# data[].attributes.body
1) From the point of view of a concerned citizen - weigh the right to privacy against the public interest.
2) You question the motivation of the PM linking uptake of the app to opening of venues and sporting events.
3) You question the focus on the app over issues such as unemployment, international travel, when benefits will be re-evaluated.
4) You want to know what happens if not enough people download the app.
5) You might compare Australia to another country in the way the apps impact citizens.

# data[].attributes.body
1) Express concern about the potential for data security breaches
2) Express concern about the potential for abuses of the app - stalking and family violence
3) Discuss issues of digital data security in an Australian v International context.  For example how is digital data used by the state in China v Australia.
4) Question:
A) the promise to delete personal data
B) the criteria for determining the end to the Covid19 pandemic
C) the track record of the Australian government when it comes to the security of personal data.

# data[].attributes.body
1) What oversight has the Federal Government put in place for the COVIDSafe app?
2) What guarantees have the government provided that the data collected will be safe?
3) Has the government provided enough safeguards against potential abuses of the app? (think family violence and stalking)
4) Why is the collected data being stored in a facility in the USA?  Why could it not be stored in Australia?
5) Why is this considered the best way to track people - what other less invasive ways are available to the government?

# data[].attributes.body
1) Express a position on Australia's public health response to Covid19
2) Outline the pro's/con's of the COVIDSafe app from a public health point of view
3) Use international examples to supprt your position for Australia - eg. Countries who have a significant uptake of app usage against countries that are not using an app to track transmission.
4) From a public health point of view (in relation to the rest of the world) outline Australia's responsibilities when dealing with a global pandemic.

# data[].attributes.body
1) How does Austraslia's response compare to the international response?
2) In 2019 Australia was rated as one of the few countries in the world well position to respond to a global pandemic - given this how has Australia’s response actually been rated in real time?
3)  What lessons has Australia learnt from watching the effects of the virus in the rest of the world?
4) From your point of view what measures apart from the COVIDSafe app could the government implement to assist in tracking transmissions in the community?  What international evidence is there to support this?

# data[].attributes.body
1) Will my personal data be kept safe?  How?
2) When will the lockdown end and how will using the COVIDSafe app help that?
3) Is it safe to send my child to school if they do not have access to the COVIDSafe app?
4) How are we to believe the promises made by this government that our data will be kept safe when there have been significant data breaches in the past?

# data[].attributes.body
1) The tracing app should not be mandatory, but we should encourage widespread adoption
2) Mandatory tracing wouldn't work in a Western country like Australia
3) Many nations like South Korea are successfully using similar tracing apps to contain the spread
4) Australians will need to be convinced the right safeguards are in place to ensure their data is safe

# data[].attributes.body
1) How have contact tracing apps worked in other countries?
2) Why might a mandatory tracing app work or not work in Australia?
3) What can we learn from the experience of other countries?
4) What measures could Australia put in place to encourage widespread adoption?

# data[].attributes.body
1) The tracing app should be mandatory for all Australians
2) While we are winning the fight against COVID-19, it's not over yet
3) The tracing app will allow us to save lives, loosen restrictions and return to normal life
4) The government has put strict protection laws around the app to ensure citizen privacy

# data[].attributes.body
1) What are the benefits of the COVIDSafe app?
2) What are potential risks?
3) How has the government attempted to address those risks?
4) Why should the app be mandatory?

# data[].attributes.headline
Will Australians trust a government with a history of data breaches and tech fails?

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Will Australians trust a government with a history of data breaches and tech fails?

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The federal government is attempting to convince Australians it can be trusted to handle personal data collected by the coronavirus contact tracing app. But it's an uphill battle due to a long history of secrecy and failures to live up to promises on security and privacy of Australians' data.

Governments around the world are dealing with the same problem: everyone wants to be able to resume some level of normal life, but authorities will need to be able to quickly find and contain people who might have the virus and not yet know it.

Currently they do this by relying on human memory of who a person who tests positive has been around and where they have been - and cases can be easily missed.

But if everyone is running an app that records a list of everyone they've been in close contact with, the process would be much more simple, and faster.

There will be some people who want to help the effort and will use the government's proposed coronavirus contact tracer app on that basis, along with those who adopt the view that they already give a lot of information out to other services, so what difference does it make?

There will be some who flat out refuse or just aren't able to use the app, and then there are those who are sceptical and need to be convinced.

The prime minister, Scott Morrison, has said the government needs 40% of the population to agree to use the app in order for it to be effective, and he will need to win over some of the last category in order to meet that target.

The problem he faces is that the government's history in this area is littered with tech fails, data breaches and misuse of personal data.

Less than two months ago, senior bureaucrats were being accused by the deputy chair of the parliament's national security committee, Labor MP Anthony Byrne, of having a "cavalier disregard" for the handling of Australians' personal data.

When the parliament passed mandatory data retention legislation in 2015 (which requires internet companies to hold much more personal data than would be held by the app for two years), promises were made that only 21 agencies, including law enforcement, would be able to access the data without a warrant.

Then the internet companies began reporting councils and 87 other agencies that should not have access to the data were still accessing it, over 8,000 times in the 2018-19 financial year.

Law enforcement were supposed to get special warrants if needing to access a journalist's metadata, but the AFP failed to do that in one instance.

Some agencies were getting sent the history of websites people had been visiting, despite the government ruling that out five years ago.

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The government released the personal Centrelink information of a writer critical of the botched robodebt scheme.

It rushed the passage of anti-encryption legislation before the end of 2018, arguing failure to do so could cause a terrorist attack over Christmas, despite the fact that key parts of the legislation would not be able to be used until well after Christmas, and amendments are now being considered to fix up issues with the law because it was rushed.

Under that legislation the government can force you to unlock your phone. We're not allowed to know what vulnerabilities the government has forced tech companies to put in their products, and it is also a crime for tech companies to disclose what they've been made to do.

Medicare numbers ended up for sale on the dark web.

The government accidentally published a spreadsheet with the personal details of 10,000 asylum seekers online.
Australia's coronavirus contact tracing app: what we know so far
Supposedly de-identified Medicare data was able to be reidentified, and rather than addressing the data breach, the government tried to make it a crime to reidentify the data in the first place.

The 2016 census was taken offline by a DDoS attack, and according to Malcolm Turnbull's memoir, A Bigger Picture, the Australian Bureau of Statistics was prepared to blame a nation state for the attack, even though it was mostly just IBM not doing the job it had been paid to do.

When people tried to sign up for jobseeker payments, Services Australia couldn't handle the traffic. The government services minister, Stuart Robert, incorrectly blamed a DDoS attack for that before correcting the record.

The Australian federal police conducted an invalid raid at the home of a News Corp journalist trying to hunt down her source.

The AFP raided the home of a Labor staffer and Parliament House during the 2016 election in order to find out who was leaking out of NBN Co.

The government was eventually forced to change legislation to prevent police from being able to access information from My Health Record after first arguing it was not an issue.

It is not difficult to see why some are not so keen to place their utmost trust in the government over handling this incredibly personal information.

The app, if developed properly and with appropriate protections in place, could work well to slow the spread and make it much easier for health officers to contact trace.

These are the protections the government has offered up so far:

The data collected from the people you are in contact with (name, age range, phone number and postcode) remains encrypted and on the phone and deletes after the infection period passes.

Location information (outside of postcode) isn't retained.

It doesn't get uploaded to the onshore Amazon server unless you test positive.

Only the health officers in your state will be able to access the unencrypted data.

All the data will be deleted on the government's server at the end of the pandemic.

It will be a crime to move the data offshore.

Some, if not all, of the app's source code will be made public.

The privacy impact assessment will be public.

The privacy protections will be legislated.

There is still much detail the government has promised to release in the next few days, meaning much of the concern around the app is based on public comments from politicians rather than clear information.

Until now the government has forced a lot of these incursions on our privacy on the Australian population, warning the public that threats demand a sacrifice of our privacy, and if you've got nothing to hide you've got nothing to fear.

Now faced with a tangible threat, while also empowering every Australian to make the decision themselves for the first time, the trust may be found wanting.
Topics

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Coronavirus app: will Australians trust a government with a history of tech fails and data breaches?

# data[].attributes.attachment_link.description
The federal government is attempting to convince Australians it can be trusted to handle personal data collected by the coronavirus contact tracing app. But it's an uphill battle due to a long history of secrecy and failures to live up to promises on security and privacy of Australians' data.

# data[].attributes.body
Congratulations! You have been invited to be a panelist on Q+A’s next episode. Each breakout room will take on the role of a different panel member and prepare for a discussion on “Should COVIDSafe be mandatory for all Australians?”

In your teams, you have 15 mins to:

1) Decide group roles: Scribe, Researcher/s, Presenter

2) Read through the position of your panel member

3) Look through padlet resources, taking notes on any key evidence to support your position

4) Discuss key questions together and draft responses in google doc

5) Get ready to return to the main session for a Q&A discussion!

Background on COVIDSafe and the discussion format, Q+A, are below

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Civil liberties group outlines design principles for app

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Civil liberties group outlines design principles for app

# data[].attributes.headline
Singapore urges citizens to download contact tracing app

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Singapore urges citizens to download contact tracing app

# data[].attributes.headline
Coronavirus tracking and the threat to civil liberties

# data[].attributes.subject
Coronavirus tracking and the threat to civil liberties

# data[].attributes.attachment_link.readable_text
Would you sacrifice one freedom to regain another? Pledge to stay away from crowded spaces, say, or limit your contact with loved ones, in exchange for the liberty to again move freely? Or-in the name of no more lockdown-would you be willing to offer up something altogether more personal: your data?

To move past the stringent social distancing measures of coronavirus containment, there is a gathering European consensus-governments must have unprecedented access to their citizens' private information.

Equipped with the knowledge of where an infectious person has been and who they have met, officials would-in theory-be able to close the net around COVID-19, winding down the risk of mass contagion.

In practice, this means the ability to harvest data from a person's smartphone, mapping their movements and notifying anyone they've contacted. For many, it's a frightening prospect-the first step on a slippery slope of state surveillance.

BEIJING, CHINA - APRIL 22: Chinese women wear protective masks as they look at their mobile phones ... [+]
Getty Images

But desperate times call for desperate measures. As unpalatable as such monitoring measures would be, they are a "price worth paying" to escape the lockdown, the Tony Blair Institute for Global Change-a think tank founded by the former British prime minister-concluded recently.

The group's argument is simple. Without an escape route from the crisis, ministers face two unbearable outcomes: complete economic collapse, or unsustainable strain on health systems. Given the dire alternatives, an extension of state snooping powers is a pill we must be prepared to swallow.

For its part, the UK government has promised that any contact-tracing measures would be fundamentally transparent, with individual's anonymity hardwired into the programme. Crucially, the scheme would also be voluntary, allowing those with doubts to opt out.

For civil liberty groups, these are welcome guarantees-but fears remain.

"We are concerned that some 'solutions' to the crisis may, via mission creep, result in systems which would allow unprecedented surveillance of society at large," warned 300 leading academics in an open letter last week.

NEW YORK, NY - APRIL 19: A person wears a protective face mask in Bryant Park during the coronavirus ... [+]
Getty Images

As is often the case with an expansion of state powers, it's the detail that matters. Tracking technology which utilises smartphone GPS is generally considered to be more invasive, as it records an individual's physical location. The second option-a virtual handshake between two devices using Bluetooth-seems to be Europe's direction of travel.

There's scant agreement on the other key issue, however: where the collected data should be stored. Despite a deep cultural distrust of state surveillance, Germany originally aligned itself with France and Britain in advocating a 'central server' solution, before joining the likes of Switzerland and Austria, who want to see information retained on individual devices.

Whichever approach they opt for, European leaders will be hopeful of emulating the success of tracking schemes in Asia. South Korea-a nation particularly lauded for its containment efforts-has used technology remarkably well to break the chain of infection.

But doing so has come at a cost. Credit card transactions and surveillance camera footage has been combined with GPS data to accurately plot the course of coronavirus suffers-sweeping measures that would incense European critics concerned at governments running roughshod over citizens' rights.

MOSCOW, RUSSIA - APRIL 22, 2020: A woman speaks on her phone in Bolshaya Dorogomilovskaya Street ... [+]
Sergei Fadeichev/TASS

Still, it seems public opinion is behind some form of population monitoring. In the UK, nearly two-thirds of people polled are in favour of using mobile data to track coronavirus sufferers and those they come into contact with-a reflection, perhaps, of the public's desperation to see lockdown rules lifted.

And so, as often is the case in times of national crisis, it looks like civil liberties might soon be taking a back seat in Europe. Weighed against the cost of economic and epidemiological catastrophe, that's maybe no bad thing-so long as it's temporary.

... Read More

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State Surveillance: Coronavirus Tracking Tech And The Threat To Civil Liberties

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Would you sacrifice one freedom to regain another? Pledge to stay away from crowded spaces, say, or limit your contact with loved ones, in exchange for the liberty to again move freely? Or-in the name of no more lockdown-would you be willing to offer up something altogether more personal: your data?

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Poland is making its citizens use a 'selfie' app during the coronavirus crisis

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Poland is making its citizens use a 'selfie' app during the coronavirus crisis

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Updated April 25, 2020 09:47:34

After two weeks of sending selfies to the Polish Government, Anna Araszkiewicz was finally free to leave her house.

But as soon as she walked down the street, she received another text, asking: "Where are you?"

She recalls: "I said, 'No, f*** it. I'm not going to have this application any longer, because I'm not in quarantine and I'm a free human.'"

She deleted the phone app immediately.

Having arrived from the United States in early April, Ms Araszkiewicz was seen by Polish health authorities as being at high risk of having coronavirus.

