Paper by Manuel Morales et al: “COVID-19 testing, the cornerstone for effective screening and identification of COVID-19 cases, remains paramount as an intervention tool to curb the spread of COVID-19 both at local and national levels. However, the speed at which the pandemic struck and the response was rolled out, the widespread impact on healthcare infrastructure, the lack of sufficient preparation within the public health system, and the complexity of the crisis led to utter confusion among test-takers. Invasion of privacy remains a crucial concern. The user experience of test takers remains low. User friction affects user behavior and discourages participation in testing programs. Test efficacy has been overstated. Test results are poorly understood resulting in inappropriate follow-up recommendations. Herein, we review the current landscape of COVID-19 testing, identify four key challenges, and discuss the consequences of the failure to address these challenges. The current infrastructure around testing and information propagation is highly privacy-invasive and does not leverage scalable digital components. In this work, we discuss challenges complicating the existing covid-19 testing ecosystem and highlight the need to improve the testing experience for the user and reduce privacy invasions. Digital tools will play a critical role in resolving these challenges….(More)”.
COVID-19, Death Records and the Public Interest: Now is the Time to Push for Transparency
Paper by Amy Kristin Sanders at the Journal of Civic Information: “As the U.S. has grappled with COVID-19, the government has resisted repeated requests to follow open records laws, which are essential to transparency. Current efforts to reduce access to death records and other public information amid the pandemic jeopardizes government accountability and undermines the public’s trust. Given that COVID-19 has disproportionately affected low-income Americans, incarcerated populations and people of color, access to government-held data has serious implications for social justice. Importantly, those goals can be met without violating personal privacy. After analyzing state open records laws, court decisions and attorney general opinions, the author has developed a set of best practices for advocating access to death records to provide journalists and government watchdogs with important public health information that’s squarely in the public interest….(More)”.
Challenging the ‘Great Reset’ theory of pandemics
Essay by Mark Honigsbaum: “Few events are as compelling as an epidemic. When sufficiently severe, an epidemic evokes responses from every sector of society, laying bare social and economic fault lines and presenting politicians with fraught medical and moral choices. In the most extreme cases, an epidemic can foment a full-blown political crisis. Thus, Thucydides describes how the repeated visitations of plague to Athens in 430-426 BC provoked widespread social disorder and the breakdown of civic norms.
‘Men, not knowing what was to become of them, became utterly careless of everything, whether sacred or profane,’ writes Thucydides. ‘All the burial rites before in use were entirely upset and… many had recourse to the most shameless sepulchres.’
As the plague progresses, Thucydides describes how Athenians were swept up in a wave of hedonism and lawlessness, threatening the foundations of Athenian democracy: ‘Men now coolly ventured on what they had formerly done in a corner… fear of gods or law of man there was none to restrain them.’
The resulting crisis, Thucydides claimed, undermined Athenians’ faith in the rule of law and the democratic principles that underpinned the Greek city state, paving the way for the installation of a Spartan oligarchy known as the Thirty Tyrants. Even though the Spartans were later ejected, Athens never regained its confidence.
Covid-19 appears to have engendered a similar crisis in our world, the main difference being in scale. Whereas the crisis Thucydides describes was confined to Athens, the coronavirus pandemic has destabilized governments from Brazil to Belarus, not just that of a 5th century city-state. The political reckoning has been particularly rapid in the United States, where Donald Trump’s inability or unwillingness to check the spread of the coronavirus was a key factor in his recent election defeat. Now, the lockdowns and social distancing measures look set to plunge the world into the worst economic depression since the 1930s, raising the spectre of further political instability.
Given the wide-ranging social, economic and political impacts of Covid-19, it is natural to assume that the same must have been true of past epidemics and pandemics. But is this the case? Do pandemics really have the historical impacts that are often claimed for them or are these claims simply the product of particular narratives and readings of history? …(More)”.
Getting Everyone Vaccinated, With ‘Nudges’ and Charity Auctions
Richard Thaler at the New York Times: “The good news is that safe and effective vaccines from Moderna and Pfizer appear to be on the way soon and that more are likely to follow.
The bad news is an usual combination: There won’t be enough vaccine on hand to meet initial demand, yet there is also a need to urge everyone to get shots.
I have some suggestions: An unusual type of charity auction, a bit of technology and a few nudges can help….
Economic theory offers a standard method for dealing with shortages. It is, basically: Let markets work. This would mean that those willing to pay the most would get the vaccine first.
Wisely, policymakers are not following this course. Nurses, other frontline workers and most nursing home residents could not win a bidding battle with billionaires. And, to be clear, they should not have to!
Yet there is a small but useful role that prices might play in determining who gets priority in the second round of vaccines, after the first 20 million people have gotten their shots.
At that point, perhaps sometime early this winter, suppose a small proportion of doses are sold in what would amount to a charity auction.
