The more you have contextual clues, it gets easier to re-identify things."
Diaz said Google and Apple appear to be trying harder to protect user privacy since their contact-tracing app won't inform users where the interaction happened.
Beyond the app's front-facing infrastructure, Diaz is concerned about where data from SafePass ends up down the road. People might be comfortable giving up location information with health officials now, Diaz said, but there's worry that under the terms of the privacy policy this information won't be deleted or it could later be shared with other authorities from other government agencies.
That could contribute to how many people will opt-in. If fewer people download the app, it's less effective.
"If you're someone worried about this data being used for police or your illness being shared with immigration authorities, you may be less likely to download the app because you don't want to put yourself and your family at risk," he said.
"The kinds of surveillance that contact tracing apps make available might be repurposed after the pandemic to do other kinds of police surveillance."
Moreover, it could harm communities of color by painting them as more dangerous, should they have higher rates of COVID infection.
County officials point out that the app is voluntary.
The app deletes GPS and bluetooth data after 30 days, said Citizen spokesperson Lily Gordon in an emailed response. And SafePass limits what information is provided to government agencies and will not sell or share data without permission.
"Citizen would only share anonymized, aggregate data with local health departments to help them identify COVID-19 hot spots or potential areas of concern," she stated. "Citizen does not share data with law enforcement agencies unless required by law, such as when they submit a subpoena or search warrants.
But she said, it could conduct "symptom surveys" for state or city government agencies.
The venture-backed Citizen is now listed as one of the top 20 free health apps in the Apple Store, Gordon said. The company has raised $59 million in capital and Frame has ambitions to grow the social app.
Citizen first emerged as Vigilante in 2016 and was taken off the Apple Store a week after launching in New York City over concerns it encouraged vigilantism by allowing users to collect and video footage of reported events.
It rebranded and popped up the following year as Citizen with a focus on safety.
The app is available in 20 cities and has five million users that it alerts to criminal activity and disaster near them with data collected from public information like police scanners. These safety alerts appear on a map of the user's city, marking more serious incidents like shootings with bigger red dots.
While the company has partnered only with L.A. County and San Joaquin County, SafePass is available to anyone in the U.S, with a smartphone. The app also offers access to a free at-home testing kit for those who have been notified of exposure through the app. Citizen said it is not charging Los Angeles County for the partnership.
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As part of the National Science Foundation Rapid Response Research award, created for situations like the ongoing pandemic, USC's Cyrus Shahabi, a professor of computer science, electrical engineering and spatial sciences, and chair of the Computer Science Department was granted $67,185. The project, entitled "REACT, for REAal-time Contact Tracing and risk monitoring via privacy-enhanced tracking of users' locations and symptoms" is a multi-university with researchers at Emory University and the University of Texas Health Science Center, with total funding at $151,477. Work officially begins on Friday.
The universities hope to have a working mobile app by August, in time for the start of the fall semester, Shahabi said.
It's yet another digital twist on contact tracing, a pillar of public health and infectious disease control that can be onerous detective work. It involves identifying those who have been in contact with infected persons to help isolate and limit spread of a virus, especially during epidemic — or, in this case, pandemic conditions.
Enabling such efforts have become a recent focus by governmental entities and organizations. In California, Gov. Gavin Newsom has said that contact tracing capacity and expanded testing are crucial measures that need to be in place before stay-at-home orders can be loosened. That includes establishing a contact tracing "workforce" and developing a statewide training academy to train 10,000 workers to do contact tracing.
Shahabi envisions a use case where people with higher personal risk scores might decide to stay home or get tested for COVID-19, and where areas that are deemed high-risk because people are later known to be infected, like a particular supermarket, might be avoided. Policymakers could warn the public to avoid an area that's known to be a potential hotspot of infection.
The main problem with contact tracing is that it relies on human memory, in this case over as long as a 14-day period, which can be especially faulty, Shahabi said. It also has a built-in delay between when an infected person is identified and when those who have been exposed are notified. Immediate isolation is only possible with digital contact tracing, he said.
A recent Science research report found that SARS-CoV-2, which causes the disease COVID-19, is spreading "too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient and happened at scale" using digital methods like a mobile app.