At the Warsaw airport, the Border Force took her temperature, photocopied her passport, wrote down her address and told her to install the Home Quarantine phone app for 14 days.

The app, developed by the Polish Government over three days in March, was optional at first, but became compulsory on April 1 for people required to quarantine - mostly those who had contact with someone with COVID-19, and overseas arrivals.

It prompts you to take a straight-face real-time selfie at the address you've provided to the authorities.

By using geolocation and facial recognition algorithms, the Government can tell whether you're at your quarantine residence or not.

"You need to take a photo, no matter how it looks like, you just need to take it," Ms Araszkiewicz, a brand marketer, said.

"Then they write, 'Your task is done, see you next time.'"

The app prompts you to take a selfie at random times, sometimes multiple times a day - and you have 20 minutes to respond.

"It was very tough for me because I had a heavy jet lag and I missed three times when it was very early," Ms Araszkiewicz said.

"I was very angry. Not with myself, but with them."

Shortly after she failed to send the selfie, the police came to check on her.

"I said, 'I know I didn't do the task,' and they said, 'OK, that's fine, we just need to see if you're fine and if you're at home," she told the ABC.

On the second week of her quarantine, the requests to send selfies "doubled".

"I needed to charge my phone all the time. I needed to be next to my phone all the time," she said.

"Even when you take a longer shower, you need to be very aware and alert all the time.

"I felt very stressed because if I didn't do the task, they could probably think I'm not in my quarantine [location] anymore.

"But I was, and I didn't do anything wrong."

Even though married couple Ieva Merke and Karolis Merkys were diligently using the Home Quarantine app after arriving from neighbouring Lithuania, the police still paid frequent visits to their address.

"They've been calling us every single day, and most often they stop with a car outside our house and they either ask us to wave through the window or they call our intercom," Ms Merke said.

The police even made an appearance during the couple's interview with the ABC - it was their second visit of the day.

"There are two ways to look at it - one might say that it is invasive, on the other hand, it is the control mechanism to make sure people stay at home," Mr Merkys said.

"It depends on which way you choose to look at it. I think we're taking it positively because we do care that this [virus] doesn't spread - and it will not spread if people stay at home."

Ms Merke said since the family had committed to following the rules, the experience had not been stressful.

"We just treat it as a compulsory rule and once it's all over, we're going to delete [the app] and that's it," she said.

Fears over Australian-style contact-tracing app

Poland was the first European country to enforce the use of a coronavirus-related app.

It has been installed on about 230,000 devices.

The Polish Government told the ABC the only people who are excused from installing it are those who are blind or visually impaired, or who sign a declaration confirming they do not use telecommunications networks or have a smartphone.

A failure to install the app results in a police visit and a fine of 30,000 zloty ($11,200).

A Government spokesperson said: "The application is based on standard solutions available on the market, it was consulted and developed by an external supplier. Its working principles are based on the idea proposed by the Ministry of Digital Affairs."

The Government said the data was kept for six years and could be accessed by the police, state governors, the Centre for Information Technology, National Centre for Healthcare Information Systems and the subcontractor.

Kozminski University researcher and cyber security expert Jan Zygmuntowski said he had reservations about the app, developed by consumer affairs company TakeTask.

"Basing that app on one that was used in product research ... I understand the speed they wanted to release it with, but I'm not really sure that is super secure," he said.

But it's another app - similar to one the Australian Government is working on releasing - that he is more concerned about.

The Polish Government has a voluntary contact-tracing app in the works. It will identify people who have come into contact with someone diagnosed with COVID-19.

"I'm not so scared about the privacy of the quarantine app, because it's still a small number of people using it," Mr Zygmuntowski said.

"It shows the location, it shows the time, it shows your face - but it's not so much of a worry as the contact-tracing one."

The Government says the objective of the contact-tracing app "is to control and curb the spread of the coronavirus".

"Our application is completely safe and secure - the user data is stored locally, on the users' devices, and never transferred outside - no-one else can access it," a Government spokesperson said.

But Mr Zygmuntowski said he was not "falling for" those assurances.

"[It] could be used to see who's friends with who. It is a worry because it can be used for manipulative purposes, by private companies," he said.

"The idea of this app is introducing the new normality, where tracking your location, tracking who you meet with and tracking your life [is] a new normality.

"You accept it as normal and you're fine with big tech basically following you everywhere. I am suspicious of this.

"It will change the mindset of people and people will be OK with stuff that goes further and further."

'I think they know everything about us'

But former Polish digital affairs minister Michal Boni told the ABC the pandemic was a "special situation", and using apps could help better contain it and speed up a return to normal life.

"My view is that at this time, during the pandemic, we need to use these kinds of apps, allowing us to know more about contacts between people. Because this is the only way to open the economy," he said.

"I think the society and people need some guarantees [from] the Government that those data will be used only at this time, and only with a purpose which is clear."

Security and privacy researcher Dr Lukasz Olejnik agrees this is an unusual situation, but says people have little choice about whether to hand over private information.

"This is a major crisis and we need to trust [the data] will be handled well, with respect to all the appropriate frameworks and legal limitations," he said.

"In principle, yes, people should trust the Government to handle a crisis situation. On the other hand, do the people who receive an order really have a choice?"

Although Ms Araszkiewicz was relieved to delete the compulsory quarantine app, she isn't spending time worrying about where her data went or what may happen to it.

"I don't really care, because they probably know everything about me. I think they know everything about us. That's the 21st century, right?" she said.

Topics: covid-19, health, diseases-and-disorders, world-politics, government-and-politics, health-policy, computers-and-technology, internet-technology, information-and-communication, poland

First posted April 25, 2020 04:48:07

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Ieva was on the phone to the ABC when the police showed up

# data[].attributes.attachment_link.description
Updated April 25, 2020 09:47:34 After two weeks of sending selfies to the Polish Government, Anna Araszkiewicz was finally free to leave her house. But as soon as she walked down the street, she received another text, asking: "Where are you?" She recalls: "I said, 'No, f*** it.

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Sweden's controversial approach to containing coronavirus

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Sweden's controversial approach to containing coronavirus

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While the rest of Europe imposes severe restrictions on public life and closes borders and businesses, Sweden is taking a more relaxed approach to the coronavirus outbreak.

Unlike its immediate neighbors Denmark, Finland and Norway Sweden has not closed its borders or its schools. Neither has it closed non-essential businesses or banned gatherings of more than two people, like the U.K. and Germany.

Sweden's response to the outbreak is being overseen largely by the country's Public Health Agency. It has taken a conspicuously different approach to the coronavirus from its international peers, trusting the public to adopt voluntary, softer measures to delay the spread of the virus.

This apparently laissez-faire approach has attracted criticism both from within Sweden, from a group of epidemiologists, as well from other countries which are locking down public life to curb the outbreak.

The Public Health Agency's lead epidemiologist, and a key figure in Sweden's national response to the coronavirus, is Anders Tegnell. He told CNBC that although his country's strategy to tackle the virus was different, the aim was the same.

"My view is that basically all European countries are trying to do the same thing - we're trying to slow down the spread as much as possible to keep healthcare and society working ... and we have shown some different methods to slow down the spread," he told CNBC Monday.

"Sweden has gone mostly for voluntary measures because that's how we're used to working," Tegnell added. "And we have a long tradition that it works rather well."

He said the agency had explained to the population why social distancing was needed, "and so far, it's been working reasonably well."

Sweden has 3,700 confirmed cases of coronavirus and has recorded 110 deaths, the latest data from the Public Health Agency shows.

In contrast, Italy, the epicenter of Europe's outbreak, has almost 100,000 cases and over 10,000 deaths, the latest data showed Sunday. Meanwhile Spain, the second worst-hit country in Europe, has close to 80,000 confirmed cases and 6,500 deaths. The U.K., considered to be around two weeks behind Italy in terms of the outbreak, has recorded almost 20,000 cases and 1,228 deaths from the virus.

"The incline (in infection and death rates) in Sweden is less steep than in many countries and that's exactly what we're trying to achieve," Tegnell said, adding that opinion polls showed the Swedish public were overall in favor of the agency's approach.

Tegnell didn't rule out more stringent measures in Sweden, however, telling CNBC that if there was a sharp increase in cases, the government and Public Health Agency would have a "big discussion on what other measures we can take."

This weekend, Prime Minister Stefan Löfven said that isolating Stockholm could happen if the outbreak worsens, but that such measures are not currently being discussed. He had previously insisted that successfully combating the spread of the virus was largely dependent on individual behavior.

Life carries on

Sweden has not completely diverged from the rest of Europe. In a similar way to its neighbors, Sweden's government has advocated working from home if at all possible, avoiding non-essential travel and the elderly are advised to avoid social contact. Of course, advice to wash hands regularly has also been promoted.

Restaurants, bars, cafés and nightclubs have been told to offer seated table service only. And as of Sunday, gatherings of more than 50 people are banned (the country had initially suspended gatherings of more than 500 people). It has also closed universities and colleges, but schools with students under 16 years old remain open.

As such, compared to elsewhere in Europe, life in Sweden feels eerily normal, Stockholm residents say.

"Being both an expat and an educator at a secondary school in Stockholm, I feel conflicted," Erik, a teacher at school in Stockholm, told CNBC Sunday.

"I still need to go into work, on a crowded bus, to teach my students who are advised to keep coming into school. We are all set up for distant learning, but secondary schools are not closing any time soon," he said.

He added that some colleagues were brushing off concerns about coronavirus saying, "It's just the flu, I'm more worried about the start of the pollen season," and he also referred to the "great trust" Swedes have in their public institutions.

Tom, an Englishman who works in construction in Stockholm, said he was impressed that the country remained so calm.

"Besides the obvious social media influences, I think if they would have enforced harsher initiatives like other countries there would have been more panic," he said.

"People have been good in accommodating small changes in their lives to help stop the spread, and have been very helpful to each other ... To be honest, Sweden has behaved exactly as I would have expected the Swedes to behave."

Stockholm residents acknowledged that there has been a decline in activity in the city, and yet social life continues.

"On Friday evening, when I went on my way home, I saw loads of groups of both young and middle-aged people hanging out on one of the central squares in Stockholm. It amazed me," Erik said.

"Whether the Swedish strategy is based on science, reluctance to limit people's freedom, or on trust that citizens will do what is needed, is not clear to me, at all."

Tide turning?

Restrictions or not, Sweden's economy won't escape unscathed from the crisis. Last week, Swedbank forecast that the economy would contract 4% in 2020.

"The downturn in the Swedish economy is broader and faster than during the financial crisis. Unemployment will reach 10% already by summer, despite unprecedented fiscal stimulus," Swedbank said in its report released last Wednesday.

"Most sectors in the Swedish economy are bleeding. In the services sector, several companies are completely without demand, abandoned as cautious households have gone home. Manufacturing is struggling with broken supply chains and falling demand."

The Swedish government has said that its aim is to limit the spread of infection in the country and the impact on critical services, and it has introduced some measures to limit the economic impact of the virus.

Last week, it announced an aid package for small- and medium-sized enterprises, saying it will guarantee 70% of new loans banks provide to companies that are experiencing financial difficulty due to the virus. It also temporarily reduced social security contributions and introduced company rent support

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No lockdown here: Sweden defends its more relaxed coronavirus strategy

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While the rest of Europe imposes severe restrictions on public life and closes borders and businesses, Sweden is taking a more relaxed approach to the coronavirus outbreak. Unlike its immediate neighbors Denmark, Finland and Norway Sweden has not closed its borders or its schools.

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Amnesty International concerns on Covid19 Tracker App

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Surveillance cameras are seen on a corner of Tiananmen Square in Beijing on September 6, 2019.

Refugees and migrants on an inflatable boat arrive in Greece.

Copyright © Amnesty International Australia ABN: 640 0280 6233. We acknowledge the Traditional Owners of this land and pay our respects to their Elders past, present and emerging. We acknowledge that this land was and always will be Aboriginal and Torres Strait Islander land. WARNING: This website may contain images or names of people who have passed away.

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Email Minister Roberts: make sure the COVID-19 app respects human rights

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Surveillance cameras are seen on a corner of Tiananmen Square in Beijing on September 6, 2019. Refugees and migrants on an inflatable boat arrive in Greece. Copyright © Amnesty International Australia ABN: 640 0280 6233. We acknowledge the Traditional Owners of this land and pay our respects to their Elders past, present and emerging.

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Experts warn contact tracing apps must not be used for mass surveillance

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Experts warn contact tracing apps must not be used for mass surveillance

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Nearly 300 leading academics have warned that some governments are building apps to trace the spread of coronavirus that do not respect privacy and will enable mass surveillance.

In an open letter, the academics praised the design of a system developed by Google and Apple to aid governments' app development, which would keep a record of whom a person had come into contact with on their phone, rather than in a central database.

They urged governments not to try to keep records of meetings centrally, saying that such a system would allow officials, hackers or private companies to spy on people, resulting in a "catastrophic" erosion of public trust.

"We are concerned that some 'solutions' to the crisis may, via mission creep, result in systems which would allow unprecedented surveillance of society at large," the letter said.

Contact-tracing apps, which use proximity or location-based tools to alert mobile phone users when they have come into contact with people infected with the virus, have proliferated globally in recent weeks as governments rush to reopen their economies after widespread lockdowns.

Earlier this month, Google and Apple announced that they would be collaborating to launch an "application programming interface" which governments and NGOs could make use of in building their apps.

But experts have grown increasingly concerned that a rushed rollout of such apps would fail to curb the disease.

A new report from UK research body the Ada Lovelace Institute argued that without a clear assessment of their technical limitations and potential social impacts, contact-tracing apps could have a damaging effect on society.

