America — and the world — is at war with a virus.
The novel coronavirus is an invisible foe that has penetrated all national defenses. It has established beachheads in every major city and every state, and it has resulted in more American casualties than the 19-year Vietnam War.
As Balaji Srinivasan has pointed out, the virus has even disabled an American aircraft carrier, the U.S.S. Theodore Roosevelt. No foe has been so fearsome since at least World War II.
The virus doesn’t care about political disagreements. It doesn’t care if people are tired of sheltering in place. And the virus can’t be intimidated, negotiated with, or turned from its path. It can only be beaten.
That is why much of the debate about “reopening the economy” is a distraction. The way to get the economy back is to start winning the war against the virus.
Without figuring out how to win — against the virus, not political opponents — trying to reinstate normal life would only give the virus free rein.
This would mean infection rates rocketing up again, fatality rates rising again (even more so than they already have), and hospital systems again threatening to buckle under the strain.
So how do we start winning this war?
We know there are two major components: Mass-testing and contact-tracing. Mass-manufacturing and supply chain coordination are critical too, but testing and contact tracing come first. These two things provide a means of tracking down the virus, figuring out where it exists and how it is spreading.
The first order of business is to gain visibility, and thus to stop being blind. Instead of letting the virus spread like an army of ghosts, we need to know its trajectory and its strongholds.
Once a means of visibility is accomplished, we can start doing spot-based quarantines, while focusing intense mitigation efforts on COVID-19 hotspots.
Again, this is the only way to get the economy back. It doesn’t matter how many shelter-in-place protesters rage in state capitols while brandishing assault rifles. Opening prematurely, without measures in place to win the war, will only result in another COVID-19 assault, and would squander the curve-flattening gains we have already paid dearly for.
Placing hope in a vaccine or a therapy is also a non-starter for now.
A useful therapy will come along eventually, and that is certainly good news. But it will likely apply to the sickest patients, and be slow in its mass distribution, and will not be something that inspires consumer confidence in terms of willingness to engage in normal life.
A vaccine, meanwhile, remains the best long-term hope of vanquishing the virus. But despite all the happy talk and optimistic pronouncements, the most optimistic assessments still suggest a vaccine is six to 12 months away — and that timeline is an extreme longshot.
The more realistic assessments — especially when considering that, as a rule of thumb, more than 90% of vaccine candidates fail — point toward a vaccine window of 12 to 18 months, if not multiple years.
So how do we get visibility? How do we get to a regimen of mass-testing and contact-tracing, the first steps toward visibility, which can then allow for spot quarantines and concentrated mitigation in hotspot areas?
The United States is still figuring this out. There is no clear-cut or well-established plan yet.
But as a point of good news, Silicon Valley is stepping up. The big tech companies — for all the privacy issues their involvement brings — can deploy game-changing capabilities the government doesn’t have.
In the virus fight, the tech giants bring three major assets: Scale, reach, and infrastructure.
In terms of scale, an estimated 3.5 billion people have a smartphone — with most of those phones running either Google’s Android or Apple’s iOS operating system — and 2.4 billion people use Facebook.
In terms of reach, Google, Apple, and Facebook have unparalleled ability to reach out to, and engage with, their billions of users across operating systems and social media platforms. Getting users to engage is the tech giant’s bread and butter.
And in terms of infrastructure, these companies know how to build and deploy robust technology applications that can serve billions of people at a time (whereas most government agencies can barely keep a website from crashing).
None of this tech-giant infrastructure, reach, or know-how can be easily replicated by governments. Just setting up and running the servers would be a nearly impossible task. And quickly building an instant connection to billions of people, with routine points of contact in their daily lives, is not possible at all.
These factors explain why the big tech companies can help us win the virus fight. And while their involvement will inevitably raise all kinds of privacy questions — and require deep scrutiny — the United States has run out of alternative options. Their help should be embraced.
To give a quick preview, Facebook wants to help with visibility — in terms of recognizing coronavirus outbreaks and hotspots — and Apple and Google are partnering to create a contact-tracing app.
In conjunction with health researchers at Carnegie Mellon University, Facebook is using its multi-billion-user social media platform to run “symptom surveys” that allow users to self-report whether they are showing COVID-19 symptoms.
Without scale, an opt-in survey like this would have little value. But scale is precisely what Facebook offers, with 223 million users in the United States alone.
When you can run a million surveys a week — or even more, across the entire country — all of a sudden, the data inputs start to have real significance.
Then, too, when it comes to mass-testing, shortages are a real problem.
Even in states like Maryland where test kits have been shipped in bulk, the tests are not being deployed due to a lack of swabs and chemical reagents. (Without swabs you can’t conduct the test, and without reagents you can’t process the results.)
But if Facebook data can provide a useful visibility proxy — by way of self-reported outbreak clusters — it could become possible for local and federal authorities to pinpoint outbreak areas and new hotspots. That would enable a much more efficient, and pinpointed, use of limited test supplies.
This would create a theoretical ability to “surge” resources into an area of outbreak, in the manner of firefighters going to the fire source. With this ability to “see” the virus, limited resources could then be concentrated where they are needed most.
This visibility could also enable the deployment of spot-based quarantine measures instead of blanket shutdowns. With better ability to distinguish between “green zones” (virus-free areas) and “red zones” (virus-afflicted areas), red zone areas could go into restriction while green zones could stay open.
Once we have real visibility, we can start deploying creative measures like this, and in so doing, strike a balance between restoring the economy and defeating the virus. Facebook’s survey efforts could help.
Apple and Google, meanwhile, are working on global deployment of a contact-tracing app.
Contact-tracing is a means of tracking the path of the virus. For example, say that Alice has a lunch conversation with Bob, and then Bob has a face-to-face meeting with Charlie. If Alice later discovers she has COVID-19, a contact-tracing app could alert Bob, and then Charlie, that they were possibly involved in a chain of transmission.
In theory, this could all be done anonymously. The contact-tracing app could notify Bob and Charlie of their COVID-19 exposure status without sharing Alice as the source, and all the data collected could be held by a public health agency, rather than Apple or Google.
A big advantage of Apple and Google working together is that the contact-tracing technology they create could have seamless interoperability between Android phones and iPhones (the two most popular smartphones in the world).
In reaching billions of users in hundreds of countries, an Apple-Google contact-tracing app would also have seamless operation across borders. That is critically important, as the virus doesn’t care about borders or political jurisdictions.
For any contact-tracing application, the privacy issues will be extreme. There is no way around this, because matters of public health are privacy-infused by definition.
To make it work, a user would not only have to share their health status, they would have to give access to their own roster of contacts. Even if all this data is anonymized, that is a frightening proposition. Apple and Google will have to ensure data is shared appropriately with public health authorities, and not used in any inappropriate way.
As with the concept of “herd immunity,” a certain critical mass percentage of users in a region will have to use the app in order for contact-tracing efforts to be effective. This means consumers will have to trust Apple and Google, and trust the public health authorities, if the technology is to be widely adopted.
In privacy terms, all the above is a whole lot to ask.
Under normal circumstances — in terms of sharing intimate personal health details and making one’s personal contact list available to a faceless suite of operators — the answer would be “no way.”
If the Apple-Google contact-tracing initiative moves forward, there will no doubt be complaints about a privatized surveillance state, and the concerns will be legitimate.
But what are the other options at this point?
In order to bring back the economy, we have to beat the virus, and that means mass-testing and contact-tracing, or a technological proxy for both that creates visibility and allows for max-efficient deployment of limited resources.
Via their infrastructure, scale, and reach, Silicon Valley is offering some genuine hope on this front.