Kochi: From contact tracing to creating buffer zones around #COVID19 clusters, India is using mapping and location-tracking technology to fight the pandemic. Maps have been used to assess and tackle diseases at least since the 1850 cholera outbreak in London. IndiaSpend looks at how mapping the disease data through geographic information system (GIS) can assist policymakers and the authorities during outbreaks, and what privacy concerns must inform such mapping.

GIS is a system designed to capture and analyse data using spatial trends. In the context of disease surveillance and monitoring, it integrates data such as the area of outbreak, population health and available infrastructure in the area to identify the population at risk. In recent years, GIS has been used to study and tackle several communicable and non-communicable diseases.

As of 8.00 a.m. on April 10, 2020, India has detected 6,412 cases of COVID-19, the disease caused by the novel coronavirus named SARS-CoV-2, according to Coronavirus Monitor, a HealthCheck database. While 504 (7.9%) patients have been discharged, 199 (3.1%) have died. Globally, 1.6 million cases have been detected, of which more than 350,000 have recovered and more than 95,000 have died, according to Johns Hopkins Coronavirus Resource Center.

How India is using location data

The Centre has tested the COVID-19 Quarantine Alert System (CQAS), an application that uses telecom data to trigger emails and text-message alerts to the authorities if a person has jumped quarantine, as The Hindu reported on April 3, 2020. "The data collected shall be used only for the purpose of Health Management in the context of COVID-19 and is strictly not for any other purposes," the report said, citing the standard operating procedure. "Any violation in this regard would attract penal provisions under the relevant laws."

Earlier, the Kerala State Disaster Management Authority and health department officials had begun collating disease surveillance data separately--with primary and secondary contacts of confirmed patients--traced and identified on a live geo-map, as the news channel NDTV reported on March 12, 2020. This allows officials to identify high-risk zones to activate containment measures. Further, the state is adding layers such as the availability of laboratory facilities and isolation wards in these areas.

On March 27, 2020, the Gujarat government launched a GIS-based mobile application to monitor the movement of those advised to be home-quarantined. Similar to the Centre's CQAS app, it alerts authorities if the person being monitored leaves quarantine. The Srinagar district had also announced plans to undertake GIS mapping of all cases including suspects, those under surveillance, quarantined and isolated, according to this March 17, 2020, report.

The Telangana government was also deploying geo-location technology to track over 25,000 people under home-quarantine using a COVID-19 monitoring system, according to this April 1, 2020, report in IANS, the news agency, published in the magazine Outlook. The state was already using 'TSCop', an app developed by the Telangana police, to geotag houses of foreign returnees, the report said. In neighbouring Andhra Pradesh, the government is using two tech tools developed by the State Disaster Management Authority to track each person in home-quarantine, and for contact-tracing of positive cases, the report said.

Punjab is also using cellphone data including call records and GPS to enforce lockdown, ensure home delivery of groceries, and for contact-tracing, as The Indian Express reported on April 10, 2020.

Tracking in other countries

Health officials in South Korea retraced patients' movements using security camera footage, credit card records, and GPS data from their cars and cellphones, The New York Times reported on March 23, 2020. Citizens are alerted of new cases, with websites and apps detailing hour-by-hour timelines of infected people's travel. People who believe they may have crossed paths with a patient are urged to report to testing centers. A separate app tracks those under quarantine.

Israel has allowed its intelligence agency to track mobile phones of confirmed or suspected patients. "We'll deploy measures we've only previously deployed against terrorists," the country's prime minister Benjamin Netanyahu said. "Some of these will be invasive and infringe on the privacy of those affected. We must adopt a new routine."

In China, entering one's apartment compound or workplace requires scanning a QR code, writing down one's name and ID number, temperature and recent travel history, as The Guardian reported in March 2020. Telecom operators track people's movements, some cities are offering rewards for informing on sick neighbours, and Chinese companies are rolling out facial recognition technology that can detect elevated temperatures in a crowd or flag citizens not wearing a face mask.

Austria and Belgium are using anonymised data from telecom operators for contact-tracing and monitoring those quarantined.

Healthmap--developed by Boston Children's Hospital--collates data from validated alerts from official sites for surveillance of emerging disease. Data ranging from air-ticketing and online networks tracking disease outbreaks in animals are used to track any unusual events and possible outbreaks. For COVID-19, Healthmap offers an interactive map, which includes a feature to show "outbreaks near me"--informing users about the disease transmission in their vicinity.

Mapping in past outbreaks

  • In 1854, John Snow investigated the source of a cholera outbreak in London using a hand-drawn map. His map overlay the locations of cholera deaths with information on public water supplies. The subsequent removal of the pump handle at a pump in central London's Broad Street reduced incidence.
  • In 2013, the African country of Cameroon had a poliovirus outbreak. The Ministry of Public Health's Expanded Programme on Immunisation mapped the poliovirus using GIS to estimate the disease's reach and determine the action required to contain further spread. Officials mapped district boundaries and gathered data on settlements, hospitals and population to visualise the outbreak in its geographic context.
  • In 1987, British geographer Stan Openshaw used GIS to analyse paediatric leukaemia clusters in the North of England. In his paper titled 'Investigation of leukaemia clusters by use of a Geographic Analysis Machine', he assessed whether living in close proximity to a nuclear facility posed a higher risk of paediatric cancer. Using geographic information tools alone would not be enough to identify the causes of leukaemia but the visual patterns provide cues for policymakers to undertake further research, he warned.
  • GIS was also used during the Ebola and SARS outbreaks for contact-tracing and assessing high-risk zones. The National Aeronautics and Space Administration used GIS to forecast risk by modelling the conditions that create conducive habitats for the aedes aegypti, the virus-carrying mosquito.

Privacy concerns

"The use of surveillance technologies, although necessary during the ongoing pandemic, has again started the long-standing debates on balancing privacy and security," said Kazim Rizvi, founding director of The Dialogue, a think-tank working in the intersection of technology and public policy. "It is important that the surveillance technologies should observe the tests laid down by the Apex Court in the Puttaswamy judgment (2017)."

The judgment permits surveillance provided that it is authorised by law, and its use is necessary and proportionate to the harm expected, he said, adding that a comprehensive surveillance law must keep privacy at the heart.

The use of spatial technologies and mapping for surveillance requires data classified as personally identifiable information. Concepts such as consent and personal data, for instance, are not defined in the Information Technology Act, 2000, rules framed under which (the Information Technology (Reasonable Security Practices and Procedures and Sensitive Personal Data or Information) Rules of 2011) regulate data protection in the country.

To rectify this, the Personal Data Protection Bill was introduced in the Lok Sabha (lower house of parliament) on December 11, 2019. It has been referred to a joint parliamentary committee for examination, but falls short in addressing privacy and accountability, Rizvi said. The Bill does not provide for an independent data protection authority that could look into the privacy concerns, he added.

"Authorising unregulated surveillance might lead to data discrimination in which marginalised community (sic) could be further excluded due to non-transparent algorithmic processes," Rizvi said.

(Nissy Solomon is a senior research associate with CPPR Centre for Comparative Studies.)

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