"The potential [for these apps] is really there," said Carly Kind, the institute's director, pointing to a survey commissioned by the FT, which found that contact-tracing via mobile phones was popular with nearly two-thirds of the public. "It would be hugely problematic if things were rushed in the rollout."

Editor's note

The Financial Times is making key coronavirus coverage free to read to help everyone stay informed. Find the latest here.

In order to be effective, any contact-tracing initiative must maintain the support of a large percentage of the population. According to a report produced for NHSX, the innovation arm of the NHS which is leading efforts to construct a UK app, the minimum uptake required would be an estimated 80 per cent of mobile phone users - or 56 per cent of the British population.

However the apps currently run the risk of excluding large swaths of the population as a result of a "digital divide" that disadvantages older and poorer people who do not have access to the latest handsets. Experts estimate that 2bn mobile phone users globally will be unable to access the system being developed by Google and Apple.

"People who are digitally excluded [such as the elderly] are least likely to be using symptom trackers but most likely to be affected," said Ms Kind.

To ensure public trust, the institute's report proposed the creation of an independent body to oversee the development of any new technology, as well as a multidisciplinary Group of Advisors on Technology in Emergencies.

It also recommended that the government introduce primary legislation to set out the purposes for data-processing, set timelines for the deletion of data and limit who has access to potentially sensitive information.
Letter in response to this article: What happens when I find out I've been in contact with a Covid-19 patient? / From Julia Rendschmidt, Berlin, Germany

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Contact-tracing apps must not be used for mass surveillance, warn experts

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Nearly 300 leading academics have warned that some governments are building apps to trace the spread of coronavirus that do not respect privacy and will enable mass surveillance.

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Outlining some of the Human Rights concerns they have regarding the Covid19 App

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Human rights at risk during COVID-19 response

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Experts are keeping a close eye on the actions of Australian governments during the coronavirus crisis

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Covid19 Himan Rights, Disability and Ethical Decision Making - Statement of Concern.  Origional document discussed in the ProBono Australia article.

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Covid19 Himan Rights, Disability and Ethical Decision Making - Statement of Concern.  Origional document discussed in the ProBono Australia article.

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Tracking App - Human Rights Issues and a look at tracking apps in Australia versus Singapore 

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Tracking App - Human Rights Issues and a look at tracking apps in Australia versus Singapore 

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One day the Australian Prime Minister suggests that an app to track the movement of Australians might be made compulsory. The next he is back-tracking, saying the app won't be compulsory after all.

What are we to make of this?

Prime Minister Scott Morrison back-tracked on initial suggestions the tracking app could be compulsory. Picture: Getty Images

Apparently, the app will be available for all Australians early next week. However, the proposed tracing app raises many troubling questions, including questions about safety, privacy, and security. Many experts are voicing concerns about the app as it stands.

As quarantine drags on and the dire economic impacts of COVID-19 become increasingly evident, both citizens and governments are keen to see a loosening of the limits on our freedom of movement. In order to do so, knowing when and where transmission is occurring, and locating those who are infected with the virus, has become an urgent problem that an increasing number of experts are trying to solve.

The cost to freedom in the war against COVID-19

Naturally, many governments are looking to other governments to see what solutions work. Unfortunately, the transferability of success in one country is not guaranteed.

Professor Sheila Jasanoff, founder of Science, Technology and Society studies at the Harvard Kennedy School notes that while responses to COVID-19 are rightly based partly in epidemiology, nonetheless social and behavioural sciences are wrongly being ignored. What one culture will happily adopt or comply with, another may not, and the nuances of human behaviour are complex and require greater attention.

Many apps are being used or contemplated to track movement of people to determine where transmission occurs. Much is being written about the different technological models, and whether they trace, track, comply with privacy and human rights frameworks, including necessary technical analyses to contemplate the risks.

Some countries, like Singapore for example, have used apps. In Singapore, less than 20 per cent of citizens downloaded the app, which meant old-fashioned, extensive detective work was required to make tracing effective.

People having smart phones is no guarantee they'll consent to using a tracking app. Picture: Shutterstock

So far the Government hasn't provided the source code for that app for 'security reasons.' The problem with this lack of transparency is that the public can't be assured of the app's safety and privacy. Yet its success is dependent on the degree to which people trust the app enough to adopt it.

It is estimated that between 40 per cent and 50 per cent of Australians will need to use the app for it to be effective in limiting community spread of coronavirus. Indeed, some academic studies estimate this required figure is as high as 60 per cent.

Can our internet cope with so many of us at home?

Given the poor uptake in Singapore, Australia's plans would appear to be a waste of time. Which raises the issue of the Prime Minister's initial suggestion that if too few Australians adopt the technology, he may make the app compulsory. While he has subsequently ruled this out, the Government may yet make an about-face rather than risking the whole effort coming to nothing.

Making the app compulsory would raise a plethora of legal, constitutional, human rights, civil liberty, and ultimately, democratic questions.

If they are to be used, technological solutions that trace or track must have sunset clauses to ensure that privacy and human rights are protected. But even with sunset clauses, the large quantity of data collected is effectively "in the wild" where it can be potentially accessed and misused.

This could pose serious risks to democracy should certain actors acquire that data, as illustrated by the Cambridge Analytica scandal and Russian interference in the 2016 US presidential election.

We should be skeptical of assurances that we can't be identified from our data. Picture: Shutterstock

Arguments that the data can be 'de-identified' should be met with skepticism, because in reality it is very difficult or impossible to prevent the re-identification of individuals.

Despite what many corporates and governments are suggesting, the use of apps to track the transmission of COVID-19 isn't inevitable or even necessary. The suggestion that the only option here is one type of app versus another is a false dichotomy - we have at our disposal a wide menu of available solutions to what is a social, behavioural, and medical problem.

Coming clean on hand sanitisers

Some governments are hesitant to adopt apps for a wide range of reasons. Belgium has highlighted that investment in people and expertise is key.

New Zealand has suggested that people should keep a diary of their contact with others, which will assist even if they do adopt a technological solution to track movement further down the track.

The essential question to ask before seeking any technological solution is: 'what is the problem we are trying to solve?' Technology may be one of the answers, but it should never be the starting point.

In the current health crisis, being able to identify who came into contact with whom is key, not necessarily knowing exactly where people went.

There are other old fashioned ways to trace infections, rather than jumping to a new technological solution. Picture: Getty Images

There are also multiple social and behavioural factors that will influence the take up of any app, and therefore its effectiveness.

Across countries, phone ownership will vary, with the very demographic most as risk from COVID-19 perhaps being least likely to carry a smart phone - people aged over 60. Indeed, nine per cent of Australians don't own a smartphone, which translates to more than 2 million people. And children, who can also carry COVID-19, rarely have smart phones of their own.

Board gaming to keep the fun in being at home

In addition, some Australians simply don't trust their governments and are therefore likely to leave their phones at home to avoid their data being collected.

Arguably, the New Zealand option of keeping a diary may result in more accurate data in circumstances where significant restrictions on movement are in place. Keeping a diary is also less likely to be subject to scrutiny by authorities and hence may build trust and so encourage self-tracking.

Most problems have multiple solutions and often the best solution isn't a high-tech one. If the app the Government is proposing doesn't have enough uptake, or if it fails in one of many of the other possible ways to achieve its goals, then finding other solutions without leaping to high-tech ones will be crucial.

Where technological solutions are found to be appropriate, assuring their safety, transparency, and privacy both at the outset and throughout the design process should be mandatory.

Banner: Getty Images

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Kobi LeinsSenior Research Fellow in Digital Ethics, Computing and Information Systems, Melbourne School of Engineering, University of Melbourne

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Dr Simon CoghlanSenior Research Fellow in Digital Ethics, Computing & Information Systems, Melbourne School of Engineering, University of Melbourne

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Dr Marc CheongSenior Research Fellow in Digital Ethics, Computing & Information Systems, Melbourne School of Engineering, University of Melbourne

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Do we really need a tracking app and can we trust it?

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One day the Australian Prime Minister suggests that an app to track the movement of Australians might be made compulsory. The next he is back-tracking, saying the app won't be compulsory after all. What are we to make of this? Apparently, the app will be available for all Australians early next week.

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How China is using tracking software and the Human Rights implications of that software

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How China is using tracking software and the Human Rights implications of that software

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China rolls out software surveillance for the COVID-19 pandemic, alarming human rights advocates

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The app sorts individuals into color-coded categories - red, yellow or green. Wuhan, China, where the first reported cases of novel coronavirus emerged ten weeks ago, reopened its borders last week. There's just one catch: A government surveillance app is required to enter and exit the region.

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Commentary on China's digital tracking.  

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Commentary on China's digital tracking.  

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How might this be different or the same from Australia's tracking app?

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"I thought the days when humans are ruled by machines and algorithms won't happen for at least another 50 years. [But] this coronavirus epidemic has suddenly brought it on early," a blogger on the popular Chinese forum Zhihu wrote. The blogger was complaining about Health Code, an app that local authorities around China rely on to make decisions about quarantining individuals amid the COVID-19 outbreak.

The Chinese authorities are notorious for using technology for surveillance, unconstrained by privacy legislation, a free press, robust civil society, or an independent legal system. In Xinjiang, northwestern China, police over the last few years have collected residents' biometrics without their consent. This and other data has been used to evaluate the level of political loyalty of the region's 12 million Turkic Muslim minority residents and to determine how much freedom of movement they will be allowed.

How does Health Code work? People first fill in their personal information, including their ID number, where they live, whether they have been with people carrying the virus, and their symptoms. The app then churns out one of three colors: green means they can go anywhere, yellow and red mean seven and 14 days of quarantine, respectively. The app also surreptitiously collects - and shares with the police - people's location data.

The app's color determination has a wide-ranging impact on the lives of its 700 million users, as local authorities throughout China require people to show their app when they hail a ride, go to supermarkets, or enter and exit residential areas and the subway. Their ability to move around, earn a living, and even obtain necessities and medical care are dependent on the app's tri-color code. The access control systems of some residential areas even use facial recognition technology, allowing only those with green code to enter, indicating that these systems are linked.

Exactly how companies designed the app and the criteria they use to categorize people remain unclear. The Zhejiang provincial government has promulgated a set of standards for the Health Code app, outlining broad and ambiguous criteria for categorization. "Having been to affected areas recently" and "belonging to groups relevant to the epidemic" are two of seven criteria that can turn a user's code red. Other local governments are authorized to establish rules for carrying out these criteria in their districts. Without further insight into the inner workings of the app it is hard for people to make sense of the color they are assigned, or what circumstances might trigger a change in color.
To read the full article >>

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China: Fighting COVID-19 With Automated Tyranny

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"I thought the days when humans are ruled by machines and algorithms won't happen for at least another 50 years. [But] this coronavirus epidemic has suddenly brought it on early," a blogger on the popular Chinese forum Zhihu wrote.

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COVID-19, surveillance and the threat to your rights

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COVID-19, surveillance and the threat to your rights

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Amnesty International commentary on potential Human Rights implications for digital tracking of Covid19

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People across the world are currently facing an unprecedented global health emergency due to the outbreak of COVID-19. Technology can and should play an important role during this effort to save lives, including by spreading public health messages and increasing access to health care. However, in the name of combatting the disease, some governments are rushing to expand their use of surveillance technologies to track individuals and even entire populations.

If left unchecked and unchallenged, these measures have the potential to fundamentally alter the future of privacy and other human rights.

Is surveillance to tackle COVID-19 legal?

Governments have an obligation to guarantee the right to health and to prevent, treat and control epidemics. In order to do this, they may temporarily restrict some human rights to respond to health emergencies in timely and coordinated ways. However, increased surveillance measures will be unlawful unless they can meet strict criteria. Governments must be able to show that measures implemented are provided for by law and are necessary, proportionate, time-bound, and that they are implemented with transparency and adequate oversight.

What this means in practice is that surveillance measures must be the least intrusive available to achieve the desired result. They must not do more harm than good.

Lessons learnt from recent history tell us that there is a real danger surveillance measures become permanent fixtures. In the wake of the attacks of 11 September 2001 (9/11), government surveillance apparatus expanded significantly. Once these capabilities and infrastructure are in place, governments seldom have the political will to roll them back.

Using Personal Location Data

Many countries are using cell phone data to track people's movements in response to the COVID-19 pandemic. Austria, Belgium, Italy, the and Germany are all reportedly gathering anonymized or aggregated location data from telecom companies.

Other countries are using cell phone data but without the added protections of anonymization or aggregation. For instance, media reports suggest that Ecuador's government has authorized GPS tracking to enforce compliance to quarantine. The Israeli authorities' move to permit the security service to use cell phone data of infected persons has already raised privacy concerns. This system is apparently already operational, with 400 people recently receiving SMS messages warning them of potential contact with infected persons.

In South Korea, authorities have been sending health advisory texts which have been accompanied with personal details of infected patients, including hyperlinks which open to detailed data about their movements. This measure has raised alarm bells because it breaches medical confidentiality and fuels stigma against people with the virus. It does not appear to meet the conditions required for surveillance to be lawful and is a violation of the right to privacy.

These measures raise important questions about how our personal information is collected, used and shared. Once personal data is collected, there is a real danger of it being shared and used for purposes other than health tracking.

Artificial Intelligence (AI) and Big Data

Several states are turning to AI and big data technologies to combat COVID-19. China is reportedly using a mix of 'smart' thermal scanners and facial recognition technologies in public places to track the spread of the virus. Chinese tech giant Alibaba has rolled out a health tracking feature that uses data about personal health and assigns a colour-coded health status to an individual. Green is for 'safe', yellow requires a seven-day quarantine and red is for a 14-day quarantine. This system is used to determine people's access to public spaces. Worryingly, the app shares this data with law enforcement authorities.

