Topics Data utilization in a new coronavirus infection epidemic Focusing on the case of the contact confirmation application

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Yasuhiko Nakatsuka, Senior Researcher, Pharmaceutical and Industrial Policy Research Institute

1. Introduction

On December 31, 2019, a new type of coronavirus (SARS-CoV-2, and the resulting disease was named COVID-19) reported as a new type of pneumonia of unknown cause in Wuhan, China, quickly spread throughout the world. and about 400,000 people have died.

Countries around the world have imposed legally binding city lockdowns, and in Japan, a state of emergency has been declared, with restrictions on people's movement and other severe repercussions for social and economic life. Although the impact of the earthquake was less severe than in Western countries, thanks to the efforts of many people, including government officials and medical personnel, it has so far caused nearly 1,000 deaths and had various effects on people's health and livelihoods. The outbreak also served as a reminder of the important role played by pharmaceuticals in supporting safety. Six months have now passed since the outbreak, city blockades have been lifted in many countries around the world, the state of emergency has been fully lifted in Japan, and expectations are high for the resumption of economic activities. At the same time, however, the lifting of the state of emergency has come as a precaution against the second wave of infection, and it is expected that individual awareness of self-protection and control against infection will remain high.

In this series of responses to the new coronavirus, attention has focused on the use of digital data in medicine, healthcare, and social life in general. During the new coronavirus epidemic, not only information is collected to analyze the situation of the new virus infection, but also statistical data such as railroad congestion and the population influx rate to the area, etc., by utilizing data collected through the location-based services of cell phones, communication applications, transportation IC cards, and other functions possessed by individuals Data on people's lives and behavior has become an important tool for infection control. In addition, from the perspective of infection prevention in emergency situations, the use of digital technology, such as online medical services to reduce human contact, online classes, and the expansion of telework, is rapidly becoming more generalized. There is a sense that the pandemic caused by the coronavirus has energized the movement toward the digitalization of society all at once.

This paper reviews the use of data in a coronavirus pandemic and reports on the "contact confirmation application" being considered by governments around the world as a concrete example of such a system.

2. data utilization

Detailed data on many infected people, treatment methods, etc., have already been accumulated and are being studied for medical and healthcare purposes, including genetic mutations of new coronaviruses, pathogenic mechanisms and factors in disease severity, and evaluation of vaccines, new drugs, and repositioning. While digital data is of course becoming increasingly useful in such responses, social behavior change is simultaneously required in the response to infectious diseases associated with this global pandemic, and the importance of digital data collection and utilization for this purpose was strongly recognized.

Under the state of emergency declaration, people were forced to change the social activities they had been engaged in by refraining from going out. The use of digital networks also made great progress, with many companies adopting teleworking and web conferencing for their operations. In the medical field, the Ministry of Health, Labor, and Welfare issued an administrative notice on April 10, 2020, regarding the "Temporary and Exceptional Handling of Medical Treatment Using Telephones and Information and Communication Devices in the Spread of New Coronavirus ^Infections1)," which had previously been limited to follow-up visits, etc., allowing initial medical examinations and prescriptions of drugs online. and prescribing of drugs online.

In utilizing data to promote behavioral change, it is important to collect and share information on novel coronavirus infection, accurately understand the situation based on this data, and take appropriate measures. Information on the infection of new coronaviruses is often accessed through various media, such as news programs, news and newspapers. From the infection status of the entire world to that of various regions and facilities in Japan, the public, private, and academic sectors are using a variety of tools to visualize the data and update it on a daily basis. For example, the World Health Organization (WHO), one of the websites that updates global infection information, shares COVID-19 global infection information and important updates in the form of daily "Situation ^reports2) ". In the U.S., Johns Hopkins University provides a dashboard that visualizes information on the global infection area, infection rate, and regional breakdown of the number of deaths, using maps and other tools ^{.3) Similarly}, The New York Times (New York Times) and The New York Times (New York Times) provide information on COVID-19. The New York Times also provides a ^dashboard4). The Centers for Disease Control and Prevention (CDC) also provides a dashboard, but it is limited to an overview of the United ^States5).

