COVIDSafe app

I know it’s not right. I feel it’s not right. Just because I lack the vocabulary to argue my point does it mean my position is untenable?

Well, no. But it certainly doesn’t help.

In such situations I find it best to put my head down, move away, and hope that no one notices. A problem arises when my position is challenged and I substitute something else in place of that visceral response which sorta sounds right and, when I say it out loud, sorta feels right, and I drift towards that position. At a fundamental level I think we are all a bit like that. But let’s talk about the COVIDSafe app or, more accurately, the conundrum of “privacy” in a data-driven world.

Life is priceless. That is to say that an individual life lost, be it in measured in days, years, or a lifetime, cannot be brought back by any amount of money. But in a communal sense life has a price. That is to say that society can - and does - put a price on what it is prepared to pay to save a life. In 2015 GiveWell estimated the price to save one life by donating to the Against Malaria Foundation to be USD $3,337.40. In 1985 Ronald Reagan made a deal to sell weapons to Iran in exchange for help freeing 39 US hostages held by Hezbollah in Lebanon while proclaiming he would “never make concessions to terrorists”. QALY (quality-adjusted life year) is a measure of disease burden that allows comparisons of health interventions for different conditions the analysis of which helps determine the cost-effective threshold for a given intervention. At the turn of the century the average cost of prepping and treating a patient with leukaemia in Australia with an allogeneic bone marrow transplant was AUD $250,000 with a survivorship of 60%.

Tomorrow’s world has autonomous vehicles challenged by the trolley problem posed as a real-world dilemma (as opposed to an interesting thought bubble). If there is a choice between striking down an elderly man who has wandered onto the road vs striking 5 children standing on a footpath what action should the autonomous vehicle take? What if the calculations indicate that the elderly man will almost certainly die if struck by the vehicle’s current trajectory but 3 of the 5 children might have moderate injuries but none will die if the car mounts the curb? What if the elderly man standing on the footpath and it is the children who wandered onto the road?

These are tough questions. The general flattening of the COVID-19 pandemic should give us pause to reflect on the social, psychological and economic ramifications of the worldwide response to it.

Let’s be clear that certain institutions full of very smart people exist specifically to ask these questions and provide guidance and answers. Governments can and should act on such advice and thereby implement rules and recommendations. I think it is fair to say that Australia has done well in this regard and the largely bipartisan support in the approach to COVID-19 has been effective.

Now let’s ponder three questions.

Who are at greatest risk of dying from COVID-19?

Who pays for the interventions used to control this disease?

What will change in order to manage this pandemic and mitigate the effect of future pandemics?

Australia is not Italy nor is it the United States. Australia has had a low infection rate for COVID-19 for a number of possible reasons. It is geographically isolated. It was able to learn from the experience of other countries (namely Italy where the disease appeared to start earlier and went like the clappers). It was able to impose a lockdown quickly and effectively. It has a reasonable safety net and a relatively healthy population (I should add a qualifier here: Australia’s indigenous community are mostly rural where infection rates are lower but they remain a high risk group). Australia has a broadly homogenous and competent medical system. And SARS-CoV-2 struck the northern hemisphere in winter while Australians were still enjoying summer.

So what’s next?

The scenario with the old man and the group of children is a common example used for the trolley problem and conveniently provides an analogous solution to the first two questions posed above. In Australia, and generally worldwide, the old and the frail die from the trajectory of COVID-19. The cost of mitigating the natural course of COVID-19 will be borne by the young. Regardless of how clever you want to be about economics there is a cost to pay and this cost rests on the shoulders of future generations. If you think that this can be blown off through fancy financial structures then recognise that the planet we live on is not some inexhaustible asset that can be pillaged without fear of repercussion. The planet is a bountiful resource. But we need to treat it carefully. And we already tested the limits to the point that many - especially young people - felt that things needed to change before anyone knew anything about COVID-19 (think climate change, over-fishing, crop monocultures, pollution etc).