Who might be the winning bidders? Very wealthy individuals and high-tech companies are likely to account for some of the demand, along with businesses that employ high-profile talent like professional athletes and entertainers.
Just imagine how much the National Basketball Association, whose season will start around Christmas, would be willing to pay to ensure that none of its players or staff would be infected! The same goes for Hollywood studios and television production companies that are eager to go back to work.
The prospect of selling off precious vaccine to celebrity athletes and entertainers, hedge fund magnates and high-tech billionaires may strike you as utterly immoral, exacerbating the inequality this disease has already inflicted. But before you dismiss this idea as outrageous, let me make three points.
First, the very purpose of the charity auction would be to redistribute money from the rich to the poor….(More)”.
What the World’s First Medical Records Tell Us About Ancient Life
Essay by Robin Lane Fox: “The Hippocratic books now known as the Epidemics are entitled in Greek epidemiai. This title does not refer to epidemics as we now painfully recognize them, individual diseases which are spread widely through a population, whether by touch, inhaling, contact with wildlife, eating, drinking, kissing (which the elder Pliny, c. AD 70, recognized to be a means of transmitting diseases) or sex, while remaining one and the same disease. In the mid-fifth century BC, the amiable Ion, a poet and author from the island of Chios, composed Epidemiai which referred to his visits to the demos, or people, of individual city-states around the Greek world. His title has sometimes misled readers of the medical Epidemiai into thinking that their title, too, refers to traveling doctors’ visits to particular places. They refer to such visits, but their use of the verb epidemein shows that for them the word epidemia referred to the presence of a disease in a community. It was not necessarily a rampant disease in our sense of the word “epidemic,” and it was not contrasted with diseases which were endemic, a category the authors did not distinguish, but it was certainly a disease at large. This meaning was still correctly understood in later ancient commentaries on the Epidemic books.
By the mid-first century AD, seven books were grouped under this title: the grammarian Erotian referred then to “seven books of Epidemics” in the list of works which he considered, over-optimistically, to be by Hippocrates himself. The title went back to earlier editors, probably at least as early as the third century BC, but it may not have been used by any of the books’ original authors. All seven books share a distinctive feature. Whereas the other texts in the Hippocratic Corpus refer to patients in general, and only once, in passing, name an individual, the Epidemic books are quite different. They contain individual case histories, most of which specify the very place where the named patient lived, even the house or location. They are the very first observations and descriptions of real-life individuals during a number of days which survive anywhere in the world. In Babylonia written case histories of named individuals are unknown.
In China none survives until c. 170 BC, and even then they were presented for a different purpose, to defend their doctor-author’s reputation. In ancient Egypt, cases were discussed individually in the now-famous medical papyri whose contents date back into the second millennium BC, but they never name patients or describe observations of them day after day, let alone locate them at an exact address….(More)”.
John Snow, Cholera, and South London Reconsidered
Paper by Thomas Coleman: “John Snow, the London doctor often considered the father of modern epidemiology, analyzed 1849 and 1854 cholera mortality for a population of nearly half a million in South London. His aim was to convince skeptics and “prove the overwhelming influence which the nature of the water supply exerted over the mortality.” Snow’s analysis was innovative – he is commonly credited with the first application of both randomization as an instrumental variable and differences-in-differences (DiD).
This paper provides an historical review of Snow’s three approaches to analyzing the data: a direct comparison of mixed (quasi-randomized) populations; a primitive form of difference-in-differences; and a comparison of actual versus predicted mortality. Snow’s analysis did not convince his skeptics, and we highlight problems with his analysis. We then turn to a re-analysis of Snow’s evidence, casting his analysis in the modern forms of randomization as IV and DiD. The re-examination supports Snow’s claims that data demonstrated the influence of water supply. As a matter of historical interest this strengthens the argument against Snow’s skeptics. For modern practitioners, the data and analysis provide an example of modern statistical tools (randomization and DiD) and the complementary use of observational and (quasi) experimental data….(More)”
Chatbots RESET: A Framework for Governing Responsible Use of Conversational AI in Healthcare
Report by the World Economic Forum: “When a new technology is introduced in healthcare, especially one based on AI, it invites meticulous scrutiny. The COVID-19 pandemic has accelerated the adoption of chatbots in healthcare applications and as a result, careful consideration is required to promote their responsible use. To address these governance challenges, the World Economic Forum has assembled a multistakeholder community, which has co-created Chatbots RESET, a framework for governing the responsible use of chatbots in healthcare. The framework outlined in this paper offers an actionable guide for stakeholders to promote the responsible use of chatbots in healthcare applications…(More)”.
Intentional and Unintentional Sludge
Essay by Crawford Hollingworth and Liz Barker: “…Both of these stories are illustrations of what many mums and gym–goers may have experienced across the United Kingdom and United States as they tried to cope with the pandemic. We, along with other behavioral scientists, would label both as sludge—when users face high levels of friction obstructing their efforts to achieve something that is in their best interest, or are misled or encouraged to take action that is not in their best interest.