In Poland, the government has rolled out an app intended to ensure compliance with home quarantining. It reportedly sends prompts for selfies to be uploaded, which are then verified using facial recognition and location data to ensure that the person hasn't violated quarantine orders. Similar apps are reportedly being rolled out in other countries, including one in India which seeks geo-tagged selfies.

AI technologies could also increase the possibility of unlawful discrimination and may disproportionately harm already marginalized communities. Many of the technologies being deployed use opaque algorithms with biased data and using these in decision-making entrenches discrimination against certain groups.

Governments should not use surveillance technologies which gather forms of data beyond what is legitimately needed to contain the disease. In addition, governments must address data protection and discrimination concerns.

Private Surveillance Companies

While public-private collaborations can provide necessary creative solutions to deal with health crises, many governments are turning to surveillance companies with deeply worrying human rights records.

For instance, controversial surveillance vendors Clearview AI and Palantir are reportedly in talks with US authorities. The Israeli surveillance company NSO Group, which has a history of selling to abusive governments, is now selling a big data analysis tool which claims to track the spread of the disease by mapping people's movements.

Like NSO Group, many surveillance companies have a history of operating in the shadows and have remained unaccountable for their human rights abuses.

It is critical that companies involved in the fight against COVID-19 identify, prevent, mitigate and account for any human rights risks that may arise from the pandemic context with regard to their operations, products and services. Companies must not use the COVID-19 crisis to evade their human rights responsibilities.

As we come together to face this unprecedented crisis, it is important to have a long-term view of the measures we are undertaking to combat the virus. These may outlast the crisis and could define what surveillance in a post COVID-19 world looks like. It is important that human rights for all remains at the centre of that vision for the future.

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COVID-19, digital surveillance and the threat to your rights

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People across the world are currently facing an unprecedented global health emergency due to the outbreak of COVID-19. Technology can and should play an important role during this effort to save lives, including by spreading public health messages and increasing access to health care.

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Australian Federal Government Covid19 Tracker Privacy Policy

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Australian Federal Government Covid19 Tracker Privacy Policy

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How is this different from other countries? What potential abuses have not been considered? What has not been included that is present in international policy?

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Australian Government Department of Health

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The Australian Department of Health, with the support of the Digital Transformation Agency in its role as the COVIDSafe IT service provider, ( we, us, our) is implementing COVIDSafe to help States and Territory health officials ( health officials) conduct contact tracing to stop the spread of COVID-19.

Contact tracing is a fundamental element of a public health response to disease outbreak. It is the process of identifying people who may have come into contact with someone who has COVID-19, so that they can be advised to take measures to help stop the further spread of COVID-19 (such as getting tested or self-isolating).

This privacy policy sets out how personal information that is collected via COVIDSafe will be handled in accordance with the Privacy Act 1988 and the Biosecurity (Human Biosecurity Emergency) (Human Coronavirus with Pandemic Potential) (Emergency Requirements-Public Health Contact Information) Determination 2020 ( Biosecurity Determination).

What personal information will be collected, and why is it being collected?

We collect personal information to help conduct contact tracing when you register for, use or upload, data to COVIDSafe.

When you register for COVIDSafe

We will ask you to consent to the collection of your:

mobile phone number - so that you can be contacted if needed for contact tracing

name - so the relevant health officials can confirm they are speaking to the right person when performing contact tracing. This will be easiest if you provide your full name, but you can use a pseudonym or fake name if you prefer​

age range- so health officials can prioritise cases for contact tracing, if needed​​

postcode -to make sure health officials from the right State or Territory who work in your area can contact you, and to prioritise cases for contact tracing, e.g. hotspot areas

If you are under 16 years of age, your parent or guardian will need to consent to the collection of your registration information and contact data.

When you use COVIDSafe

Your app will only record the following contact data: (1) the encrypted user ID, (2) date and time of contact and (3) Bluetooth signal strength of other COVIDSafe users with which you come into contact. This information will also be recorded on the other users' devices.

An encrypted user ID will be created every 2 hours. This will be logged in the National COVIDSafe data store ( data store), operated by the Digital Transformation Agency, in case you need to be identified for contact tracing.

No location data (data that could be used to track your movements) will be collected at any time. No user will be able to see the contact data stored on their device as it will be encrypted. Any attempt to decrypt contact data is an offence. Contact data stored on a device will be automatically deleted after 21 days.

We cannot access any contact data stored on a device, or share this with health officials, unless and until a COVIDSafe user consents to upload the data to the data store.

If you test positive to COVID-19

A health official will contact you and ask for consent to enter your mobile number into the data store to generate a PIN to be sent to you by SMS.

If you enter the PIN, you will give your consent to upload contact data on your device into the data store to share with health officials to enable contact tracing.

If another user tests positive to COVID-19, they may upload their contact data, which may include details of their contact with you.

How will personal information be collected?

Use of COVIDSafe is completely voluntary. You can install or delete COVIDSafe at any time.

As part of your use of COVIDSafe, we will collect:

your registration information after you successfully enter a PIN sent by SMS

information about your encrypted user ID when you have COVIDSafe open or running on your device

information that you have tested positive to COVID-19 when you agree to a health official sending you an SMS to enable you to upload your contact data

your contact data, when you or another COVIDSafe user you have come into contact with tests positive to COVID-19 and chooses to upload contact data on their device

No user should feel pressured to install or continue to use COVIDSafe, or to agree to upload contact data to the data store. This is prohibited under the Biosecurity Determination. If you feel pressured to do any of these things, you can make a complaint to us (see below), the Office of the Australian Information Commissioner, or the Australian Human Rights Commission.

How will personal information be stored?

We will store all registration information, encrypted user IDs and contact data, in the data store. It is a cloud-based facility, using infrastructure located in Australia, which has been classified as appropriate for storage of data up to the 'protected' security level.

We will delete all data in the data store after the COVID-19 pandemic has concluded as required by the Biosecurity Determination.

Contact data on your device will be automatically deleted from your device 21 days after contact occurs. It will also be deleted if you remove COVIDSafe from your device or upload your contact data to the data store.

How will personal information be used and disclosed?

We will use or disclose your personal information to enable contact tracing by health officials. This includes:

using your mobile number to send you an SMS to confirm your number or upload your contact data

using encrypted user IDs in uploaded contact data to identify other COVIDSafe users that a positive COVIDSafe user had contact with in the last 21 days (contact users)

providing health officials with access to the registration information and contact data of contact users to enable contact tracing

Contact users may be advised to take such measures as are required by their State or Territory (such as self-isolating). Failure to comply with these measures may be in breach of State or Territory law.

We will also use or disclose your personal information to:

ensure the proper and lawful functioning of COVIDSafe

if it is necessary, prosecute a breach of the law in relation to contact tracing under the Biosecurity Determination and the Biosecurity Act 2015

We will not use or disclose your personal information for any other purpose.

Data about generation of encrypted user IDs to create de-identified reports about uptake of COVIDSafe will be prepared by the Digital Transformation Agency. We will also receive de-identified analytical data from iTunes and Google Play about COVIDSafe including the number of downloads, average use time and deletions.

Can personal information be deleted?

We will delete any of your personal information held in the data store when you make a request via Health web request form.

You can also uninstall COVIDSafe at any time. This will automatically delete all information stored on your device and stop other users from collecting your contact data.

Uninstalling COVIDSafe will not automatically delete any information already uploaded to the data store, or any of your contact data stored on another user's device in the last 21 days, which could still be uploaded to the data store and used for contact tracing purposes. If you wish any of your contact data uploaded to the data store to be deleted you can expressly ask us to delete your information.

Can a user correct or access personal information?

You can:

change your registration information by deleting and re-installing COVIDSafe

delete the registration information we hold in the data store by contacting us

register the correct information on COVIDSafe

To ensure maximum security of your COVIDSafe data, you will not be able to access your data held in the data store.

Further information about privacy

As well as this policy, we have an Australian Department of Health privacy policy.

You can obtain a copy of the privacy policy by contacting us using the contact details set out at the end of this notice. The privacy policy contains information about:

how you may complain about a breach of:

the Australian Privacy Principles (APP)

a registered APP code that binds us, and

how we will deal with such a complaint.

Contact us

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The Australian Department of Health, with the support of the Digital Transformation Agency in its role as the COVIDSafe IT service provider, ( we, us, our) is implementing COVIDSafe to help States and Territory health officials ( health officials) conduct contact tracing to stop the spread of COVID-19.

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Comprehensive look at international Covid19 tracking measures.  Broken down by country, state, reigion or town.  Looks at personal data protections and other implications of tracking people both in person and digitally.
This is a website with links to other sites, articles and resources. Be weary of how you 'read' this site, you will need to be choosey when selecting what to look at.

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According to a company announcement, Telepower Communication (Telpo), a leading Chinese manufacturer of smart point-of-sale systems and intelligent hardware, has integrated into its terminals new features to support a wide variety of contactless use cases. The company's family of terminals for

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Tracking the Global Response to COVID-19

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Tech companies, governments, and international agencies have all announced measures to help contain the spread of the COVID-19, otherwise known as the Coronavirus. Some of these measures impose severe restrictions on people's freedoms, including to their privacy and other human rights. Unprecedented levels of surveillance, data exploitation, and misinformation are being tested across the world.

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This is the from the UK - outlining all the evidence used to support the British Health response to Covid19

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Washington Post Article looking at the EU and issues with digital tracking in Europe.

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Washington Post Article looking at the EU and issues with digital tracking in Europe.

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Compares resisence to digital tracking in the EU to more aggressive digital tracking in countries like China and South Korea.
Analysis:  The EU is less than 100 years from authoritarian governments that were in place for WW2.
Why is digital tracking working more in Asian countries than in the EU?  How do these international examples compare to Australia.
Is there a difference in Human Rights standards, interpretations, enforcements across different international regions?

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Coronavirus tracking apps meet resistance in privacy-conscious Europe

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BRUSSELS - European leaders anxious to reopen their societies are counting on mobile phone tracking technology to help keep the novel coronavirus in check, but they face a formidable obstacle: convincing their privacy-conscious citizens to use the tools.

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How smartphone apps can help contact trace Covid-19

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How smartphone apps can help contact trace Covid-19

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Get up to speed on what contact tracing is and how it works

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OAKLAND, Calif. (Reuters) - A global race is on to develop smartphone apps and other types of mobile phone surveillance systems to track and contain the spread of the novel coronavirus.

The process known as "contact tracing," which is used to control the spread of infectious diseases, was boosted last week when the top two smartphone software makers, Alphabet Inc's Google () and Apple Inc (), said they were collaborating on apps that can identify people who have crossed paths with a contagious patient and alert them.

HOW CAN MOBILE PHONES HELP COMBAT THE NEW CORONAVIRUS?

Smartphones and some less-sophisticated mobile phones keep track of their location via cell-tower signals, Wi-Fi signals and the satellite-based global positioning system, known as GPS. Smartphones also use so-called Bluetooth technology to connect with nearby devices.

The location data can be used to monitor whether people, either individually or in aggregate, are obeying orders to stay inside their homes. It can also be used for contact tracing: determining whether people have been in contact with others who have the virus, so they can get tested or quarantined.

Smartphones can also be used to take surveys of people about their health via messaging, record their health histories via various forms of data entry and even produce a health "score" based on a combination of location information and health data.

HOW CAN PHONES HELP WITH CONTACT TRACING?

Using Bluetooth, smartphones can log other phones they have been near. If someone becomes infected, there is a ready list of their prior encounters. Phones on the list would get push notifications urging them to get tested or self-isolate.

In principle, this system is more efficient than traditional contact tracing methods that require large staffs to interview patients about their travels and then call or knock on the doors of contacts.

The Bluetooth solution is far from perfect. Phones can log one another even when 15 feet apart or on separate sides of a wall, even though a cough from an infected person likely would not be problematic in those cases. But developers have been working on ways to better define "contacts" based on the length and strength of so-called handshakes between devices.

Bluetooth also remains more accurate than GPS or cell tower location data, which can wrongly associate everyone on a busy city block as contacts.

ARE ANY OF THESE METHODS CURRENTLY IN USE?

Singapore pioneered contact tracing via Bluetooth with an app called "TraceTogether." Israel, which made headlines by employing its powerful government surveillance system to track cases, has also rolled out an app called The Shield. India also has an app.

South Korea is using mobile phone location data for contact tracing, while Taiwan uses it for quarantine enforcement and is also developing an app. China is employing a range of app-based tracking systems.

Meanwhile, dozens of efforts to develop contact tracing apps are underway around the world, many led by government research institutes and health authorities. In Europe, for example, a German-led effort is aiming to rally other European countries behind a technology platform that could support contact tracing apps across the 27-member EU. But several other European countries are pursuing their own apps. An effort is also underway in the United Kingdom.

The United States government has yet to promote an app, but at least two university research groups and one ad-hoc software development team are trying to gain endorsements from state and local bodies.

HOW DO APPLE AND GOOGLE FIT IN?

The two companies said they were concerned about competing approaches and agreed to develop tools, to be released in May, that will enable apps to "handshake" with one other. They also address battery drain and other issues that have limited the utility of some early apps.

Apple and Google also plan to go a step further later this year by integrating logging functionality directly into their phone software nearly worldwide.

People who catch the virus would still need to download an app to initiate contact notifications, but even those without apps could receive notifications.

ARE THERE PRIVACY AND SECURITY CONCERNS?

Yes. The most sensitive issue is who can view a phone's list of devices it has crossed. Nearly everyone agrees on deleting logs after about one month.

