What should the private sector do?

After learning about the essential epidemiological concepts, you can understand the importance of all the above measures like social distancing, quarantine, stay-at-home, all efforts to “flatten the curve”. In theory, we know we must implement these public health measures in order to be effective in response to this pandemic. What that looks like in real-life application drastically varies. Effective application of these theoretical epidemiological concepts must be done to achieve the shared goal of decreasing the severity of the pandemic and its effects. Tackling these aspects are paramount to the success of influencing the response. We will discuss certain actions that the private sector should take in response to the reality of this hellish pandemic, specifically the importance of addressing social distancing, contact tracing, testing kits and related privacy concerns involved.

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Social Distancing and Privacy Concerns

Social distancing, also known as physical distancing, is one of the main instructions guided by infectious disease experts and epidemiologists around the globe. In the U.S., the CDC states how to protect yourself: “everyone should avoid close contact with people who are sick (even inside your home), stay at least 6 ft between yourself and other people outside of your home, don’t gather in groups, and stay away from crowded places” [1]. The touted phrase “social distancing” has been thrown around by regulators and lawmakers, creating a buzz word for people all over the world. We see that people of all backgrounds have been quick to use hashtag #SocialDistancing illustrating different activities that either support the movement, or provide ironic responses and call out people for disobeying the guidelines. Social distancing has become a new norm. Nearly everyone is aware that we should be practicing it. This section aims to address how successful implementation of social distancing rules requires enforcement, including the involvement of machine learning and privacy regulation. Discussion will entail how the path to clarity on social distancing is elusive and complex.

 

Once the government deemed that only essential businesses were allowed to stay in operation, there was a rush to change business practices to properly respond to Covid-19.  Essential businesses include: restaurants, grocery stores, shipping and mailing centers, pharmacies, etc. How exactly will it be implemented and enforced? Guidance have been released by the CDC, telling employers and businesses that they “should implement and update as necessary a plan that: is specific to your workplace, identifies all areas and job tasks with potential exposures to Covid-19, and includes control measures to eliminate or reduce such exposures” [2]. The CDC also suggests that employers can use barriers, remind employees and customers to use cloth face coverings, provide training, establish policies and practices for social distancing by staggering shifts, increasing physical space between employees and customers, increasing physical space between employees, use visual cues to indicate 6 ft apart, and using electronic, contactless payment readers [2]. While these guidelines are a great starting point that give concrete examples of how to adjust a business or worksite to respond to Covid-19, it can remain vague since every workspace, public retail space, or convenience store is significantly variable in location characteristics (spatially, design set-up). Implementing physical distancing along with the rest of the Covid-19 guidelines entails knowing how rules apply and what one is working with in each specific context. Enforcing social distancing requires accurate measurements which means accurate means for data collection. 

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So on to the question, how does a responsible or risk mitigating employer or business re-open successfully? How does a responsible or risk mitigating employer or business implement and enforce said guidelines? Ideally, the solution marries implementation and enforcement to bear efficacy. The issue is that every space varies and every business has different needs, movements of people, employees and customers alike. Even Occupational Safety and Health Administration (OSHA) has given guidance on preparing workplaces for Covid-19: prevention measures and an infectious disease preparedness and response plan, highlighting the need for social distancing [3]. Thus, the private sector must produce social distancing solutions and strategies in hopes of risk mitigation and appropriate Covid-19 response. There has been a boom in companies rushing to solve these new problems. Companies are forced to pivot, whether through invention of new technology or apps or simply adapting pre-existing solutions to help with this dire need. Emerging technologies spike a concern for privacy as many technologies can infringe upon privacy and use personally identifiable information (PII). On May 24, 2018, the European Union applied regulations for “the protection of natural persons with regard to the processing of personal data and on the free movement of such data”, called the General Data Protection Regulation (GDPR) [4]. Thus setting forth the drive for the U.S. to produce a similar regulation. This prompted individual states to act and create their own version of GDPR. For example, in California where there are serious concerns around privacy, a demand for strict data regulation gave rise to the California Consumer Privacy Act (CCPA) enacted on June 28, 2018. The law went into effect on January 1, 2020, providing consumers with “groundbreaking new rights” on the use of their PII relating to “access to, deletion of, and sharing of PII that is collected by businesses” [5]. With many compliances needing to be met, the private sector must ensure that their business practices are meeting their respective data regulation per governing state or the GDPR if they deal with data belonging to Europeans. 

