How intrusive should contact tracing be?

Contact tracing, as it’s come to be recognized in the common parlance, is all the rage these days. Previously, we were “flattening the curve” and “stamping out wildfires,” as New York Governor Andrew Cuomo liked to say. But as the number of new cases continues to fall in many places, now we’re supposed to be proactively rooting out potential incidents of transmission of the novel Coronavirus and locking them down before they can turn into a problem.

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The method being pushed is the aforementioned contact tracing. When a person shows up presenting symptoms or testing positive, people are interrogating them to find out who they’ve been in contact with recently. Then those people can be tracked down and interrogated in turn, isolating them as required. This is being hailed as the great next step forward in the battle against the virus. You get a sense of how excited some people are from the title of this recent piece from The Hill. “States build contact tracing armies to crush coronavirus.”

State governments are building armies of contact tracers in a new phase of the battle against the coronavirus pandemic, returning to a fundamental practice in public health that can at once wrestle the virus under control and put hundreds of thousands of newly jobless people back to work.

California is already conducting contact tracing in 22 counties, and it eventually plans to field a force of 10,000 state employees, who will be given basic training by University of California health experts.

Massachusetts and Ohio have partnered with Partners in Health, a global health nonprofit originally established to support programs in Haiti, to field teams of contact tracers. Maryland will partner with the University of Chicago and NORC, formerly the National Opinion Research Center, to quadruple its contact tracing capacity.

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It’s almost enough to leave you breathless, isn’t it? Just look at all of the benefits. We’re going to “wrestle the virus under control” and put tens… nay, hundreds of thousands of unemployed people back to work. It’s like we’re vaulting ahead into the future in great leaps and bounds. I can’t wait until Robocop shows up. I’ve always wanted to get an autograph.

But perhaps we should pause for a moment, catch our breath, and consider precisely what this all means. Now we won’t just be counting the number of new cases and isolating them. We’ll be hounding the sick for a list of friends, family members, coworkers and other individuals they have engaged with for as far back as two weeks. Newly minted state employees will be scouring the land to find all of them and ask about their health and their recent movements. They will suddenly be back in a lockdown situation even if everyone else has been allowed back out in public.

And who precisely will be doing all of this “tracing” once we’re fully in gear? In California, for example, they will be unemployed people who have received “basic training” from University of California “health experts.” That’s not going to make them doctors or experts in the transmission of infectious diseases. For that matter, that doesn’t even ensure they have the basic skills to go out and locate and interrogate people. Not many folks have that skillset unless they happen to be unemployed cops or private detectives.

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How will they know what questions they can and can’t ask? Will they be trained in privacy considerations and HIPPA regulations? If they have to interact with the contactees in person, will they even know the best practices required to not turn into carriers of the virus themselves?

And finally (and perhaps most importantly), where will all of this information they’re collecting be stored? I’m sure you can easily imagine how useful a massive database of hundreds of thousands or millions of people with a long list of people they associate with could be to any number of groups. That could include anyone from politicians to law enforcement agencies to advertisers. That sizable mountain of personal data on the daily activities of Americans would be almost priceless, particularly when it lands in the wrong hands.

Contact tracing sounds like an extremely useful tool for medical professionals at the beginning of an outbreak. For example, if six new cases of smallpox suddenly showed up in one place. But we’re about to embark on a process of inflating it to a massive national scale using 21st-century data management tools. This sounds like something that’s going to require some oversight, but we’re already rushing headlong into the void.

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