The tools coming from Google and Apple keep names off contact lists and leave the lists secret to everyone involved, which has drawn plaudits from privacy experts. Only governments, which must verify that people who say they tested positive for coronavirus actually did so, would know the identity of disease carriers, and even they would not have access to the contact lists.

But some governments and technologists favor collecting a central database of all "handshakes" between phones because it is an easier system to design and manage. Privacy advocates worry that such a database would be a hackers' goldmine and prone to governmental abuse.

Some researchers have suggested apps also track GPS information to better map the spread of the coronavirus. But GPS data could undermine people's privacy and leave places visited by people who test positive ostracized, activists said.

WILL PEOPLE BE REQUIRED TO TURN ON CONTACT TRACING?

No country is known to have required an app, but workplaces or other facilities could end up mandating usage. Apple and Google said that apps seeking to use its tools would need to be voluntary.

But the apps won't achieve their purpose unless they are widely used. Some epidemiologists have said at least 60% of a country needs to activate digital contact tracing for it make an impact.

(Graphic: Tracking global spread of coronavirus - tmsnrt.rs/3aIRuz7)

(This story was refiled to to add dropped words paragraphs 13, 16 and 23)

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Explainer: How smartphone apps can help 'contact trace' the new coronavirus

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OAKLAND, Calif. (Reuters) - A global race is on to develop smartphone apps and other types of mobile phone surveillance systems to track and contain the spread of the novel coronavirus.

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Israeli court bans lawless contact tracing

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Israeli court bans lawless contact tracing

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Israel's Supreme Court has banned its intelligence agency from tracing the phone location of those infected with Covid-19, until new laws are passed.

The Shin Bet internal security service had been given emergency powers in March to use the technology.

Now, the court says legislation must be brought in for it to continue past 30 April.

It warned of a "slippery slope" of using the "extraordinary and harmful tools" against innocent citizens.

"The state's choice to use its preventative security service for monitoring those who wish it no harm, without their consent, raises great difficulties and a suitable alternative... must be found," the court said.

Surveillance 'price worth paying' in Covid-19 fight

Watch: What is contact tracing?

NHS coronavirus app to target 80% of smartphones

It also decided that if tracking laws are brought in, they should include a provision that journalists who become infected can apply for an exemption, in order to protect their sources.

The decision effectively closes the door on phone location tracking using emergency powers granted by the cabinet without parliamentary approval. A parliamentary oversight committee shut down a similar police operation last week.

The Association for Civil Rights in Israel, one of the groups which brought the court challenge, welcomed the decision, saying: "Israel must not be the only democracy operating its secret security service to monitor its citizens, even in the fight against the coronavirus."

Energy Minister Yuval Steinitz, however, said he was concerned by the court's decision, and that the operations had contributed to the effort to fight the outbreak.

The country has had just over 200 deaths from the virus in the outbreak, with around 15,000 cases.

HOPE AND LOSS: Your coronavirus stories

LOOK-UP TOOL: Check cases in your area

TESTING: Can I get tested for coronavirus?

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Israel 'cannot use phone data for tracking virus'

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Israel's Supreme Court has banned its intelligence agency from tracing the phone location of those infected with Covid-19, until new laws are passed. The Shin Bet internal security service had been given emergency powers in March to use the technology. Now, the court says legislation must be brought in for it to continue past 30 April.

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More than 2 million Australians have downloaded the Government's COVID-19 tracing app, COVIDSafe.

The announcement the app was in development kickstarted a national debate over privacy safeguards, and the app's launch on Sunday prompted further questions about functionality.

With almost every country in the world grappling with ways to manage the coronavirus spread, many other nations are deploying similar digital contact-tracing tools.

So what do the tracing technologies look like in other countries, and what lessons can Australia learn from their rollout?

Coronavirus update: Follow the latest news in our daily wrap.
Here's what the COVIDSafe app looks like and what it wants to do

As Australia looks to implement an app that will help ease coronavirus restrictions, privacy concerns remain.

Singapore

We've all heard of the lessons heeded from the rollout of Singapore's Bluetooth-based tracing app, TraceTogether, on which COVIDSafe was partially modelled.

On Sunday, Health Minister Greg Hunt cited aspects of Singapore's model as a cautionary tale of what not to do.

iPhone issues plagued Singapore's app, with the app required to be in the foreground on an unlocked iPhone to work efficiently.

TraceTogether has reportedly been downloaded by less than 20 per cent of the country, and its Apple App Store page is littered with reviews that complain of not being able to take phone calls while allowing the app to properly function.

Australia "had the benefit of seeing what happened [in Singapore]," Mr Hunt said, and has "been able to work to ensure that that is not an issue in Australia".

Stay up-to-date on the coronavirus outbreak

United Kingdom

Coronavirus questions answered

Breaking down the latest news and research to understand how the world is living through an epidemic, this is the ABC's Coronacast podcast.

The UK Government has announced its own contact-tracing app is undergoing testing and will likely be available by mid-May.

Its app will give users the option of more active interaction with the technology than the Australian version offers, with app users who feel sick invited to log their symptoms within the app.

A yellow warning notification will then be sent to app users who have been in close contact with that person.

If that person is subsequently cleared of COVID-19, their close contacts will be sent a notification saying "You're OK right now".

However, if that person is confirmed to have coronavirus, a red warning notification will be distributed, telling close contacts "You need to isolate yourself and stay at home".

China

China's use of technology to control the coronavirus spread extends to many aspects of daily life, Reuters reports.

China is using QR technology to determine admission into public places.(Reuters: Carlos Garcia Rawlins)

Signs displaying Quick Response (QR) codes are displayed at public checkpoints, including office buildings, shopping centres, bus and train stations, and airports.

Users are required to scan the QR code with their phones and wait for their devices to display a colour-coded signal to determine whether they can pass.

A green code allows the user unrestricted movement, while a yellow or orange code requires seven days of quarantine.

If the code returned is red, the user is determined to be either a confirmed case of COVID-19 or a close contact, and must be placed in isolation.

As well as controlling people's movement, the app also has contact-tracing mechanisms in place to notify users if they come into contact with infected people.

Your questions on coronavirus answered:

South Korea

One of the first countries after China to experience a surge in coronavirus cases, South Korea's Government has been deploying a series of digital-tracing tools since March.

Will COVIDSafe work on iPhone?

Want the Government's new COVID-19 tracing app to work properly? Keep your iPhone charged.

Using mobile phone location data, along with the country's prolific CCTV and credit card transaction records, authorities retrospectively track the movements of people who later test positive.

Because the technology uses GPS location data, and phone companies in South Korea require all customers to provide their real names and national government registration numbers, it's effectively impossible to avoid being tracked if you own a smartphone.

The routes taken by people later confirmed as infected are often published online, while an alert - similar to a bushfire or flood alert we might receive in Australia - is pushed to the phones of people who had visited the same locations.

After some users subject to quarantine requirements reportedly flouted tracking systems by simply leaving their phones at home, authorities announced plans to ask repeat offenders to begin wearing tracking wristbands.

What the experts are saying about coronavirus:

The practice of authorities accessing mobile phone location data purely for contact tracing is not legal in Australia.

In Australia, the Government can apply to telecommunications companies to request access to this data for the purposes of law enforcement, national security, and protecting public revenue.

Taiwan

Taiwan is not yet using a contact-tracing app, but authorities are also using location-based technology to enforce quarantine.

The location data of anyone required to quarantine at home is monitored to ensure compliance.

If the device monitored is switched off for 15 minutes or longer, an alert is sent to authorities.

Users are phoned twice a day to ensure they're close to their phone and haven't left home without it.

Germany

German authorities initially backed a locally produced tracing model which was set to store data on a central server, but authorities backflipped on this plan after criticism from privacy advocates.

The country will now collaborate with Apple and Google in developing a Bluetooth tracing app that will see data stored on users' phones instead - similar to the model used in Australia.

German authorities have stressed the tool will be strictly voluntary, and will alert smartphone users when they've been in contact with someone infected.

Israel

Israeli authorities launched a contact-tracing app called The Shield at the end of March, which had been downloaded by 1.5 million users as of the beginning of April, as reported by Reuters.

The app is similar to the Australian version in that it stores users' data on their devices, and users who are subsequently diagnosed with coronavirus must decide whether to release their location data to authorities.

Israeli authorities were also initially using phone location data to monitor the movements of potential virus carriers, until the practice was halted due to privacy concerns.

Hong Kong

Hong Kong uses similar technology to enforce quarantine, with users required to wear a wristband with a unique QR code that pairs to their smartphone.

Users download an app called StayHomeSafe, which uses geofencing technology to track their movements.

At random points throughout the day, the user is required to use their phone to scan their wristband, to ensure the user hasn't left the house without their phone.

What you need to know about coronavirus:

Space to play or pause, M to mute, left and right arrows to seek, up and down arrows for volume.

Dr Norman Swan compares Australia's coronavirus response to Sweden's.

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Australia has COVIDSafe. Here is how other countries are using contact tracing apps in the fight against coronavirus - ABC News

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More than 2 million Australians have downloaded the Government's COVID-19 tracing app, COVIDSafe. The announcement the app was in development kickstarted a national debate over privacy safeguards, and the app's launch on Sunday prompted further questions about functionality. With almost every country in the world grappling with ways to manage the coronavirus spread, many other nations are deploying similar digital contact-tracing tools.

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ABC Q&A Episode: Coronavirus:  Where to Next?

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ABC Q&A Episode: Coronavirus:  Where to Next?

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5 panelists offer different perspectives on the Covid19 pandemic.
Focus is on Australia's response.
This is an example of the ways we want you thinking about the Tracker App and the various implications you have been asked to consider.
Also be thinking about this in an international context.
Think about competing interests.
Where interests clash - how would you determine the validity of one over the other?  Should you even try to?
How might the interests of people you've been elected or employed to represent differ from your personal interests?
The idea is for you to think like one of the interest groups indicated in the other columns - not to necessarily just present your own opinions.

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Nobel Prize winning immunologist says he will be downloading the app

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Nobel Prize winning immunologist says he will be downloading the app

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Strict protection laws govern the use of the app

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Strict protection laws govern the use of the app

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PM says app will help life get back to normal

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PM says app will help life get back to normal

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Article outlining Singapore's Public Health response to Covid19 and how it was informed by the SARS outbreak in 2003.

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World Health Organisation online resource

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World Health Organisation online resource

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World Health Organisation - list of resources, tools, information pack and other general information from the WHO regarding the global Public Health response to Covid19.
There is a great deal of information here - links to other resources - be selective in what you choose to access.

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Feature article analysing the public health responses of 5 different countries. What are the commonalities and differences to the Australian response?

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[Este artículo ha sido escrito por Carlos Chaccour y Adelaida Sarukhan, con la colaboración de Joe Brew y Pau Rubio]
Durante las últimas semanas la epidemia por COVID-19 se ha convertido en una pandemia, extendiéndose fuera de China y dando lugar a un preocupante -y creciente- número de casos y muertes en varios países de Asia, Oriente Próximo y Europa (especialmente Italia y España).
Las curvas epidemiológicas de los países afectados se están comportando de manera distinta, y el coste social y económico de las respectivas respuestas puede ser diferente.
A pesar de las múltiples incertidumbres que, a nivel biológico, clínico y epidemiológico, siguen subsistiendo en relación con este nuevo virus, lo que ya parece claro es que cada país ha respondido -o está respondiendo- a la misma amenaza con diferentes medidas y/o con una temporización diferente. Este hecho hace que las curvas epidemiológicas de los países afectados se estén comportando de manera distinta, y que el coste social y económico de las respectivas respuestas pueda ser diferente.

Fuente: https://www.databrew.cc/

China: Bloqueo rápido y cuarentena forzada

Por ser el lugar de origen de la epidemia y, hasta el momento, el país con el mayor número de casos (más de 80.000 casos y 3.213 muertes), todos los ojos están puestos en China y en la respuesta sin precedentes de su sanidad pública: forzó un rápido cierre de emergencia de la provincia de Hubei (el 24 de enero, aproximadamente tres semanas después de percatarse de que se trataba de una nueva enfermedad), obligó a 60 millones de personas a una cuarentena forzosa, restringió el movimiento entre y dentro de las ciudades, impuso restricciones rigurosas a cientos de millones de ciudadanos, hizo cumplir el uso de códigos QR de salud en los teléfonos móviles, llevó a cabo labores de esterilización de edificios y calles varias veces al día, aisló todos los casos sospechosos en instalaciones, e incrementó la capacidad hospitalaria en más de 50.000 camas para así poder testar, admitir y tratar a todos los pacientes.

Los resultados de estas rápidas y drásticas medidas son plenamente visibles. Ayudaron a retardar la propagación del virus desde Hubei a otras provincias, que mostraron una curva epidemiológica menos pronunciada. Actualmente, menos de dos meses después del bloqueo, China está notificando unos 20 casos nuevos cada día, en vez de los 4.000 casos diarios durante el pico de la epidemia. La ventaja de esta estrategia radical es la de forzar la cooperación y reducir rápidamente la presión sobre el sistema sanitario. Estas medidas, sin embargo, tienen un alto costo económico y social asociado al aislamiento de todos los casos positivos en instalaciones sanitarias y la restricción rigurosa de la libertad individual de movimiento. Además, requiere datos actualizados a nivel poblacional y fuertes capacidades en manejo de datos, algo de lo que muchos otros países carecen. Aún no está claro lo que ocurrirá una vez que las restricciones se levanten y se reinicien las actividades normales, o si será necesario imponer nuevos bloqueos en caso de futuros brotes.