In Europe, the European Centre for Disease Prevention and Control (ECOC) updates the "COVID-19 situation update ^worldwide6) " daily.

In Japan, the Ministry of Health, Labour and Welfare (MHLW) is also providing daily updates and disseminating the "Current situation of novel coronavirus infection and MHLW's ^response7). After the lifting of the emergency declaration, the Tokyo Metropolitan Government has created a "Tokyo ^Alert8) " to accurately inform the public of the infection situation in the city and call for vigilance, and has set monitoring ^indicators9) for infection to prepare for the second wave of infection. The use of data to promote behavior change can be broadly categorized as follows.

(2) Information on (2) is also becoming widely available through the mass media. Furthermore, railroad companies and transportation applications have begun to provide services such as displaying the congestion status of trains and presenting information on available connections. In addition, the development of applications that can take countermeasures against the spread of infection by (3) is attracting attention because of its connection to cluster countermeasures and the monitoring of nosocomial infections. In the next section, we will discuss the details of "contact confirmation applications," which are classified as (3).

Types of Contact Confirmation Apps for the New Type of Coronavirus

With the full lifting of the state of emergency declaration, people are expected to have more opportunities to go out and have more contact with others. Under such circumstances, the development and use of contact confirmation apps (called contact tracing apps in other countries) for people infected with the new coronavirus are beginning to be considered.

Contact confirmation apps are mostly of the type that use Bluetooth, a short-range wireless communication standard for smartphones, to notify contact with an infected person. There are reports that the introduction of such apps that detect contact has spread to more than 60 countries, but the first country to start providing apps was China, where the National Health and Health Commission (NHC) released a "Concentrated Contact Detection App" to the public on February 9, ^202010). This app informs the user whether or not he or she was in the vicinity of a person confirmed or suspected to be infected with the new virus.

The purposes for which such contact confirmation apps are used vary from country to country and can be broadly classified into three categories as described below.

While contact confirmation apps are used for each of these purposes, the characteristics of contact confirmation app specifications are classified into four categories as shown in Figure 1.

There are four types of contact person data: the "location-based type," in which location information is used to allow authorities to identify app users who have been in contact with infected users; the "Bluetooth and personal identification type," in which personal information such as phone numbers is used to allow authorities to identify and contact contact contact persons; the "Bluetooth and anonymous (central server processing) type," in which each user's contact person data is managed on a server owned by the authorities; and the "Bluetooth and anonymous (smartphone terminal processing) type," in which each user's contact person data is managed on his/her terminal. Bluetooth and anonymous (central server processing) type," and "Bluetooth and anonymous (smartphone terminal processing) type," in which each user's contact person data is managed by each user's terminal. The type used for the above-mentioned purpose (1) is the use of "location-based" applications.

India and Israel, which use the "location-based type," have a relatively greater impact on privacy compared to the other methods (Figure 2). (Figure 2)

For example, in India, an app called "Aarogya Setu" is used to trace contact history with infected persons using cell phone location data. The app also allows users to check their own risk of infection based on their online chat and contact history with infected persons. However, it is unclear how personal information, such as phone numbers, and location data associated with them obtained by the authorities will be used in this application, and the problem is that transparency is not sufficiently ensured.

Australia and Singapore use the "Bluetooth and personal identification type," which requires the acquisition of phone numbers and other information, and personal information is held by the government or authorities.

The United Kingdom, France, Germany, Switzerland, and other countries are operating or considering the use of anonymized information via Bluetooth, and the impact on privacy is expected to be relatively small. Each country seems to be trying to find a balance between public opinion on privacy and the demands of public health, and each country seems to be responding to its own situation.