 

Successful application of physical distancing requires an accurate means to measure. This may seem like an insurmountable feat given the highly variable circumstance per each environment, but it has been made possible by integrating machine learning, a subset of artificial intelligence. Introducing a social distancing solution, FastSensor’s Active Distance Alert and Monitoring (ADAM), gives “up-to-the-moment data on proximity and concentration (not just capacity) of everyone at your location(s) using real-time tracking of personal devices'' [6].  FastSensor’s Executive Vice President of business development, Welch says, “ADAM uses machine learning to look for duration and physical location over time, identifying how long people stay in a location and how they move through a space, then compare it to how other people are moving, essentially seeing a breadcrumb trail of location data in any environment on the grid”. This sounds fantastic, but how accurate and reliable is it? He adds, “ADAM is built on a 95% confidence interval for predictive accuracy and has over 90% predicted penetration of the audience. However, once tested the technology actually produces 95-98% penetration”. Welch also shares that FastSensor and the ADAM feature are both GDPR and CCPA compliant, via passively emitted signals and listening passively to these signals. Here, passive means that the person does not have to engage, opt-in, or be aware of tracking, since the signals emitted from their personal devices are emitted passively. He states, “there is no way to tie our data to any specific human being” [7]. With every ADAM purchase, FastSensor is also donating ten percent of revenue to healthcare workers fighting Covid-19 [6]. 

 

Even countries that have been more successful in responding to this pandemic like South Korea, social distancing waned after about a month after the South Korean government launched a social distancing campaign on March 21, 2020 [8]. Institutions like schools and universities, manufacturing plants, research facilities, and corporate buildings, still have a responsibility to implement set guidelines, regardless of individuals’ choice in obeying. Due to the imperfect nature of human beings, inevitably, people may need help in restoring “appropriate” behaviors like social distancing, especially if behavioral fatigue occurs. This is where the private sector and companies, like FastSensor, can help and provide a tool for accurate measurement. Then businesses and employers can work towards making evidence-based decisions in their specific environments, instead of guessing or “troubleshooting” with no basis to start. We all know the need to implement social distancing, but this will effectively aid in appropriate response and enforcement through data and measurement.

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[1] Centers for Disease Control and Prevention. (2020). Coronavirus (COVID-19). Retrieved from 

https://www.cdc.gov/coronavirus/2019-nCoV/index.html.

[2] Centers for Disease Control and Prevention. (2020). Plan, Prepare and Respond to Coronavirus Disease 2019. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html.

[3] U.S. Department of Labor, Occupational Safety and Health Administration. (2020). Guidance on Preparing Workplaces for COVID-19. Retrieved from https://www.osha.gov/Publications/OSHA3990.pdf 

[4] European Commission. (2020). Data protection in the EU. Retrieved from https://ec.europa.eu/info/law/law-topic/data-protection/data-protection-eu_en

[5] State of California Department of Justice, Office of the Attorney General. (2020). California Consumer Privacy Act (CCPA). Retrieved from https://oag.ca.gov/privacy/ccpa

[6] FastSensor. (2020). Monitor social distancing, and get back to business. Safely. Responsibly, Quickly. New data for today’s new reality. Retrieved from https://www.fastsensor.com/adam

[7] Welch, K. (2020, May 24). Interview by C. Thomas Nguyen [Zoom audio recording]. COVID-19 preparedness project, University of California, Los Angeles, Soc Gen 108. Personal interview.

[8] Hyun-ju, O. (2020). [From the scene] Social distancing wanes in S. Korea. The Korea Herald. Retrieved from http://www.koreaherald.com/view.php?ud=20200412000218

[9] Trapp, Dylan (2020, March 26). Social Distancing Activities to Do From Home. Retrieved from https://www.813area.com/entertainment/social-distancing-activities-to-do-from-home.html.

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Contact Tracing Biotechnology

Contact tracing is essentially the process of identifying and testing individuals who have come in close contact with an individual who has tested positive for a disease. This method is incredibly useful for getting outbreaks under control and could allow the United States to loosen stay-at-home orders and social distancing precautions. However, the United States does not currently have the resources required to conduct contact tracing on a large scale (at least not at the beginning of the pandemic). Though the CDC is currently increasing the number of contact tracers, or individuals equipped to contact trace, more technology and applications are required to make this effort effective. [1] Apple and Google have recently joined forces to establish the “Coronavirus Tracking Project.” This public health project would help United States public health agencies track the ongoing outbreak. While similar projects have been successful in other countries, it is unknown whether the United States would be able to conduct such a large project. [2] Though Apple and Google issued statements declaring that user privacy and security would be central to the design of such applications [3], many questions regarding the security of these technologies remain. Software engineers under these companies have taken precautions to prevent breaches in privacy. Phones with the application installed and running in the background would send out information to other phones. Since it would be difficult to trace back information from these Bluetooth codes sent out by each phone, the application data would mostly be secure. However, hacking the system and creating a list of every individual who has contracted the disease, while very difficult, would theoretically not be impossible. Proponents of these technologies note that other applications on most individuals’ phones track and record more sensitive data than the applications created by this tracking project would, and thus there is no elevated security concern. [2] Moreover, the applications posed thus far would not be able to pinpoint individuals who have tested positive directly on a map, and contact tracing would be entirely voluntary as individuals would need to install the application and enable the tracing function. Others, however, argue that if such technologies were created, they should involve additional constraints to ensure that only necessary information is collected and that it is only used for public health initiatives. Since talks regarding these discussions are so new, many of these questions remain unanswered. [1]

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[1] Wetsman, N. (2020). What is contact tracing? The Verge. Retrieved from https://www.theverge.com/2020/4/10/21216550/contact-tracing-coronavirus-what-is-tracking-spread-how-it-works
[2] Brandom, R. (2020). Answering the 12 biggest questions about Apple and Google’s new coronavirus tracking project. The Verge. Retrieved from https://www.theverge.com/2020/4/11/21216803/apple-google-coronavirus-tracking-app-covid-bluetooth-secure
[3] Apple and Google (2020). Privacy-Preserving Contact Tracing. Apple. Retrieved from https://www.apple.com/covid19/contacttracing/.
 

