Researchers in Switzerland who helped develop one of the first Covid-19 apps have highlighted the challenges of developing such apps to tackle the pandemic.
The researchers at ETH are now pointing out the ethical challenges that need to be taken into account and the issues that need careful consideration when planning, developing and implementing such tools.
However technical shortcomings, lack of acceptance by the population and inaccurate data are all factors that could hinder their success. In the worst case, digital aids could become a data protection nightmare or lead to discrimination against certain groups of the population say the researchers. The data protection issues are the subject of a court case in the UK, for example, and adoption in Switzerland is half the expcted level.
“These [apps] can naturally be very useful instruments, but you can’t expect miracles from them,” said Effy Vayena, Professor of Bioethics at ETH Zurich. She and her group have published a comprehensive study outlining the ethical and regulatory aspects that must be considered when developing and implementing digital tools.
The study looked at four tool categories: Covid-19 contact tracing apps, including the SwissCovid app co-developed by EPFL and ETH Zurich; programs that can be used to assess whether an infection is present based on symptoms; apps for checking whether quarantine regulations are being observed; and flow models of the kind that Google uses for mobility reports.
Although such tools are all very different, in each case it is crucial to carefully weigh up the advantages of the technology against the potential disadvantages for the society – for example with regard to data protection. “People sometimes have completely unrealistic expectations of what an app can do, but one single technology can never be the answer to the whole problem. And if the solution we’ve come up with is flawed because we didn’t consider everything carefully enough, then that will undermine its long-term success,” she said.
For that reason, Vayena stresses the critical importance of rigorous scientific validation. “Does the technology actually work as intended? Is it effective enough? Does it provide enough reliable data? We have to keep verifying all those things,” she said, explaining that there are also lots of questions surrounding social acceptance: “Back in April, over 70 percent of people in Switzerland were saying they would install the coronavirus app as soon as it became available,” she says. “Now, at the end of June, over half say they don’t want to install it. Why the sudden change of heart?”
The researchers highlight a whole range of ethical issues that need to be considered in the development stage. For example, developers must ensure that the data an app collects is not used for anything other than its intended purpose without the users’ prior knowledge. The researchers cite a Chinese app for assessing Covid-19 quarantine measures which reportedly shares information directly with the police. Another key issue is that these digital tools be deployed only for a limited timeframe so as to ensure that the authorities do not subsequently misuse them for monitoring the population.
Some apps also collect socio-demographic data. While this information is useful for health authorities, there is a risk it may lead to discrimination. At the start of the outbreak, it became apparent just how quickly some people were prepared to denigrate others in a crisis, when all people of Asian origin were being wrongly suspected of possibly carrying the coronavirus. “You have to think about these adverse effects from the outset,” said Vayena.
The researchers provide a step-by-step overview of the questions that must be answered in each phase of the development process – from planning all the way through to implementation. “Of course, there will always be certain features that are specific to different countries,” said Vayena. “But the basic principles – respecting autonomy and privacy, promoting health care and solidarity, and preventing new infections and malicious behaviour – are the same everywhere. By taking these fundamentals into account, it’s possible to find technically and ethically sound solutions that can play a valuable role in overcoming the crisis in hand.”