23-04-2020

During the Senates’ hearing on April 21st, Italian Prime Minister Giuseppe Conte confirmed that population tracking will be one of the basic tools of the new phase coinciding with the end of the lockdown which will start on May 4th. It is a system capable of tracking the movements of COVID-19 positive people during the estimated latency time of the infection, in order to trace close contacts and activate health checks in search of  potential new cases. A contact tracking system managed through a mobile application. This is Immuni, the App of the Bending Spoons SPA, that the Civil Protection agency has chosen from 300 candidates. The application will be installed on a voluntary basis and must guarantee the anonymity of the traced subjects, the authorities rushed to confirm requests for clarification about the possible violation of the privacy protection regulations that Italy has signed by mutual agreement with other European countries. Those who choose not to install the app for whatever reason risk prolonged lockdown. To put it lightly, the tone of the government’s message was threatening, and was inadmissible according to the constitutional dictate.

Another noteworthy fact on which, apparently, the debate is still open is whether the contact data should be visible only from mobile phones or if they will be centralized on a peripheral software. The risk is that the centralization of data may be followed by future management that is not in line with the purposes for which they were collected. And since we are dealing with sensitive data on people’s health, according to an open letter from Nexa Polito – a research center headed by Turin Polytechnic – we need to be very careful about what we do, because this data would be prized by many companies looking to make a profit. This is the major argument against the risk of violation of privacy which is often trivialized and reduced to petty debate, even by commentators who in their respective fields have the reputation of being competent. It happens when you read the amazement, or perhaps it would be more correct to say the indignation, of those who argue that in the face of such a serious and important health issue, it is absurd to worry if Immuni records what we do, who we see and where we go. After all, Facebook, Google and Amazon do the same, when they chase us with their advertising alerts exemplified on our recommendations and purchases, it is the argument they use to support their marketing strategy, to conclude that there is no scandal.

Avoid centralizing data except in an absolutely anonymous form and make information available to healthcare professionals only if it is unrelated to the identity of the individual. In addition, make sure that the objectives of the application are clear and not superimposable, without passing the wrong idea that the traceability of contacts is comparable, for example, with an immunity license for those who have already contracted the virus and have come out of it . These are the privacy rules from which Immuni cannot deviate, according to the long list of the experts that appears in the line at the open letter mentioned above. This is a matter of higher consequence quite different from that of the advertising for personalized purchases that haunt us online.

Another aspect that remains to be clarified concerns the effectiveness of this App. According to an epidemiologist used to working on statistical projections Professor Enrico Bucci of the Temple University of Philadelphia, only 66% of Italians own a smartphone. Based on the factor R0, or the contagion capacity of the coronavirus, which is estimated at 2.5, meaning each virus positive person is estimated to infect 2.5 other people (for comparison, the common cold is 1.4 to 1.6). If the App was supplied to a presumed percentage of 50% of the population, it is projected that the R0 would decrease by about half: 1.25. Unfortunately, 1.25 is still too high for the complete eradication of the virus. Only when the R0 becomes less than 1, will the infection tend to decrease to negligible percentages.

Another controversial aspect still to be clarified are the limits of the connection of the contacts. We know that Immuni will work by relying on Bluetooth technology, which is able to determine the proximity of two mobile phones but without recognition of any barriers that act as a screen or, on the other hand, risks despite regulatory distancing (such as via sneeze droplets). The first case is that of two people sleeping a whole night in two different hotel or apartment rooms. According to Bluetooth they will have slept half a meter away but without specifying that there was a wall dividing them. The second case, however, is that of someone who shares a large open space but equipped with the same air conditioning system. While in this case Bluetooth will record no irregularities given the distance, without acknowledging that the two subjects, one of which is already contagious, have breathed the same air filtered by the ventilation systems.

The final figure to understand if a subject is at risk of contagion is to get tested. Despite the low amount of pharyngeal swabs made so far, are we sure that from 4 May there will be enough of them and other testing kits to allow hospitals and local doctors to track down new infected patients and all subjects with whom the patient came in contact with while harboring the virus thanks to Immuni? In other words, without a truly widespread analysis strategy, the App might be useless. Those who raise this doubt do so on the basis of what happened in Vo ‘Euganeo, a small village of 3400 residents in the province of Padua in which, at the end of February, the first cases of Covid-19 in Veneto were recorded. Based on the mass survey, in Vo ‘43% of the positive cases were asymptomatic but contagious as much as the symptomatic ones and, what is even more alarming, without any difference in intensity of transmission.

Written by Alberto Ferrari

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