We can think of what the English mum goes through as unintentional sludge—friction due to factors like rushed design, poor infrastructure, and inadequate oversight. The mother is trying to access a benefit that will help her and which she has a right to claim, and which the government genuinely wants her to access. Yet multiple barriers prevented her from accessing the voucher that would help feed her children. Millions of parents found themselves in this situation as schools closed in England earlier this year. All over the country schools ended up paying for food parcels and gift vouchers out of their own budgets to help families who were going hungry.
What the New York gym-goer faces is different. It is intentional sludge—friction put in place knowingly to benefit an organization at the expense of the user. The gym doesn’t want him to cancel the membership, which would mean lost revenue. Even absent the pandemic, the policy would be considered unnecessarily difficult to cancel. The gym’s hope is that people forget, give up, or don’t bother canceling in person or over the phone, or that it takes them longer to do so. This translates into revenue for them, without any of the costs of providing a service. Stories like this have resulted in class-action lawsuits against companies that make it overly difficult or impossible to cancel gym memberships. One lawsuit alleged that one large gym company was stealing over $30 million per month from customers….(More)”.
UK response to pandemic hampered by poor data practices
Report for the Royal Society: “The UK is well behind other countries in making use of data to have a real time understanding of the spread and economic impact of the pandemic according to Data Evaluation and Learning for Viral Epidemics (DELVE), a multi-disciplinary group convened by the Royal Society.
The report, Data Readiness: Lessons from an Emergency, highlights how data such as aggregated and anonymised mobility and payment transaction data, already gathered by companies, could be used to give a more accurate picture of the pandemic at national and local levels. That could in turn lead to improvements in evaluation and better targeting of interventions.
Maximising the value of big data at a time of crisis requires careful cooperation across the private sector, that is already gathering these data, the public sector, which can provide a base for aggregating and overseeing the correct use of the data and researchers who have the skills to analyse it for the public good. This work needs to be developed in accordance with data protection legislation and respect people’s concerns about data security and privacy.
The report calls on the Government to extend the powers of the Office for National Statistics to enable them to support trustworthy access to ‘happenstance’ data – data that are already gathered but not for a specific public health purpose – and for the Government to fund pathfinder projects that focus on specific policy questions such as how we nowcast economic metrics and how we better understand population movements.
Neil Lawrence, DeepMind Professor of Machine Learning at the University of Cambridge, Senior AI Fellow at The Alan Turing Institute and an author of the report, said: “The UK has talked about making better use of data for the public good, but we have had statements of good intent, rather than action. We need to plan better for national emergencies. We need to look at the National Risk Register through the lens of what data would help us to respond more effectively. We have to learn our lessons from experiences in this pandemic and be better prepared for future crises. That means doing the work now to ensure that companies, the public sector and researchers have pathfinder projects up and running to share and analyse data and help the government to make better informed decisions.”
During the pandemic, counts of the daily flow of people from one place to another between more than 3000 districts in Spain have been available at the click of a button, allowing policy makers to more effectively understand how the movement of people contributes to the spread of the virus. This was based on a collaboration between the country’s three main mobile phone operators. In France, measuring the impact of the pandemic on consumer spending on a daily and weekly scale was possible as a result of coordinated cooperation between the country’s national interbank network.
Professor Lawrence added: “Mobile phone companies might provide a huge amount of anonymised and aggregated data that would allow us a much greater understanding of how people move around, potentially spreading the virus as they go. And there is a wealth of other data, such as from transport systems. The more we understand about this pandemic, the better we can tackle it. We should be able to work together, the private and the public sectors, to harness big data for massive positive social good and do that safely and responsibly.”…(More)”
Open government data, uncertainty and coronavirus: An infodemiological case study
Paper by Nikolaos Yiannakoulias, Catherine E. Slavik, Shelby L. Sturrock, J. Connor Darlington: “Governments around the world have made data on COVID-19 testing, case numbers, hospitalizations and deaths openly available, and a breadth of researchers, media sources and data scientists have curated and used these data to inform the public about the state of the coronavirus pandemic. However, it is unclear if all data being released convey anything useful beyond the reputational benefits of governments wishing to appear open and transparent. In this analysis we use Ontario, Canada as a case study to assess the value of publicly available SARS-CoV-2 positive case numbers. Using a combination of real data and simulations, we find that daily publicly available test results probably contain considerable error about individual risk (measured as proportion of tests that are positive, population based incidence and prevalence of active cases) and that short term variations are very unlikely to provide useful information for any plausible decision making on the part of individual citizens. Open government data can increase the transparency and accountability of government, however it is essential that all publication, use and re-use of these data highlight their weaknesses to ensure that the public is properly informed about the uncertainty associated with SARS-CoV-2 information….(More)”