While companies like Apple and Google who have engaged in a rare collaborative effort to create an "exposure notification API" that would be utilized to inform people via bluetooth signals on their phone that they may have been near an infected person -- allegedly without jeopardizing privacy.
Shahabi said that Apple and Google's proposed method could provide many false positives or negatives, because it doesn't take into account factors like whether a person is wearing a mask or how close they are. For those who are warned, it could be unclear as to what to do about it, and eventually people may become inured to alarm bells that are raised because of it, he said.
Countries such as South Korea or China have used location-based digitized contact tracing. However, it has only been successful because citizens are forced to download it, opt into location monitoring, and regularly check in or otherwise be visited by enforcement authorities, according to Dr. Jeffrey Klausner, a professor of medicine in the division of infectious diseases at the David Geffen School of Medicine at UCLA who has worked in contact notification for 25 years in areas like HIV in the United States.
"In that setting where there's 100% mandated compliance, it's been shown it can work, in our setting in the United States, I don't see that really happening," Klausner said. "We have enough problems with governors issuing orders and denying free personal movement, that the idea that people are going to be ordered to download apps to monitor their movement is highly unlikely and probably not constitutional."
Privacy advocates have repeatedly raised alarms over efforts by governments in China, South Korea, Israel, and other areas in the world to stop the viral spread through surveillance, and have warned about ensuring that any privacy tradeoffs are narrow and time-limited.
"There's several red flags," said Bennett Cyphers, a staff technologist with the Electronic Frontier Foundation, a nonprofit digital rights advocacy group. That includes the fact that GPS, when you're not in an area with tall buildings, provides accurate information roughly down to 15 feet. Precise location data isn't accurate enough to do reliable contact tracing. If people choose to limit the specificity of their location data, then it will be even worse.
"Even if I just stay in my house all day, there are probably hundreds of people within a thousand feet of me that I never interact with," Cyphers said.
Shahabi has repeatedly brought up concerns about privacy implications of the work in an interview with dot.LA and in the grant itself, stating that "such use also heightens concerns on individual privacy and data abuse" and that there needs to be "a careful balance or privacy protection with public health benefits."
The app would enable users to control and refine how frequently their data is captured and how detailed it is, the grant states. The grant would also investigate "privacy-preserving" ways to share collected data for further research studies.
Shahabi would aggregate the risk scores for individuals using AI to calculate risk scores for community areas as part of what he wants to call his pandemic tool kit, or Pandemic Risk Evaluation Platform (PREP). He believes that this aggregation would somewhat alleviate individual privacy concerns for public use of the data by policymakers and others, and is also less potentially problematic than the Apple and Google method.
Cyrus Shahabi, USC professor of computer science, electrical engineering and spatial sciences, and chair of the Computer Science Department.Shahabi said he is working on getting some raw location data from an outside company to begin doing some risk analysis work.
For privacy advocates like Cyphers, the concern is if user location data is ultimately collected and stored by a single entity, it ups the privacy risk to people who participate. And the privacy risks are still "massive" even with low-resolution data, he said. The data can give a general idea of where a person lives and works, plus when the person arrives there and elsewhere. Such cell-site data is used by police to make cases regularly.
Risk scores could also become problematic if a school or employer requires students or workers reveal them as a condition of receiving a benefit, entering a building or returning to their office, Cyphers said. How the scores are created, whether users are informed about what makes them up, and how they're used are all crucial questions that need to be transparently answered.
"When you introduce 'scoring' that takes other factors into account, it complicates everything, and increases the risk that users will be misinformed or discriminated against due to factors beyond their control," Cyphers said.
In China, the government has used Alipay Health Code, giving citizens a QR code inside the app that's colored red, yellow or green to indicate your health status, with the color green enabling you to travel freely. Law enforcement authorities were involved in the app's development, according to China's state-run media.
Klausner, the epidemiologist, said "we generally feel that voluntary notification where we educate people and empower them with tools to do the notification themselves is the most effective (way) and we've built digital tools for them to use over the past few decades," including a new one that lets you notify people swiftly and directly via text or email immediately and directly.
He added: "It's going to be difficult to get Americans to agree to involuntary surveillance" and to agree to download or opt into such location tracking on a basis large enough to be effective.
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