from the connecting-the-dots dept.
Pamela Engel writes that Americans need only look to Nigeria to calm their fears about an Ebola outbreak in the US. Nigeria is much closer to the West Africa outbreak than the US is, yet even after Ebola entered the country in the most terrifying way possible — via a visibly sick passenger on a commercial flight — officials successfully shut down the disease and prevented widespread transmission. If there are still no new cases on October 20, the World Health Organization will officially declare the country "Ebola-free". Here's how Nigeria did it.
The first person to bring Ebola to Nigeria was Patrick Sawyer, who left a hospital in Liberia against the wishes of the medical staff and flew to Nigeria. Once Sawyer arrived, it became obvious that he was ill when he passed out in the Lagos airport, and he was taken to a hospital in the densely packed city of 20 million. Once the country's first Ebola case was confirmed, Port Health Services in Nigeria started a process called contact tracing to limit the spread of the disease and created an emergency operations center to coordinate and oversee the national response. Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected. As soon as people developed symptoms suggestive of Ebola, they were isolated in Ebola treatment facilities. Without waiting to see whether a "suspected" case tested positive, Nigeria's contact tracing team tracked down everyone who had had contact with that patient since the onset of symptoms making a staggering 18,500 face-to-face visits.
The US has many of these same procedures in place for containing Ebola, making the risk of an outbreak here very low. Contact tracing is exactly what is happening in Dallas right now; if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested. “That experience shows us that even in the case in Nigeria, when we found out later in the timeline that this patient had Ebola, that Nigeria was able to identify contacts, institute strict infection control procedures and basically bring their outbreak to a close”, says Dr. Tom Inglesby. “They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria… I do believe we will stop it here.”
Ross Anderson, a researcher at the Security Group at the University of Cambridge Computer Laboratory, has written about contact tracing in the real world enumerating in detail some of the many shortcomings with and false assumptions about contact tracing as means of fighting a pandemic.
There are also real systems being built by governments. Singapore has already deployed and open-sourced one that uses contact tracing based on bluetooth beacons. Most of the academic and tech industry proposals follow this strategy, as the “obvious” way to tell who’s been within a few metres of you and for how long. The UK’s National Health Service is working on one too, and I’m one of a group of people being consulted on the privacy and security.
But contact tracing in the real world is not quite as many of the academic and industry proposals assume.
First, it isn’t anonymous. Covid-19 is a notifiable disease so a doctor who diagnoses you must inform the public health authorities, and if they have the bandwidth they call you and ask who you’ve been in contact with. They then call your contacts in turn. It’s not about consent or anonymity, so much as being persuasive and having a good bedside manner.
He is not alone in pointing out that claims of being able to anonymize personal data have largely been proven to be bunk. The rules we set in place now will be with us for a long time and have far-reaching effects. The need to be given an appropriate level of consideration.
Security researcher Bruce Schneier posted his concerns on the same contract tracing story.
(2020-04-11) Apple and Google are Launching a Joint COVID-19 Tracing Tool for IOS and Android
(2020-04-08) Senators Raise Privacy Questions About Google's COVID-19 Tracker
(2014-10-16) How Nigeria Stopped Ebola