Fuente: https://www.databrew.cc/

Corea del Sur: identificar, diagnosticar y tratar

Corea del Sur, que también ha logrado cambiar la trayectoria de la curva epidemiológica a pesar de un elevado número de casos (más de 8.000), usó una estrategia veloz, transparente y preventiva. En contraste con China, no implementó bloqueos o restricciones de movimiento, y no prohibió viajes (salvo "procedimientos especiales de inmigración"). Su estrategia se ha basado en el diagnóstico activo, gratuito y masivo (incluyendo "estaciones de servicio" para las pruebas diagnósticas) para individuos sintomáticos, contactos de casos y viajeros (hasta 15.000 tests por día con más de 250.000 tests realizados hasta el 13 de marzo). Las mascarillas y el gel desinfectante se han usado masivamente, y se han implementado medidas de distanciamiento social (cierre de escuelas, teletrabajo, y evitar aglomeraciones). Las camas de hospital se ofrecieron a aquellas personas que más las necesitaban, mientras que aquellas con síntomas moderados podían irse a su casa. De manera importante, se transmitieron mensajes televisivos diarios y actualizaciones del gobierno para proporcionar información a la población, además de una página web y mensajes telefónicos para informar a la gente sobre posibles contactos con individuos infectados. Estas medidas han logrado disminuir el número diario de casos de 600 el 3 de marzo a 130 una semana más tarde. Para el 13 de marzo, el número de pacientes recuperados era mayor que el de casos nuevos.

Una gran ventaja de esta estrategia es que proporciona una cantidad masiva de datos para la identificación de clústeres, permite una auto cuarentena rápida, e incrementa el denominador (número de casos), reduciendo así la estimación de tasa de letalidad. El conjunto de medidas parece haber reducido el impacto social y económico a lo largo de la fase temprana y más tardía de la epidemia. Sin embargo, la medida en la que contribuyó la cultura inherente a la sociedad coreana es un elemento clave, y la viabilidad y sostenibilidad de dicha estrategia en otros países podría ser un problema.

Fuente: https://www.databrew.cc/

Italia, España: un cierre menos restrictivo

Las medidas en Italia y en España han sido algo mixtas. Las medidas de contención (rastreo de contactos y focos) no fueron suficientes, lo que condujo a una escalada de medidas restrictivas destinadas a mitigar la epidemia y "aplanar la curva". Se prohibieron las reuniones masivas, se cerraron las escuelas, solo se permite cierto tipo de trabajo fuera de casa, y los viajes se han restringido en parte. A diferencia de China o de Corea del Sur, no se ha aplicado tecnología de rastreo en España (a fecha del 17 de marzo). La curva puede estar empezando a suavizarse en Italia, donde se anunció un primer cierre de las provincias del norte el 7 de marzo (más de un mes después de que el 29 de enero se reportasen los primeros casos, aunque se cree que el virus ha circulado desde mediados de enero), seguido en breve por un cierre a nivel estatal. Todavía es demasiado pronto para comenzar a ver un impacto del bloqueo en España, que comenzó el 14 de marzo (un mes y medio después de que se detectaran los primeros casos en las Islas Canarias); se tarda entre 5 y 7 días (el tiempo medio de incubación) en comenzar a ver un efecto en el número de casos y alrededor de entre 14 y 20 días en comenzar a ver un efecto en las muertes.

Fuente: https://www.databrew.cc/

Esta respuesta más suave y gradual puede haber retrasado el impacto económico en la etapa inicial de la epidemia, al tiempo que promovió la cooperación ciudadana a través de la ley. Sin embargo, también ha llevado a la sobrecarga de los sistemas de salud, como demuestran las tasas de mortalidad más elevadas que en China y Corea del Sur. Además, las restricción en la realización de pruebas diagnósticas conducirá a tasas de mortalidad sobreestimadas y limitará el valor de la información epidemiológica disponible. ¿Cuánto tiempo se puede mantener estas restricciones y cómo se evitará un segundo pico de enfermedad una vez que se levanten? Siguen siendo preguntas abiertas.

Reino Unido: contener, retrasar, investigar, mitigar

Reino Unido está implementando un enfoque basado en un continuo entre estas cuatro etapas, mediante el cual las medidas específicas se enfatizan más o menos según la situación. Las escuelas han permanecido abiertas, bajo el argumento de que los niños suelen desarrollar una enfermedad más leve. Las medidas restrictivas anunciaron un mes y medio después de que se informaran los primeros casos, pero dirigidas solo a los más vulnerables: las personas mayores y aquellas que presentan comorbilidades pueden tener que permanecer confinadas hasta cuatro meses. Esta estrategia también supone que algunas muertes serán inevitables y apuesta por ir generando inmunidad colectiva para evitar un segundo pico invernal en el último tramo de 2020.

La ventaja de esta aproximación es que las restricciones retardadas pueden aplanar los costos sociales y económicos, y las autoridades han declarado que las medidas de contención podrían dar tiempo para mejorar la capacidad del sistema de salud. Sin embargo, esta estrategia requiere una precisión casi quirúrgica para implementar o eliminar medidas restrictivas que podría no ser factible y que requiere un alto grado de cooperación pública. Dicho de otro modo, el riesgo de sobrecargar los servicios de salud y de tener un pico de muertes entre los grupos más susceptibles es alto. Esta estrategia también implica una apuesta por el desarrollo de inmunidad protectora entre todas las personas infectadas, tanto si han desarrollado síntomas como si no, lo cual es una gran incógnita por el momento.

Fuente: https://www.databrew.cc/

Sudáfrica, Ghana, Kenia, Botswana: fuerte protección de las fronteras

Varios países de África están apostando por contener el virus fortaleciendo sus fronteras, restringiendo los vuelos en función de su origen o de su ruta, negando los visados en base a la nacionalidad y pidiendo a los extranjeros que cumplan cuarentenas de 14 días. Las escuelas y universidades están cerradas, no se permiten reuniones masivas y cualquier persona con síntomas es derivada al hospital. Como en muchos otros países, se alienta el uso masivo de desinfectante para manos en espacios públicos y el pago sin efectivo.

Estas medidas pueden ser efectivas en las primeras etapas de la epidemia, con costos sociales y económicos limitados. Sin embargo, podrían ser contraproducentes al impulsar el pico en el invierno austral (en el caso de los países del hemisferio sur), al conducir a la discriminación contra los extranjeros (y tener un impacto al trabajo de cooperación realizado por personal y organizaciones extranjeras) y al afectar al comercio, algo que indirectamente puede hacer incrementar las muertes. Todavía no está claro si el hecho de contar con temperaturas más altas y poblaciones más jóvenes pueden ayudar a disminuir la propagación y el impacto de la epidemia en África.
Cada país debe adaptar la respuesta según las capacidades de sus sistemas de salud, sus recursos económicos e infraestructura, y el grado de responsabilidad colectiva e individual.
Conclusión

En conclusión, no existe un único enfoque universal que permita responder de manera efectiva a una situación actual en rápida evolución. Cada país debe adaptar la respuesta según las capacidades de sus sistemas de salud, sus recursos económicos e infraestructura, y el grado de responsabilidad colectiva e individual y de cumplimiento de las recomendaciones emitidas por las autoridades. La próxima generación de profesionales de la salud analizará las diferentes respuestas a COVID-19 descritas anteriormente y, con suerte, extraerá lecciones para futuras epidemias de enfermedades infecciosas.

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COVID-19: Cinco respuestas de salud pública diferentes ante la epidemia - Blog

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Este artículo ha sido escrito por Carlos Chaccour y Adelaida Sarukhan, con la colaboración de Joe Brew y Pau Rubio] Durante las últimas.... Blog sobre salud global. Abierto a todas aquellas ideas que persigan un acceso equitativo a la salud. En todo el mundo.

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Official Covid19 webpage.
Comparing a regional partner's response to Australia's.
Commonalities/Differences
The focus has been on China and Asia, North America and The EU/UK in terms of transmissions, deaths and impact on health departments and economies.
But how has this disease effected small Pacific Island nations who are dependant on financial and material support from countries like Australia?
International Citizenry can mean many things and often our Pacific Island neighbours (so often thought of as being within Australias sphere of infulence) are forgotten in such matters.

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CORONAVIRUS DISEASE 2019 (COVID-19) OUTBREAK

On 7 January 2020, the Government of China identified a novel coronavirus from a cluster of pneumonia cases of unknown aetiology in Wuhan City, Hubei Province. The virus has spread throughout China, and has also been identified in a growing number of countries around the world. Most cases confirmed in other countries as of end of January 2020 have been linked to China through travel history, or close contact with a person with a history of travel to China.

The outbreak was declared a public health emergency of international concern on 30 January 2020. The situation continues to evolve rapidly in China and internationally, and further spread of the virus should be anticipated.

There are still many unknowns about the virus including the clinical spectrum of disease, its severity and transmissibility. These factors are critical to enable evidence-informed risk assessments to be conducted, and to determine appropriate and proportional public health responses. In the absence of this knowledge, countries are encouraged to leverage IHR core capacities and existing national influenza pandemic plans to prepare for multiple scenarios, from importation of cases, containment and mitigation.

The Government of Papua New Guinea (PNG) through the National Department of Health (NDOH) has developed a preparedness and response plan that outlines the strategic components for managing a public health response to COVID-19. The plan considers priority actions to take in the event of community transmission. This plan is a live document that will be regularly updated based on the evolving situation and as more information is generated about the outbreak.

HEALTH SITUATION REPORT:

PNG Situation Report 14 on Preparedness for COVID-19 (2020-03-28)

PNG Situation Report 16 on Preparedness for COVID-19 (2020-04-12)

AWARENESS VIDEO:

What is Corona Virus Disease or COVID-19?

Covid-19 is a new disease which is very infectious and is caused by one of a group of viruses called corona virus. Already known types of diseases caused by corona viruses are common cold, SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) to name a few. Covid-19 stands for corona virus disease 2019.

Symptoms of Covid-19.

What you need to look out for in a person who has contracted covid-19;

Sneezing

Fever

Tiredness

Dry Cough

Shortness of breath

Aches and pain

Sore throat

Sometimes diarrhea, nausea (feel like voting), or running nose

Mode of Spread of COVID-19 and How to Avoid It

Human coronaviruses most commonly spread from an infected person to others through:

The air by coughing and sneezing.

Close personal contact, such as touching or shaking hands with other person already infected.

Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands.

You can avoid infecting yourself or others by;

Self-isolation- avoid public gatherings, clubs, markets etc.

Social distancing - it is recommended that you should be at least 2 meters away from other person. This is sufficient distance to avoid the virus jump from one person to another.

Avoid close contact - avoid unprotected contact with sick people (including touching ones eyes, nose or mouth) and with live farm or wild animals, also avoid touching objects and surfaces such as (tables and door handles) contaminated from a person with Covid-19.

Practice food safety - wash your hands between handling raw and cooked food. Wash your hands frequently with soap and water, before and after eating, and after going to the toilet.

What to do if you are sick?

Only common sense actions will help reduce risk to you and to others.

If you are sick, stay away from others - that is the most important thing you can do. You should also practice good hand and sneeze/cough hygiene

cover your cough and sneeze, dispose of tissues, and use alcohol-based hand sanitizer.

if unwell, avoid contact with others by staying 2 meters away from people.

At this time, there are no specific vaccines or treatments for COVID-19. However, there are many ongoing clinical trials evaluating potential treatments.

In PNG, any suspected cases can be reported by calling these hotline toll free numbers;

Further information on COVID-19 can be viewed on the following webpages;

RISK ASSESSMENT FOR PAPUA NEW GUINEA

As of 28 February 2020, the World Health Organization (WHO) has increased the assessment of the risk of spread and risk of impact of COVID-19 to very high at the global level. (Note that the risk assessment is updated regularly based on new information.) The very high risk assessment applies to PNG. For preparedness and response planning purposes, the following factors were also considered in Papua New Guinea:

PNG is geographically accessible by air, sea and land through its points of entry.

PNG health system has limited capacity and resources to manage a potential large-scale response.

Given the high profile nature of the outbreak and with the massive coverage in international and social media, the public risk perception is high. The PNG public is very concerned and has strong opinions on the health measures that need to be in place.

COVID-19 PREPAREDNESS UPDATE

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CORONAVIRUS DISEASE 2019 (COVID-19) OUTBREAK On 7 January 2020, the Government of China identified a novel coronavirus from a cluster of pneumonia cases of unknown aetiology in Wuhan City, Hubei Province. The virus has spread throughout China, and has also been identified in a growing number of countries around the world.

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Analysis of the public health response in Pacific Island Nations and how humanitarian funding cuts from countries like Australia are effecting the health response to Covid19.
How have poorer island nations responsed from a public health point of view and how is the same or different from Australia?
Given the pandemic staus of Covid19 and public health measures that a wealthy western country like Australia have been able to implement - what are the international implications of Foreign Aid funding cuts?
How might this be a thing post-Covid19?

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Devpolicy Blog from the Development Policy Centre

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An effective health response to the COVID-19 pandemic requires public health, epidemiological, laboratory and clinical care services all functioning within a robust and coordinated health system. In Papua New Guinea, Timor-Leste and the Pacific island Countries, the focus so far has rightly been on public health and social distancing measures to prevent entry and spread of the virus to Pacific communities, but clinical preparedness is also key, and being put in place.

As Terence Wood recently highlighted, foreign aid for health to the Pacific has diminished over several years. In addition, preventative public health has long been the focus of international aid to the region, but arguably at the expense of clinical care, resulting in declining and limited clinical services for Pacific peoples. Yet, as this pandemic has graphically revealed, this is a false dichotomy: well designed and equipped health facilities staffed by trained clinicians are as essential to diagnosis, treatment, and ongoing care of diabetes, heart disease, dengue or tuberculosis, as the public health interventions that focus on healthy lifestyles, environment, and surveillance. Indeed, hospitals and emergency departments are often the first or only contact between the community and health services, not the 'luxury items' that some in the Australian aid sector believe. Poor or inadequate biomedical clinical services that the community do not trust can result in adverse social and health outcomes for vulnerable populations.

