‘Bridge to health’? Why some question India’s contact tracing app.

After over a month of a particularly strict lockdown against COVID-19, in which even walks are banned, Indians perching on terraces and balconies for what little fresh air they can get agree on one thing: Now is time to think about what comes next.

It’s clear that here, as elsewhere, people will not return to the norms of pre-pandemic life for a long time. But as the costs of the stay-at-home order mount, the country is already deploying measures to gradually reopen as safely as possible. 

Among these is a contact tracing app, Aarogya Setu (Bridge to Health), which has been downloaded more than 50 million times in less than two weeks from its launch. According to its creators, the app will enable citizens to self-assess their risk of contracting the novel coronavirus, based in part on identifying whether they’ve come in contact with someone diagnosed with COVID-19.

Many countries have toyed with using mobile phones to track the pandemic, despite concerns over privacy – including the United States, United Kingdom, Israel, and Russia. But in India, the world’s largest democracy, the stakes are especially high.

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The country has 1.3 billion people, 23% of whom live below the poverty line, and is eager to allow laborers back to work. But the government’s record on digital tools has left many experts skeptical that a tracing app could be deployed without violating civil liberties, or building larger surveillance systems that could be exploited down the road.

For example Aadhaar, the world’s biggest biometric identification system, has been at the center of numerous controversies over the past decade, including massive data breaches. Recently, a journalist’s investigation uncovered plans to combine Aadhaar with a range of other databases to create a registry of everything from someone’s caste and disabilities to his or her family tree.

“Given the global scale of the coronavirus pandemic, governments may decide to use certain sophisticated technological responses. And given that it is an extraordinary situation, it may be difficult to question the use of these systems,” says Sidharth Deb, policy and parliamentary counsel at the nonprofit Internet Freedom Foundation in New Delhi, who recently released a working paper on COVID-19 tracing in India. 

Early on in the pandemic, he explains, observers pointed to seeming success in places like Taiwan, Singapore, South Korea, and even China, so the Indian government tried to replicate some of their solutions. “But instead of investing in testing, or health care facilities,” he says, “there’s been a greater emphasis on developing technological tools in India.”

False confidence?

Sumit Ray, a critical care specialist in a private hospital in Delhi, says he’s seen very few positive cases so far. But he doubts that Aarogya Setu will be useful in keeping the situation under control. “Contact tracing and isolation can be managed in other ways,” such as talking with patients to reconstruct their movements, he says, and the project is based on shaky premises. 

For example, Aarogya Setu can only be effective if at least half the population registers, according to its developers – in a country where only 1 in 4 own a smartphone. And given the stigma of testing positive, and leaks that have exposed patients’ identities, people are cautious. In the past few weeks, people suspected of having COVID-19 have been assaulted, and aggression toward health care workers is rampant. 

“Imagine what could happen to patients,” says Dr. Ray. With contact tracing apps, “you are turning individuals at risk into criminals.”

Given the scale and risks of the pandemic, some public health experts have encouraged contact tracing apps, despite concerns about privacy. But proximity doesn’t take into account factors such as whether people are wearing protective equipment, says Sean McDonald, a senior fellow at the Centre for International Governance Innovation in Canada. An app “drives people into seeking care that they may not need, at a time when the single most important indicator of morbidity at this point is health care system capacity.”

Citizens’ responsibility

Shriyak Jain, a young teacher living in a gated Delhi neighborhood, says he has downloaded the app, and he sees sharing personal data with the government as his duty in a time of crisis. 

“I particularly like the fact that the app contains all sorts of information related to COVID-19, including live updates, steps to take for personal protection, and it knows whether you are getting in touch with an infected person,” he says.

Most of his neighbors and family share the same view, he says.

The government maintains that the app is optional, though it has made the app mandatory for all public- and private-sector employees. “It’s still voluntary,” says Abhishek Singh, CEO of the National e-Governance Division with the Ministry of Electronics and Information Technology. “No one is forcing anyone to go to work; one can stay home and be safe.”

The Monitor has obtained a message circulating to heads of Delhi’s Residents Welfare Associations that instructs them to request residents download the app and report compliance to the city’s Disaster Management Authority. Officials have proposed making it compulsory for other public activities, like traveling by Metro or plane, and the government has reportedly asked smartphone manufacturers to install the app by default. The Noida municipality, in the outskirts of Delhi, has reportedly made not installing the app punishable with up to six months in jail.

There are also concerns about the app’s use of Bluetooth and GPS, which critics call excessive. Contact tracing can be performed with Bluetooth alone: When two phones are in proximity, they exchange a “digital handshake,” acknowledging that they’ve been in close contact without keeping a record of where or with whom. No data, encrypted or not, is uploaded onto the server. On the other hand, a GPS signal creates a map of each individual’s movements, enabling inferences about their work, socioeconomic status, and even political leanings, Mr. Deb explains.

Officials have dismissed such concerns, saying the app, which is a public-private partnership, was built to put “privacy first.”

“All personal information submitted is securely encrypted [before being] stored on the server,” says Mr. Singh. He also defends the use of GPS technology. “Your location data, on an aggregated basis, will be used to identify the locations that need to be sanitized and where people need to be more deeply tested and identify emerging areas where infection outbreaks are likely to occur,” he says. “The location data is not used for any other purpose.”

The bigger picture

Of the many app experiments around the world, the only one that could become a model of ethical contact tracing, in Mr. McDonald’s opinion, is Australia’s. The app “lets contact tracers contact you personally if you show up as a proximity beacon to someone who’s been tested,” he says, “but the whole operation is truly voluntary.” Australian officials say that the information won’t be used in other policy areas. India’s government, on the other hand, reserves the right to pass the data it collects through Aarogya Setu to other public agencies.

As knowledge about the novel coronavirus grows, the focus will shift to monitoring people’s behavior so the virus doesn’t spread, Mr. McDonald says. The problem will then become how to enforce policies in a way that respects human rights.

“Marginalized communities all over the world now have to consider the specter of having their movement tracked by people that have not always been kind to them,” he says. 

In India, for example, discrimination against Muslims has escalated sharply; days of deadly riots in February were the country’s worst interreligious violence in decades. A Delhi event organized by an Islamic missionary group has been blamed for about 30% of all COVID-19 cases reported between March and early April, causing another spike in anti-Muslim attacks.

But here, as elsewhere, groups may not have a choice about handing over their personal information if they want access to basic services. 

“This is not just a privacy-versus-public-health story anymore,” says Mr. McDonald. “Instead we’re making the turn into the field of fundamental rights.”

Editor’s note: As a public service, all our coronavirus coverage is free. No paywall.