In Japan, the government-led "Secretariat of the New Coronavirus Infectious Disease Control TechTeam," which is studying the use of technology to prevent the spread of new coronavirus infection, ¹¹⁾ is discussing efforts to introduce contact confirmation applications. ¹²⁾ In addition, the government is also considering the use of technology to prevent the spread of new coronavirus infection, and is currently working on the introduction of a new contact confirmation application. The purpose of the Contact Confirmation App of the "TechTeam Secretariat for Countermeasures to Combat New Coronavirus Infections" is to (3) "confirm changes in one's own behavior" by using smartphones, and they are considering adopting a "Bluetooth anonymous (smartphone terminal processing) type" application. The government is also considering the use of a "Bluetooth anonymous (smartphone terminal processing) type" for the purpose (2), which is "to notify the person in close contact when he/she is found to be infected, and to enable the person in close contact to register himself/herself in the national system for identifying and managing persons infected with new-type coronavirus (tentative name), subject to privacy protection and the consent of the person in question. (Figure 3)

The government will introduce a system for efficient infection control and monitoring of infection status, including the use of contact confirmation applications, SNS, and other technologies, as early as possible, and will collaborate with the Ministry of Health, Labor and Welfare and health centers to take more effective cluster countermeasures. In order to prevent the spread of the disease, we will make it known that it is effective to monitor the infection status of event participants by using contact confirmation applications and SNS, etc., which are under consideration for introduction. The specifications of the contact confirmation application under consideration in Japan include the use of Bluetooth to record "contact" between users of the application on their smartphones. Contact is defined as "a continuous state of proximity of at least 15 minutes at a distance of approximately 1 meter or less. Currently, Google and Apple are jointly developing an Application Programming Interface (API) for contact verification ^{applications13)}, and applications in Japan are being considered and developed for release in June 2020, utilizing this API. One of the features of this API is that it uses Bluetooth and does not collect GPS information (location information); the Bluetooth identifier is only an identifier that cannot identify an individual, and personal information such as location, phone number, and e-mail address is not obtained. Records after 14 days will be deleted. In addition, users themselves will be able to operate the application, and they will be able to choose whether or not to report a positive diagnosis. (Figure 4)

4. issues

There are some problems, however. In order for the public to actually use the app, it will be necessary to provide an app that can be trusted by the public while ensuring privacy protection and transparency. In the above-mentioned APIs that Google and Apple are planning to provide, privacy and security issues accounted for more than half of the answers in the ^Q&A14), and it appears that careful consideration will be given to privacy protection and transparency, and these issues will be addressed.

However, it does not necessarily follow that app use will spread once security and privacy concerns are eliminated. In fact, in Singapore, where the contact verification application "Trace Together" was introduced early on, only about 25% of the population uses the application due to concerns about privacy violations. In Iceland, where progress is being made in the use of IT technology and genome information, the contact verification application "Rakning C-19," developed with government support, is reported to have a 38% penetration rate among the entire population. It is pointed out that at least 60% use of the contact verification application is necessary to make it ^effective15), but achieving a 60% penetration rate is expected to be extremely difficult. Therefore, in order to spread the use of apps, it is important that data providers (the public) realize the benefits of using apps, and it will be necessary to consider how to return value to data ^providers16).

5. summary

The fight against new coronas is expected to be a long-term battle, and the introduction of contact confirmation apps is expected to be one of the useful tools in preventing the second wave, such as contributing to the early and effective implementation of cluster control measures. It is hoped that the development of such apps will lead to further expansion of their use as the public enjoys the benefits in a tangible way. In the future, it is likely that apps and data will be similarly utilized not only for new coronaviruses, but for new infectious diseases as well.

It is necessary to pay sufficient attention to privacy protection and security when using data and applications, but it is not difficult to imagine that it will be important to ensure transparency sufficient to gain the public's trust, to inform the public in order to encourage use, and to provide value-added benefits to the public.

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