Emergency care (EC) is in fact a critical component of the health system. It addresses all urgent illness and injury by providing life-saving interventions at the scene, during transport and at health facilities - both for everyday care and during surge events such as outbreaks and disasters. Importantly, EC is not the same as emergency response; it is the long-term foundation that enables effective emergency responses.

The ability of health systems in the Pacific region to respond safely and effectively to the COVID-19 pandemic is severely restricted because of under-developed, limited, and sometimes absent EC systems. Despite repeated and well-received emergency responses from Australia and New Zealand to the Pacific region in the immediate aftermath of climactic disasters or outbreaks, there have been few long-term aid and development investments in building robust EC systems.

Inconsistent triage, overcrowded emergency rooms, insufficient basic equipment, poor data collection and clinicians with limited training for EC all impact negatively on the ability of a health service to deliver safe and effective care. This is the case every day in many health facilities in the Pacific. Faced with the predicted surge demand from a COVID-19 outbreak, the potential consequences for the health workforce and for Pacific communities are serious. As frontline clinical service providers, EC clinicians across the region face enormous challenges and bear great responsibility for delivering health care during the pandemic response. How can we support our colleagues in the region to rapidly build an EC service in their facilities that will protect them and deliver effective care for their patients?

The Australasian College for Emergency Medicine (ACEM) is the peak body for emergency medicine in Australasia. ACEM members have been involved in EC development, training, research and education within low- and middle-income countries (LMICs) for over 20 years. In the Pacific, we have partnership agreements with The Pacific Community (SPC), Fiji National University, and the University of Papua New Guinea.

In light of the COVID-19 crisis and at the request of our EC colleagues across the Indo-Pacific, ACEM has pivoted its focus to provide technical assistance and support in the management of this pandemic.

Since late March, ACEM and SPC have hosted regular online support fora for Indo-Pacific LMIC EC providers to discuss the COVID-19 pandemic situation, their preparations and needs. By providing a safe environment for EC stakeholders across the region to share concerns, test ideas, learn from and support each other, these fora are an invaluable platform for the emerging EC community of practice and engender solidarity between countries and colleagues facing similar COVID-19 challenges.

The COVID-19 pandemic is undermining popular assumptions about global health. Some of the most highly developed and mature EC systems, such as those in the United States and United Kingdom have been overwhelmed through inadequate preparation and slow responsiveness. By contrast, our colleagues from the Indo-Pacific region work routinely with limited resources and are familiar with unexpected and sudden surge events. Along with our Pacific EC colleagues, ACEM aims to research the experience and lessons learnt during the pandemic response. Findings can be used in advocacy and action to strengthen EC developments in the region and improve future responses when demand for urgent health care surges again.

COVID-19 is a frightening prospect for all communities and health workers worldwide, but is also an opportunity to highlight the centrality of EC to an effective health system response, and invest in long-term partnerships that can result in sustained, robust EC systems development throughout the Pacific.

Both Dr Phillips and Dr Cox are members of the ACEM Global Emergency Care committee.
This post is part of the #COVID-19 and the Pacific series.

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COVID-19 and emergency care in the Pacific - Devpolicy Blog from the Development Policy Centre

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An effective health response to the COVID-19 pandemic requires public health, epidemiological, laboratory and clinical care services all functioning within a robust and coordinated health system. In Papua New Guinea, Timor-Leste and the Pacific island Countries, the focus so far has rightly been on public health and social distancing measures to prevent entry and spread ...

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"We are winning, but we have not yet won" - Health Minister 

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"We are winning, but we have not yet won" - Health Minister 

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Country measures based on disease progression

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Country measures based on disease progression

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Diagram showing measures to implement depending on disease progression (McKinsey).PNG

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Timeline of Covid-19 measures vs. daily case count

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Timeline of Covid-19 measures vs. daily case count

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Graph showing Australian measures by new cases (Guardian).PNG

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Sydney Morning Herald article announcing the formation of a Covid19 oversight committee taksed with monitoring the government's response generally and ministerial response specifically.

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Parliament meets on Wednesday to vote on the government's $130 billion wage subsidy but is not due to meet again until August 11, after the government scrapped the usual sittings in May and June.

At least 94 members from the two major parties are staying away from the House of Representatives, which means the lower house would have 57 members if all crossbench MPs attend. The Senate will also be pared back to limit the capacity to spread the COVID-19 virus.

Labor, the Greens and crossbench senators are confident of gaining a majority in the Senate on Wednesday to establish a select committee to review government decisions, using teleconferences rather than large public hearings.

Centre Alliance Senator Rex Patrick said the crossbench party would support a joint committee or, failing that, a Senate inquiry, to meet the two constitutional functions of the upper house.

"The first function is to review, amend or pass legislation, and the second is to provide oversight of the government," he said.

"It is always the duty of the Senate to provide oversight and check what the government is doing on behalf of the people.

"You can't have a situation where there are such significant actions by the government and not have any oversight at all."

Tasmanian independent Jacqui Lambie is also backing the select committee proposal, while Labor is hopeful of gaining support from Pauline Hanson's One Nation.

Eight independent MPs and senators have written to the federal government raising concerns that all discussions about the stimulus packages have taken place between only the Coalition and the opposition.

The letter, signed by Greens leader Adam Bandt, Victorian independent MP Helen Haines, Queensland MP Bob Katter, South Australian Rebekha Sharkie, Tasmanian Andrew Wilkie, NSW MP Zali Steggall, Centre Alliance senator Stirling Griff and his colleague Senator Patrick, says the crossbench has been deprived of "an important part of our role as parliamentarians".

Labor industrial relations spokesman Tony Burke said Parliament should continue sitting during the crisis because government bills would need amendment and to oversee decisions.

"There has never been a time where the meeting of the Parliament has been more important," he said.

Mr Burke also argued the last sitting, on March 23, had proven the value of Parliament with a question time that did not engage in the usual partisan tactics.

"Let's face it, we haven't had a question time like this in years," Mr Burke said.

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"Parliament at the moment is working exactly as it should and that's why we should meet more often."

Six former judges, including former High Court justice Mary Gaudron, last week called for Australia to adopt New Zealand's approach of using an all-party select committee to scrutinise government decisions.

The New Zealand Epidemic Response Committee has the power to compel witnesses and subpoena documents and is chaired by the country's Opposition Leader, Simon Bridges.

The British Parliament has used its Health and Social Care Committee to ask questions of government medical advisers throughout the crisis.

A Senate select committee would usually have a chair from the non-government parties, most likely Labor.

An alternative approach would be to gain bipartisan agreement on a joint committee agreed by both houses of Parliament, with a chair from the government parties.

David Crowe is chief political correspondent for The Sydney Morning Herald and The Age.

Rob Harris is the National Affairs Editor for The Sydney Morning Herald and The Age, based at Parliament House in Canberra

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Committee to monitor government on COVID-19 measures

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Parliament meets on Wednesday to vote on the government's $130 billion wage subsidy but is not due to meet again until August 11, after the government scrapped the usual sittings in May and June. At least 94 members from the two major parties are staying away from the House of Representatives, which means the lower house would have 57 members if all crossbench MPs attend.

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Interactive map of the world which rates the capacity of every country to respond to a global pandemic.  This has a date on it of 2019 - so it was prior to the Covid19 outbreak.
How accurate is this map?
Given that Australia is ranked as 'most prepared' how does this status compare with the actual response.
How have other contries fared compared to their 2019 rating?

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85% show no evidence of having completed a biological threat-focused International Health Regulations (IHR) simulation exercise with the World Health Organization (WHO) in the past year

Fewer than 5% show a requirement to test their emergency operations center at least annually

77% do not demonstrate a capability to collect ongoing or real-time laboratory data

24% show evidence of a nationwide specimen transport system

89% do not demonstrate a system for dispensing medical countermeasures during a public health emergency

19% demonstrate at least one trained field epidemiologist per 200,000 people

Recommendations:

Countries should test their health security capacities and publish after-action reviews, at least annually. By holding annual simulation exercises, countries will show commitment to a functioning system. By publishing after-action reviews, countries can transparently demonstrate that their response capabilities will function in a crisis and can identify areas for improvement.

Health security financing, evaluations, and planning should prioritize functional capability and regular exercises.

Read more on the Report & Model page.

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85% show no evidence of having completed a biological threat-focused International Health Regulations (IHR) simulation exercise with the World Health Organization (WHO) in the past year Fewer than 5% show a requirement to test their emergency operations center at least annually 77% do not demonstrate a capability to collect ongoing

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Cumulative count of confirmed cases by state and territory in Australia

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Cumulative count of confirmed cases by state and territory in Australia

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Cumulative count of confirmed cases in Australia (Guardian).PNG

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ABC news article comparing oversight of Victoria's Covid19 response to other jurisdictions.

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ABC news article comparing oversight of Victoria's Covid19 response to other jurisdictions.

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Victoria is not using the same oversight systems as the rest of Australia or Internationally.
Why is this telling?  What this the difference?  Is universal oversight systems good or bad?
What are the implications of this difference?

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When Victoria's MPs head into Parliament on Thursday they will be making some big decisions, casting votes on a huge financial package needed to help the state combat the economic carnage wrought by the coronavirus pandemic.

Treasurer Tim Pallas's $24.5 billion recovery war chest is significant - it will add considerably to state debt.

Modelling shows that the unemployment rate will more than double and 270,000 Victorian jobs could be lost under a worst-case scenario.

Scrutiny must be applied to this fund.

There are calls far and wide for Parliament to sit more often, not less, and there are calls for more sitting dates to be set.

The Parliament must also run the ruler over a giant omnibus bill that covers everything from councils to WorkCover, and grants unprecedented powers to the justice system.

Coronavirus update: Follow the latest news in our daily wrap.

The Federal Parliament and other countries have set up oversight bodies dominated by non-government parties but Victoria is not doing the same.

Instead, the Public Accounts and Estimates Committee, dominated by Labor, will be put in charge.

Known as "PAEC", it's the equivalent of Canberra's Senate estimates, but for years it's been overrun by petty political point-scoring and a platform for the government of the day to spruik its performance.

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It seems a little counterproductive that this body be given the job of crisis oversight.

Retired Supreme Court judge Stephen Charles QC, who helped set up the state's anti-corruption watchdog, says now is the time for more - not less - oversight of government decision-making.

Mr Charles, who is a member of the Accountability Roundtable think tank, says the group isn't opposed to the measures being taken by the Government, but greater scrutiny needs to be applied by Parliament.

Coronavirus questions answered

Breaking down the latest news and research to understand how the world is living through an epidemic, this is the ABC's Coronacast podcast.

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"We are supportive of what Government is doing but we need oversight - we don't distrust them, we just need to know what is going on,'' he told the ABC.

"It's at a difficult time when Government are being forced to act in a way that may turn out to be either wrong, or need amending, and oversight should not be dominated by Government personnel.''

He said Australia should follow other democracies, which are continuing to hold parliamentary sittings even in these tough times.

Internal bickering threatens Opposition's focus

The challenge for the Opposition and crossbench in the Upper House is to work together to apply some level scrutiny.

But there is a major problem for the Opposition.

Internal bickering is continuing to bog down Michael O'Brien's leadership at a critical time.(ABC News)

Rather than focusing on the greatest challenge in a generation, it continues to be bogged down by internal bickering - even at a time like this.

Opposition Leader Michael O'Brien's nearly 18-month tenure has been the subject of internal criticism for some time.

Too many people think he is not doing enough, or scoring any goals against the Government - a tough ask against an experienced Premier brimming with confidence.

There have been very public displays from frontbencher Tim Smith projecting an angry front.

Over the weekend he took to social media to lambast the Chief Health Officer Brett Sutton, describing some of his rationale for social restrictions as "bullshit."

And then there were the bats in his leafy Kew electorate.

What the experts are saying about coronavirus:

Featuring some local party branch members, Smith managed to get a story up on Channel 9's Sunday news about the pesky bats and the need to move them on because of coronavirus.

O'Brien hasn't sought to rock the boat in this crisis, offering to work with the Government while questioning some of the budget decisions.

Smith's behaviour over the weekend, and some less inflammatory comments from former leader Matthew Guy, have agitated some in the O'Brien camp - so much so that the leader promised to have a word to Smith.

Tim Smith has been projecting an angry front, criticising the Chief Health Officer.(AAP: James Ross)

Leaked story pours 'fuel on the fire'

On Tuesday, a story appeared on the front page of The Age stating that O'Brien had tried to soothe tensions in the party by telling Smith and company to cool their jets on their criticism of the Chief Health Officer during a Shadow Cabinet meeting.

The problem is Matthew Guy is just a backbencher, so he wasn't at the meeting, and other members of the Opposition frontbench said no such edict was made at Shadow Cabinet.

Throughout the party, MPs and staff were ropable that this story appeared.

The leaked story did nothing but "pour fuel on the fire", one MP said.

Others went as far as to suggest this behaviour could end O'Brien's leadership.

It is a dire time for the Victorian Liberals.

Changing horses during a crisis would shred even more credibility from the party that is still very much licking deep wounds from the Dan Andrews belting in 2018.

As a few wiser heads inside the party this week said "we aren't necessarily at our lowest ebb, we can get worse".

And given the state's economy is in freefall, things will get harder for Labor, so there may just be opportunity to gain ground for the Opposition - that is, if the team can work together.