Every life has incalculable value to the individual and to those around them. But just because life is precious does not mean that it cannot be priced. If you choose to take the metric of lives lost from COVID-19 then you must also accept the metrics used to determine the price needed to offset such a loss. QALY is a more nuanced and useful measure but is harder to implement (as is any tool that requires greater granularity in the dataset). It is also political suicide to suggest that a rich, liberal society with a Christian monotheistic background would consider the life of a sick or old person to be less worthy than that of a well or young person. It suffices to say that many (but by no means all) people that have died from COVID-19 are older and/or suffer other ailments.

At this point in time epidemiologists, economists and social scientists generally agree that the money and effort thrown at the COVID-19 pandemic is, and has been, worthwhile even as the cost of such measures and the future of the world economy remains unclear.

So where we are heading with COVID-19? In short, I don’t know.. and neither does anyone else. The Australian Federal Government launched the COVIDSafe app a week ago at 6pm on the 26 April 2020. This is an app that has the capacity to trace contacts of an individual over a 21 day period providing that bluetooth is turned on and the smartphones are within 1.5m of each other. It is one of the key components for allowing the relaxation of physical distancing measures currently used to combat COVID-19. There are a number of technical and practical issues but the concept and implementation has rock solid foundations. If people want to do what people generally want to do - ie hang out together - then the reality of COVID-19 means they should download and activate the COVIDSafe app. This app requires a greater than 40% participation rate to be useful as a contact tracing tool. As of Friday, 1 May 2020, 3.5 million Australians (population 25 million of which 16 million carry smart phones) have downloaded the app.

One reason against getting the COVIDSafe app is that it might not be required. This might be more sensible than it sounds. The Northern Territory and Western Australia are two regions in Australia with very low infection rates of COVID-19 and are quite comfortable keeping their borders locked while the other states get their game in order. In a couple of weeks these two territories might well be rid of COVID-19 and get back to socialising in pubs and restaurants (as they are expected to). But they will need to remain extra vigilant. Cautious optimism should be exercised given that Australia, in general, tests only those with symptoms and those that have come into contact with COVID-19 while the latest data from China suggest that most of the current cohort testing positive for SARS-CoV-2 are asymptomatic. Nonetheless these two Australian regions have relatively small populations and good infrastructure and may well succeed where others have failed. China being the exception*.

And this is the conundrum. The opposition to the COVIDSafe app is mainly that of privacy and there can be no doubt that there are very real concerns in this area. But I’m not so sure that this is the main reason. Sure, the topic that encompasses “privacy” is what most people think is the reason for their opposition to the COVIDSafe app but given the way search engines, social networks, online entertainment, and mapping tools work (and the way algorithms work in general) I suspect that privacy is a word many people attach to fears of tracking, tracing and surveillance but deep down a much harder to define issue lies at heart. The issue at heart might be what it means to exist as a human. The idea that one should be allowed the freedom to do and say and think and experience and express whatever might arise from an entrenched belief in free will and individual rights and that such things should flourish above all else is an identity that many people share. Make no mistake, wars have been fought and many have died in the preservation of such beliefs. This is identity, not privacy. It is individualism as opposed to collectivism.

Why some people are comfortable spending time on TikTok and Zoom but are uncomfortable with downloading COVIDSafe citing concerns about privacy and autonomy seems illogical but the absurdity exists. In abundance. The fact that many are young and internet savvy suggests either herd mentality with selective defocussing or an inability to express a visceral concern for the impact of COVIDSafe on personal identity. I’m not a social scientist but I do know where I stand on this. I recognise that privacy has long been waylaid in a world that moves ever faster and is largely driven by market forces and convenience. I am coming to terms with that. The Australian government can already access a vast network of cameras out there in the community in the name of law enforcement. That, and more. COVIDSafe is a step up in potentially overt surveillance and comes attached with a government request for rapid assimilation. As a person that watched the events of Tiananmen unfold in April-June 1989 and sees COVIDSafe as the thin end of a wedge (COVID-19 is out of the bag and cannot be eradicated without herd immunity or an effective vaccine; this is not the first pandemic and certainly won’t be the last; a pandemic is, by definition, a global problem; a global problem requires a means for countries to interface and share identification data in order for borders to reopen; the problem of oversight and asymmetry in governance and technology between countries; the possibility that this is another entry point for AI to establish oversight) resulted in an immediate objection to it. 

