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Technology to Combat the Spread of COVID-19

April 24, 2020

On January 27,2020, we came down to our breakfast dining area in a wonderful hotel in Bangkok to discover that the guests from Wuhan, China had left the previous evening. It turns out that they had fled Wuhan several weeks before as the rampant spread of the disease was generally known there at that time, despite the failure of the Government of China to alert the world of the future pandemic. On the other hand, all of the signs and coverage of the impending pandemic quickly became apparent though the western world chose to ignore the viral tidal wave ahead. In fact, some leaders were in total denial stating that it would disappear in warmer weather as seasonal influenza does.

However, the Wuhan Chinese were ordered home by the Chinese Government through individual WeChat transmissions as the government knew where these people were at that moment. This action seems like something out of a George Orwell novel as "big brother is watching" through everyone's cell phone. Nonetheless, their forced return home seemed reckless as they were returning to the source of the disease after having safely escaped and were in good health. The Harvard Business Review published an article entitled How Digital Contact Tracing Slowed Covid-19 in East Asia.
It is easy to understand in the totalitarian world of Orwell that exists in China today that cell phones could be used to order people around in remote locations. However, data shows that the type of regime is less important than it might seem. Both the top and bottom performers in Covid-19 containment cover the spectrum from autocratic to democratic. China flattened the curve. Whereas, the vibrant democracy of South Korea did as well while the U.S., Spain, Italy and France have not demonstrated the same results. The authors of the article, Yasheng Huang, Meicen Sun and Yuze Sui, have put forward the theory that the countries in East Asia tend to be actively deploying technology to collect data on the virus's progress and efforts to contain it, including tracking those who are infected and their contacts.

The Economist recently published an article entitled App-Based Contact Tracking Devices May Help Countries Get Out of Lockdown. The application would require frequent testing as well as clear invasion of personal liberties which would cause a conflict in many different cultures and societies which poses another dilemma. Further, testing that confirmed the presence of antibodies would require identification that the individuals were cleared to return into society from previous self-quarantines.  
Not only did China provide the source of the Covid-19 virus and originate the pandemic, they have created an App that can track victims by residence in China. There goes the neighborhood and property values.
The Japanese have been developing Covid-19 technology and adaptations to their culture that in some cases are peculiar to their lifestyle. The Nikkei Asia Review recently published several articles about technology advancements in light of the fear of touching surfaces that has developed in response to the pandemic. The most notable is touching entrances and being forced to remove a mask for identification purposes. Images of the individuals wearing masks, sun glasses or hats are fed into artificial intelligence applications for future recognition purposes. Employees at NEC Electronics no longer have to remove their mask for facial recognition purposes to enter secure areas. This application is being introduced into the market.  
The reluctance to touch anything is being solved by the development of applications to preclude the need to handle greasy food menus. The image is projected on a surface to read and from which to place a verbal order. 
Infrared capability on elevators and doors can eliminate the need to touch buttons as the commands are addressed by waving a hand.
Moreover, old habits are eliminated due to the change in work conditions from home. In the early seventies, during a three-year tour in Japan, it was mystifying that all checks had to be signed and stamped by a registered personal hanko or chop which was kept in the office safe. Well, electronic work conditions have eliminated this archaic relic as electronic signatures have reduced the number of personal signatures. Somehow, it did not seem possible for Donald Trump to personally sign the millions of bail-out stimulus checks that were recently mailed out though the application of the facsimile signature likely caused a delay in getting the funds out. On the other hand, like other things that have exhausted their shelf-life, it was time for the hanko, shown below, to be relegated to a museum.
The clear debate is one of a loss of personal freedoms balanced by the need to protect the health and welfare of mankind. A very recent development in Massachusetts described in The New York Times article An Army of Virus Tracers Takes Shape in Massachusetts illustrates the old-school method of direct dialing using a fleet of contact tracers responsible for tracking down people who have people who have been exposed to Covid-19. Massachusetts is the first state to invest in an ambitious contact-tracing program, not unlike that implemented in Vietnam over a month ago.

Governor Charlie Baker has budgeted $44 million to invest in this ambitious program. The objective is to identify pockets of infection as they emerge so as to prevent infected people from spreading the virus further. Interestingly, Jim Young Kim, a co-founder of Partners in Health, who recently stepped down as president of the World Bank, suggested it to Governor Baker. It worked successfully in South Korea, so why not try it here by dialing for data. Dr. Kim emphasized his point that social distancing is inadequate to bring the infection rate low enough to lift the current restrictions. There is certainly no shortage of available workers given quarantines and those who have lost their jobs.

Dr. Paul Farmer, one of the co-founders of Partners in Health, is shown below leading a video training session for newly contracted tracer staff. There is a potential army of people who could be enlisted in this most worthy cause to be guided by Dr. Farmer who dedicates his time as a volunteer to direct the effort.
Given the gravity of the pandemic, it would make sense to employ every weapon possible, both in terms of technology as well as human effort. Telephone pinging may be acceptable in a crisis environment as it can be reversed to protect privacy when the crisis has passed. The clear danger is reversing whatever gains have been achieved from social distancing by returning to an "open for business" environment prematurely. Moreover, if we cannot adequately test people for the virus and, perhaps more importantly for antibodies, whatever gains achieved in the past several weeks could be rapidly reversed.

Japan is one example that recognized their situation early though they made certain trade-offs to protect the Olympic Games. Once the Olympics were deferred, they took greater containment and identification actions but the human toll grew in that interim period. Sadly, the U.S. has chosen to suspend funding of the World Health Organization at this most critical time in history. Global efforts to contain the pandemic by joining hands to share information and resources should not be abandoned due to the actions of its leader, Tedros Adhanom Ghebreyesus. As an Ethiopian, his country is deeply financially indebted to China and he deferred to the Chinese wishes in the beginning before he announced the gravity of the Covid-19 impending pandemic.

Most importantly, the U.S. has much to learn from others as we seem to cover both ends of the statistical comparisons-high in death rates per capita and near the bottom of number of tests per confirmed case of Covid-19. Not surprisingly, those statistical relationships carry through most country comparisons with Vietnam and Taiwan showing the best results for their people. Never since the bombing of Pearl Harbor has the U.S. ignored all of the clear signals of disaster and still cannot come to grips as to what to do next other than return to "normal" and "back to work."

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