What you need to know about coronavirus:

Space to play or pause, M to mute, left and right arrows to seek, up and down arrows for volume.

Some parts of Australia have had no new coronavirus cases in more than a week.

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Victoria's coronavirus crisis calls for more oversight and an end to Opposition infighting - ABC News

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As Parliament prepares to examine the coronavirus omnibus bill, Victorians need more - not less - oversight of Government decision-making and an Opposition that can work together to get the state through this crisis, writes state political reporter Richard Willingham.

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Croakey - Independent Journalism for Health

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Croakey - Independent Journalism for Health

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This is an article that analyses the international public health response to Covid19 agains the 2019 Gloal Health Security Index.
Countries that were highly rated prior to the Covid pandemic have had very poor responses to the pandemic.
There is not a comprehensive analysis of why this has happend - only pointing out which countries it has happened in.
Does look at Australia as well as other counties in the article.

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In an occasional series, public health researcher Alison Barrett reports on key public health and scientific publications and developments in the COVID-19 pandemic.

COVID-19 gives the lie to global health expertise
The Lancet, 26 March

"Global health will never be the same after COVID-19 - it cannot be," states author, Sarah Dalglish, as she discusses different countries' responses to the COVID-19 pandemic.

The Global Health Security Index compiled in 2019 shows ratings of 195 countries' ability to respond to outbreaks of infectious diseases; USA and UK were at the top of the list (first and second respectively), indicating they were the countries 'most prepared' for an infectious disease outbreak.

By comparison, South Korea was ranked ninth, China 51st and Australia fourth.

As the global pandemic unfolds, it has become evident that the USA and UK "have provided among the world's worst responses to the pandemic," conducting limited testing and contact tracing; and with limited access for health workers to appropriate personal protective equipment; nor enough hospital beds for patients.

This is in contrast to countries, such as China (ranked 51st) and South Korea (ranked 9th), which have delivered quick and effective responses, largely due to their experience dealing with the Middle East respiratory syndrome and severe acute respiratory syndrome outbreaks.

Most African countries were ranked as 'least prepared' to respond to an infectious outbreak.

While it is too soon to tell how the pandemic will affect them, African countries, such as Uganda, Rwanda, Senegal and Nigeria, have implemented measures "worth imitating," the author advises. These include proactive screening, handwashing stations at transport centres, WhatsApp chatbots delivering reliable communication, and celebrity campaigns and call centres to encourage sensible behaviour during the pandemic.

In summary, the author provides an interesting discussion on the notion that the current global health model has been largely based on the expertise, capabilities and technical assistance of rich countries, such as the USA and UK, whose response so far to the pandemic has been slow.

To move forward, it is vital conversations must occur to have a "more democratic, more multipolar, more networked, and more distributed understanding and operation of global health," says Dalglish.

Meanwhile, the Somali Government is reported to have sent has sent 20 doctors to Italy, volunteers from the Somali National University, following an appeal from the Italian government for international help to contain the virus.

The psychological impact of quarantine and how to reduce it
The Lancet, 26 February

This rapid review of published studies explores the psychological impact of quarantine and if there are any contributing factors that may predict who is most likely to experience worse outcomes from a period in quarantine.

The key finding from the review of 24 studies is that quarantine can result in a considerable psychological impact and that the impact can be ongoing.

This is important for health officials to consider when determining appropriate measures to fight an infectious disease outbreak, such as COVID-19.

The studies included in the review explored the psychological impact of quarantine during SARS, Ebola, H1N1 influenza, Middle East respiratory syndrome and equine influenza outbreaks. They used a variety of measures to determine outcome, including interviews, focus groups, surveys and diagnostic scales such as the Generalised Anxiety Disorder 7-item (GAD-7) scale.

The reviewed studies found a range of psychological impacts from periods in quarantine, including post-traumatic stress, anxiety, alcohol abuse, avoidance behaviours, low mood, insomnia and exhaustion. A qualitative study found that "for some, the return to normality was delayed by many months".

Evidence was mixed about what factors predicted adverse psychological impact of periods in quarantine.

While one study indicated that being a health care worker wasn't linked to poor psychological outcomes, another found that those that had been quarantined, had higher levels of post-traumatic stress than people from the general public who had also been quarantined.

Stressors during and after quarantine included the length of quarantine, boredom and frustration, worry over infection in themselves or infecting others, challenges accessing basic supplies, insufficient provision of information and guidelines, financial burden and stigma.

Whilst quarantine may be an essential measure to prevent or slow the spread of infectious diseases, the poor psychological impacts identified by this review highlight a need for appropriate strategies to be implemented to alleviate the adverse effects.

Strategies suggested by the authors include limiting the length of quarantine periods as much as possible, providing extra support to health care workers and those who have pre-existing mental health issues, and improving public health communications.

The authors identify some limitations to their review: due to the limited time available to conduct the review, a critical appraisal was not performed and grey literature not searched. Except for one study, long-term outcomes were not measured.

In conclusion, while quarantine is likely to result in negative psychological outcomes for some people, the authors point out that the result of not quarantining people, in order to manage infectious diseases and letting the disease spread, might result in worse psychological outcomes.

Why we need better rural and remote health, now more than ever
Rural and Remote Health Journal, 24 March
Professor Paul Worley, National Rural Health Commissioner, discusses the COVID-19 pandemic in the context of rural and remote populations in Australia where access to critical health services, such as testing clinics, is limited.

In preparing rural health systems to meet the demands of COVID-19, Worley writes that a global community response is required to fight the COVID-19 pandemic, at "social, economic and health system levels".

He suggests we learn from First Nations peoples and follow a "holistic approach that is grounded in an appreciation of the places in which we live and where we share both our history and future."

Rural health systems would be better prepared if they adopted the principles of integration and generalism, he says.

The four levels of integration he suggests are:

1. Across primary, secondary care and other social service sectors - it is more effective to service smaller rural communities with generalist GP models rather than "siloed specialist" models that are used in urban settings

2. Across professions - teams of generalists with broad skills can rapidly change their practice patterns without the need to hire new clinicians

3. Across towns and villages within regions - collaboration of services within rural regions is particularly critical when one health service is closed down for a period of time due to a natural or other disaster

4. Across care, teaching and research - training of the next generation.

Integrating a generalist approach to rural health will result in resilient, responsive and responsible practitioners, and reassurance for patients that they can access care closer to home, Worley says.

Social, economic and health systems can be improved by sharing data, developing strong telehealth systems and understanding that preventative health is an asset to a society's economic security.

Community mitigation strategies in a pandemic
BMJ, 17 March
With health systems overloaded and no vaccines or medication available, countries and communities need to implement systematic measures to alleviate the spread of COVID-19.

The key point from this editorial is that community interventions, such as measures already in place in Australia, like social distancing and travel restrictions, will be relied upon to ensure the health system is able to help all those in need during this pandemic.

Clear and transparent communication from health officials is vital, to ensure that misinformation, fake news and confusion are minimised and the public respond to intervention measures appropriately. This is a view supported by Victoria's Chief Health Officer Professor Brett Sutton, who has provided honest and timely communication to the Australian public throughout the pandemic to date.

As places of work can contribute to the spread of respiratory infections, the authors recommend some workplace strategies to enable social distancing measures, such as enabling video conferencing and expanded leave policies for staff, and scheduling shifts to reduce the number of people in one location.

While acknowledging there is limited evidence about the spread of the novel coronavirus among children, the authors suggest there may be a risk of infection to adults who are in school environments and to children who may have pre-existing health conditions, and recommend the closure of schools as another social distancing strategy.

However, they advise that schools should not be closed unless remote learning is implemented and school meals are available for children in need.

Other community mitigation strategies the authors discuss are cancellation of events and large gatherings, strategies that have been gradually implemented in Australia over the previous two weeks, including cancellation of many events and the recent restriction for no more than two people allowed to gather together (with exceptions).

In summary, if the number of times and length of contact with other people is reduced by implementation of community mitigation strategies, this will decrease the transmission of the novel coronavirus; and thus, help medical staff respond more effectively to those patients who are infected.

A long-term care facility in King County, Washington

The New England Journal of Medicine, 27 March

As previously mentioned, older adults are at a higher risk of severe or fatal outcomes from COVID-19 than younger adults.

This article, a case study of a COVID-19 outbreak in King County, Washington, USA, provides additional evidence of this, and also highlights how rapidly outbreaks can occur in long-term care facilities (aged care/assisted living facilities).

In February-March 2020, the US Centers for Disease Control and Prevention (CDC) and Public Health department in Seattle and King County (PHSKC) investigated a cluster of COVID-19 cases that occurred in King County, finding that by 18th March 2020, 167 confirmed cases of COVID-19 had been linked to a long-term care facility.

Among residents of the facility, 101 positive results were confirmed out of 118 tests, while 50 healthcare personnel and 16 visitors linked to the same facility were also found positive.

The residents, with a median age of 83 years, had higher hospitalisation and fatality rates than staff and visitors; most of the residents had pre-existing health conditions. The authors also found that three other facilities in the county had confirmed cases linked to the first facility.

Surveys and on-site visits in the long-term care facilities found a few reasons for the number of linked cases; including staff that worked in multiple facilities, working while symptomatic, not being familiar with PPE, having limited access to PPE and testing, challenge in identifying potential cases and transferal of residents between facilities.

The authors identified some limitations in their investigation: testing and case identification increased after the outbreak was recognised in the first site, but it is unclear if infections had occurred in other facilities in the area prior to that; there was not a complete record of visitors to the first site, which may have resulted in some infections among visitors being missed; and not all residents and staff were tested and interviewed, so there may be an under-representation of infected people.

In summary, the investigation into this outbreak provides valuable insight into the impact of COVID-19 among residents and staff of long-term care facilities (or similar aged care/assisted living facilities in Australia), highlighting the importance of identifying infected people and implementing effective infection control measures.

The authors concluded:

The experience described here indicates that outbreaks of Covid-19 in long-term care facilities can have a considerable impact on vulnerable older adults and local health care systems. The findings also suggest that once Covid-19 has been introduced into a long-term care facility, it has the potential to spread rapidly and widely.

This can cause serious adverse outcomes among facility residents and staff, which underscores the importance of proactive steps to identify and exclude potentially infected staff and visitors, early recognition of potentially infected patients, and implementation of appropriate infection prevention and control measures."

World Health Organization perspectives
Director-General statement, 27 March
Tedros Adhanom Ghebreyesus summarised key outcomes from a meeting of world health ministers, where China, Japan, Republic of Korea and Singapore shared their experiences and lessons learned from the pandemic in their country.

Some of the common practices that have worked for these countries include:

Early detection and isolation of confirmed cases is important

Contacts of confirmed cases need to be identified, followed up and also isolated

Care needs to be optimised

Communities need to be engaged in the fight.

The most urgent common challenge faced by many countries was the shortage of personal protective equipment (PPE) that is required to save lives.

Dr Tedros stressed the importance of not using medication or therapies that haven't yet been deemed effective in treating COVID-19: "We must follow the evidence. There are no short-cuts."

WHO's ongoing response to the crisis includes the publication of guidance documents online, training health workers on OpenWHO, the COVID-19 Solidarity Fund, and WHO's WhatsApp HealthAlert, which has 12 million users worldwide.

On 26 March, he told the leaders of G20 countries to use every resource possible to fight COVID-119, that countries should unite together during the pandemic, and that industry and innovation of G20 countries are important asset in producing and distributing required equipment.
Director-General statement, 30 March
Dr Tedros urged countries to ensure that essential health services continue, as previous outbreaks had shown that when health systems are overwhelmed, deaths due to vaccine-preventable and treatable conditions increase dramatically.

To help countries manage the surge in COVID-19 cases while maintaining essential services, WHO has also published a detailed, practical manual on how to set up and manage treatment centres for COVID-19, covering three major interventions:

First, how to set up screening and triage at health facilities, using a repurposed building or a tent.

Second, how to set up community facilities to care for mild patients;

Third, how to set up a treatment centre, by repurposing hospital wards or entire hospitals, or by setting up a new hospital in a tent.

The manual also covers structural design, infection prevention and control measures, and ventilation systems.

In implementing measures that restrict the movement of people, he said countries must respect the dignity and welfare of all people.

It's also important that governments keep their people informed about the intended duration of measures, and to provide support for older people, refugees, and other vulnerable groups.

Governments need to ensure the welfare of people who have lost their income and are in desperate need of food, sanitation and other essential services.

Countries should work hand-in-hand with communities to build trust and support resilience and mental health.

Dr Tedros explained that he sent the tweet above because:

COVID-19 is reminding us how vulnerable we are, how connected we are and how dependent we are on each other.

In the eye of a storm like COVID, scientific and public health tools are essential, but so are humility and kindness.

With solidarity, humility and assuming the best of each other, we can - and will - overcome this together."

Croakey thanks and acknowledges Alison Barrett for providing this column as a probono service to our readers.
See her previous compilation: COVID-19 wrap: smoking, kids, communities and cruise ships
* Alison Barrett is a Masters by Research candidate and research assistant at University of South Australia, with interests in public health, rural health and health inequities. Follow on Twitter: @AlisonSBarrett

Follow this Twitter list for informed news sources, global and Australian

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COVID-19 wrap: ranking global health, impact of quarantine, rural and remote health concerns, outbreak investigations, and reasons for humility

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In an occasional series, public health researcher Alison Barrett reports on key public health and scientific publications and developments in the COVID-19 pandemic. The Lancet, 26 March "Global health will never be the same after COVID-19 - it cannot be," states author, Sarah Dalglish, as she discusses different countries' responses to the COVID-19 pandemic.