But I might have reasoned my way through it. 

For me, the conscious experience of life finds its greatest rewards in things that are remarkably difficult to pin down. The moment of being in the present, the recollection of things that have passed, the expectations of the future; the sensation of joy, hope, love, sadness, anger, fear, grief; the process of doing a job, being in the garden, playing with a toy, or watching someone else play with a toy; beauty, passion, wonder; the achievement of goals; the pain of love lost. I think that these are the most precious things we experience in the time we are given. The most precious things in the timeline we call life. We can barely put words to them without somehow diminishing their value. And we can’t properly measure them. This is identity. This is what it means to be me.

The COVIDSafe app is simply a tool. But its application suggests something about an individual’s place within society that, for some, doesn’t bear reminding. A data-driven world targets the individual and the fact that it works remarkably well reinforces the business model honed on opportunity and the increased sense of personal identity of the user that evolved with it. The speed and severity of COVID-19 galvanises the collective and the role of the individual within the community. Yes, you are individual. Take a bow. But you and the details of your experiences are not in any way special. 

For a person that rarely cooks I think a lot about food. It is sustenance and convenience usually packaged in a frozen or takeaway meal. But the efficiency of convenient food suits where I am in life. I am aware that food means different things to different people. The preparation, giving, sharing, and partaking of food is a social event in many societies. In the past food was a much more communal affair. Way back in hunter-gatherer times food was work and recreation that took the better part of the day. The concept of food has evolved and gained complexity. At its essence food is about calories and nourishment. And yet it is so much more.

For a person that doesn’t study physics I have spent a lot of time pondering entities that are better understood in terms of mathematical equations. Not understanding the maths does not preclude the ability to wonder what a physicist might find inexplicable and yet entirely tractable. That light is understood in terms of its passage through space only encompasses the observer’s impression of what light is when taken as an identifiable entity. Even then the act of measurement and description forces it into a specific state of existence which is but one of an infinite number of possible solutions. And yet we have lasers and X-rays and MRI machines and radar and radio and television and fiberoptic cables. We can’t really describe what light actually is and yet that doesn’t stop us applying what do know about it and exploring its curious interaction with matter. Call it what you will but that’s progress. Without a microwave my food is less conveniently cooked.

In short, you can’t unmoor the metaphysical from the physicality of existence. That’s not to say that the physical world constrains the metaphysical, just the observation that changes to the former has consequences for the latter. The COVIDSafe app is a state surveillance tool - it isn’t the first and it won’t be the last. We live in a free and lucky country but the world is changing fast. You may feel compelled to download COVIDSafe for financial or economic concerns; others may do so because of faith in the government response to COVID-19; others again simply think it is the right thing to do; a doctor might feel obliged to follow the direction of colleagues more learned in the area. But for some COVIDSafe is seen as an intrusion of civil liberties or capitulation to a treatment plan they cannot come to terms with. Many Australians - from a wide variety of backgrounds - do not share the collectivism of their Asian neighbours. 

In times of crisis Australians will do what Australians generally do better than anyone else: they don’t equivocate, they just get on and muddle through the mess. Some will download the COVIDSafe app. Some will not. There is respect for the choice the other has made. But I’m a precious princess: if we tread in the footsteps of those that trod the earth before us I want to know where we stand so I can see where we are going in order to make my peace with it. 

What I see is inevitability. 

*New Zealand took a different approach to extreme lockdown measures and is stepping down from this but only China has properly stepped down to the position where their factories and shops are open while New Zealand has merely stepped down to where Australia currently stands on lockdown.