Testing Kits

Testing kits are a necessary tool in isolating patients who have contracted Covid-19. The issue currently regarding testing kits is that there has not been a universal test created for all countries that screens patients quickly and accurately. The South Korean has been a leading figure for the pursuit of an efficient testing kit as the South Korean Ministry of Food and Safety (MFDS) enacted two notices which encouraged laboratories to create urgently needed medical devices and regulated the distribution of said medical devices in late January [1]. Many companies were able to create new testing kits that got approved by the South Korean Center of Disease Control and Prevention as well as the MFDS, leading to four companies’ testing kits being approved by March 10. These companies detected Covid-19 in patients through Real Time RT-PCR or reverse transcription polymerase chain reaction which is able to amplify the virus DNA, so that they detect the known Covid genes: E gene, RdRP gene, and N genes [2, 3]. However, these testing kits show results in varied time, ranging from 1 to 6 hours which has led to more companies in South Korea to start creating tests that use antibodies to detect Covid-19 in patients. Companies such as PCL have created testing kits that examine the levels of IgM and IgG, antibodies known for being part of the first response against a viral infection, which are able to detect patients in the earlier stages of the infection [3,4]. President Trump on the other hand had barely issued the Defense Production Act in late March to combat the issue of shortages with medical devices including PPE and testing kits, and has reached out to countries such as South Korea to import testing kits [5,6]. He belatedly responded to the shortages in the US, only taking measures when the severity of the pandemic had escalated in the United States which prevented US research on Covid-19 testing kits to rely on other countries' advances.

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Spotlight on Thermo Fisher Scientific:

Getting expert insight in one of the leaders in providing diagnoses, tools, and research, an American company, Thermo Fisher Scientific was one of the first two companies to gain EUA clearance for RNA viral test kits. Thao Sebata, senior product manager in the biosciences division, illuminated what the bottlenecks were in this specific supply chain process for testing kits. She stated the challenge was that no one was prepared for scaling up to the extent that was needed. In the first weeks of the pandemic, Thermo Fisher Scientific scaled to producing 5 million test kits per week and to do so, reallocation of resources was needed for this purpose. As for the challenges, scaling up required having the necessary reagents and components, and additional manufacturing shifts to produce that many test kits. Once kits were manufactured and available to clinical test sites such as Labcorp or Quest Diagnostics, those facilities require specialized equipment and trained personnel to run the assays. Interestingly, she shared that many scientists have shifted the type of work, outside of their specialty or realm of training to fight this pandemic. This relates to the concept of human capital, which happens to be one of the rate-limiting steps in this scenario. Addressing how her company responded to the limitations of the predicament, Sebata spoke on shifting to take into account (supplies, personnel, equipment) while respecting social distancing guidelines. She stated that space was an issue, both time and physical space [7]. Successful response to a pandemic must include effectively considering personnel, infrastructure, supplies, and fluid interaction between different partners and decision-makers, in order to ramp up production of a necessary resource that directly shapes the severity of the pandemic tolls.

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[1] Herr, T. (2020). South Korea issues final revisions to regulations for medical device importation requirements. Emergo by Byul. Retrieved from https://www.emergobyul.com/blog/2020/01/south-korea-issues-final-revisions-regulations-medical-device-importation-requirements

[2] Lee, G. (2020). South Korea approves first four COVID-Retrieved from under urgent-use license. BioWorld. Retrieved from https://www.bioworld.com/articles/433783-south-korea-approves-first-four-covid-19-test-kits-under-urgent-use-license

[3] Li, Z., Yi, Y., Luo, X., Xiong, N., Liu, Y., Li, S., … Ye, F.  (2020).  Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. Journal of Medical Virology. doi:10.1002/jmv.25727.

[4] Tan, M. (2020). Korean Firm Develops Simpler Test to Detect COVID-19 in 10 Minutes. ASIATECHDaily. Retrieved from https://www.asiatechdaily.com/korea-firm-covid-19-testing-kit/

[5] Siripurapu, A. (2020). What is the Defense Production Act? Council on Foreign Relations. Retrieved from https://www.cfr.org/in-brief/what-defense-production-act

[6] Kirk, D. (2020). Korea Races To Export Test Kits After Trump Asks Moon For Help Fighting COVID-19. Forbes. Retrieved from https://www.forbes.com/sites/donaldkirk/2020/03/27/korea-races-to-export-test-kits-after-trump-asks-moon-for-help-fighting-covid-19/#77f242031244.

[7] Sebata, T. (2020, May 18). Interview by C. Thomas Nguyen [Zoom audio recording]. COVID-19 preparedness project, University of California, Los Angeles, Soc Gen 108. Personal interview via Zoom.

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