[Skip to Content]
[Skip to Content Landing]

Digital Smartphone Tracking for COVID-19Public Health and Civil Liberties in Tension

Educational Objective
To understand the ethical dilemmas in using smartphones to track COVID-19 outbreaks
1 Credit CME

Contact investigations have been a vital public health strategy, most recently in controlling tuberculosis and sexually transmitted infections including HIV. Yet, the sheer scale of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections poses major challenges to contact investigations. Strategies in China, Singapore, South Korea, and Taiwan have supplemented traditional manual approaches with digital surveillance through smartphone applications.

The US has not used digital surveillance as a tool, but Google, Apple, the Massachusetts Institute of Technology (MIT), as well as 2 pan-European consortia and a variety of independent efforts are developing Bluetooth smartphone technology to enable rapid notification of users that they have had a close exposure to individuals diagnosed with medically verified coronavirus disease 2019 (COVID-19). How does digital tracking differ from manual tracing? Although digital surveillance has the distinct advantages of scale and speed, does it confer sufficient public health benefit to justify adoption given privacy concerns? How do the design choices of digital contact tracing systems affect public health and privacy?

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Lawrence O. Gostin, JD, Georgetown University Law Center, 600 New Jersey Ave NW, McDonough 568, Washington, DC 20001 (gostin@law.georgetown.edu).

Published Online: May 27, 2020. doi:10.1001/jama.2020.8570

Conflict of Interests Disclosures: Mr Cohen reported serving as a bioethics consultant for Otsuka on its Abilify MyCite product. Mr Gostin reported being the director of the World Health Organization Collaborating Center on National and Global Health Law. Mr Weitzner reported being co-principal investigator on the MIT PACT project (https://pact.mit.edu/), which is one of the technologies discussed in this article.

Funding/Support: Mr Cohen was supported by the Collaborative Research Program for Biomedical Innovation Law, a scientifically independent collaborative research program, which is supported by grant NNF17SA0027784 from the Novo Nordisk Foundation. Mr Weitzner’s research group, the MIT Internet Policy Research Initiative, was supported by a grant from the MIT-IBM Watson AI Lab for COVID-19 efforts.

Role of the Funders/Sponsors: The funders/sponsors had no role in the preparation, review, or approval of the manuscript or decision to submit the manuscript for publication.

References
1.
Faulders  K , Pecorin  A , Kim  SR , Rubin  O . States race to start coronavirus testing, a monumental task ahead. Accessed April 22, 2020. https://abcnews.go.com/US/states-race-start-coronavirus-contact-tracing-monumental-task/story?id=70285156
2.
Contact tracing of cases of AIDS, HIV related illness or HIV infection. NY Pub Health Law §2133.
3.
Bond  S . Getting back to normal: big tech’s solution depends on public trust. Accessed April 10, 2020. https://www.npr.org/2020/04/14/834460127/apple-google-team-up-to-develop-cellphone-data-contact-tracing
4.
Park  S , Choi  GJ , Ko  H .  Information technology–based tracing strategy in response to COVID-19 in South Korea—privacy controversies.   JAMA. Published online April 23, 2020. doi:10.1001/jama.2020.6602 PubMedGoogle Scholar
5.
Klimburg  A , Faesen  L , Verhage  P . Pandemic mitigation in the digital age: digital epidemiological measures to combat the coronavirus pandemic. Accessed April 25, 2020. https://hcss.nl/report/pandemic-mitigation-digital-age
6.
Haaretz website. Israel's Top Court: No Shin Bet Tracking of Coronavirus Patients Without Knesset Oversight. Accessed May 25, 2020. https://www.haaretz.com/israel-news/.premium-israel-s-top-court-no-shin-bet-tracking-of-coronavirus-patients-without-knesset-ove-1.8690253
7.
Watson  C , Cicero  A , Blumenstock  J , Fraser  M . A national plan to enable comprehensive COVID-19 case finding and contact tracing in the US. Accessed April 25, 2020. https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2020/200410-national-plan-to-contact-tracing.pdf
8.
Ferretti  L , Wymant  C , Kendall  M ,  et al.  Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing.   Science. 2020;368(6491):eabb6936. doi:10.1126/science.abb6936PubMedGoogle Scholar
9.
Fernandez  E . Privacy and contact tracing apps—Google and Apple debate with world governments. Accessed April 24, 2020. https://www.forbes.com/sites/fernandezelizabeth/2020/04/24/privacy-and-contact-tracing-appsgoogle-and-apple-debate-with-world-governments/#306208f94518
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close
Close

Lookup An Activity

or

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close