--- title: "Virtual Quarantine" language: "de" type: "page" original_url: "https://www.atlas-digitale-gesundheitswirtschaft.de/virtual-quarantine/" human_version: "../mensch/virtual-quarantine/" date: "2020-07-06" section: "Übersichtsartikel" categories: ["Big Data", "Public Health"] reading_time: "15 Min." description: "COVID-19 Quarantine: Potentials and threats of technologies for symptom tracking using the example of China" publisher: "Lehrstuhl für Management und Innovation im Gesundheitswesen, Universität Witten/Herdecke" --- # Virtual Quarantine *06.07.2020 · Übersichtsartikel* Quarantine ### Corona – now what? Highly infectious diseases pose a significant threat to global health. After a rapid spread, the World Health Organization (WHO) declared the Chinese epidemic COVID-19 a pandemic on 11 March 2020 (1). Identification of the infection source (or index case), the clustering of cases and transmission routes is crucial to prevent further spreading (2). The WHO recommended intensifying active surveillance by quarantining infected persons after their immediate isolation as well as induviduals who have had contact with them (1). As no treatment is currently available, the only tools that we can deploy are contact tracing, social distancing, and quarantine, all of which are slow to implement (3). There are two main approaches, which most countries follow: the techno- and human-driven (4). The first is based on the implementation of intelligent technologies and implies the use of IoT (Internet of Things) devices (4). This includes processing large amounts of data collected from smartphone users or other sensor-based tracking devices and triggering real-time alerts (3). The human-driven approach preferred by western countries is based on the motivation of civilians to follow government recommendations without further technological surveillance (4). The additional use of data requires compliance with high data protection standards. For this reason, tracking applications are rarely used in this context, but rather tracing applications that enable anonymous and local data storage. Which threats and potentials can be identified by using digital technologies and especially tracking applications in the extreme example of the People’s Republic of China? ### Chinese Status Quo Due to the nationwide implementation of technologies at points of contact in everyday life, the Chinese government, which has been criticized for human rights violations such as censorship or expropriation in the past, was able to ‚convert‘ existing technological infrastructure autocratically – to completely surveil the public (5). Cameras and sensors to record traffic data or the pollution level, the introduction of payment methods with face recognition for public transport or cashless payment with mobile phones became standard in China. As a result, almost all payments can now be traced back or travel routes can be restored, even to public transport passenger lists at specific times (6). ### Chinas first measures On January 23, 2020, the Chinese government ordered a strict lockdown of the Hubei province, especially in Wuhan. Public transport, including airport and metro, came to an immediate stop. The strict ban forced the residents not to leave the city without permission. In the next few days the government ordered the closure of all non-essential facilities, schools, public places and shops. On February 1, further cities in the Hubei province enforced the application of outdoor restrictions. Only one person from each household was allowed to go outside once in two days. From January 23 to February 16, more than 233 million Chinese were subject to outdoor family restrictions (7, 8). Government enforced and managed quarantine. Owners of mobile operators and payment platforms passed on data to police and health authorities in order to track the movements of citizens. Nevertheless, it was still impossible to record all contacts of those infected automatically. As a result, more than 1800 teams of five or more epidemiologists tracked tens of thousands of contacts. At the same time, all quarantine towns were divided into small control zones with checkpoints for mandatory body temperature measurement. In addition, party members regularly visited citizens to conduct (involuntary) examinations to detect COVID-19 symptoms (8, 9). ### Quarantine extreme Citizens suspected of being infected were quarantined and monitored by embedded door sensors with mobile connection. Whenever the sensor registered a door opening, a human operator called the quarantined person to check if all residents were at home and if there was a need to open the door (e.g. medical examination). Otherwise, the police received notice of a case on quarantine violation (3). China, as an export nation and essential player in the supply and service chains of global corporations, was particularly keen to reopen its factories as quickly as possible and for this reason focused on solutions to separate healthy and infected citizen. Therefore, at the beginning of February, the Chinese government was the first to introduce a corona tracking application called Health Code. In general, contact tracking applications raise serious privacy concerns when collecting personal data (8). In China, in particular, the government does not disclose how the analysis works and for what other purposes the collected data will potentially be used (9). ### The Health Code App The app, which runs on the Alipay and WeChat platforms, is connected to a state big-data analysis centre, processes historical data on movements of identified virus-positive people and contains additional personal data. Citizens have to complete a digital in-app questionnaire as a prerequisite for outdoor activities. According to analysis by the underlying AI, users receive one of three health codes as a result: Green, yellow, red. The green code allows its owner to move freely, the yellow code obliges the person to a 7-day quarantine. A red code is followed by a 14-day quarantine (8). Moving in the wild, user have to scan an in app QR code, which supports continuous tracking even further. Since quarantine measures are based exclusively on digital information and are simultaneously implemented through digital measures, one can speak of the first digital quarantine in this context. The Health Code App, embedded in already implemented digital surveillance systems, successfully identified, isolated and quarantined infected individuals (10). At the same time, the isolation led to an increase in online and telemedical services, from which Chinese companies like Ali Health, Good Doctor, Weiyi or Lilac Garden profited greatly (11). The price paid by depriving the population of privacy and personal rights is high. ### Learning and adapting The pandemic has dramatic consequences for the global economy. It has impacted every aspect of our daily lives. The Chinese example shows an extreme form of using digital technologies to identify and isolate people who are infected or possibly infected with SARS-CoV-2. On the one hand, the measures taken by the Chinese government have considerably accelerated technological progress. On the other hand, the containment of the virus spread has been compromised by violations of privacy and general human rights. In order to learn from the positive findings but remain true to democratic values western countries have begun to implement a mixture of human- and techno-driven approach, relying on reasonable, rational and considerate public behavior and offering traceability applications. Germany launched its Corona Warning App in mid-June 2020 to sustain the currently stable national situation. The future will show whether and how this form of digital support can contain virus spread. Sources 1. WHO Director-General’s opening remarks at the media briefing on COVID-19 [Internet]. 2020. [go to source](https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020) 2. Leong K-I, Si Y-W, Biuk-Aghai RP, Fong S, editors. Contact tracing in healthcare digital ecosystems for infectious disease control and quarantine management. 2009 3rd IEEE International Conference on Digital Ecosystems and Technologies; 2009: IEEE. [go to source](https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=f854816f114260b712c985047e58b7690f280aa9) 3. Ferretti L, Wymant C, Kendall M, Zhao L, Nurtay A, Abeler-Dörner L, et al. Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science. 2020;368(6491). [go to source](https://science.sciencemag.org/content/sci/early/2020/03/30/science.abb6936.full.pdf) 4. Kummitha RKR. Smart technologies for fighting pandemics: The techno-and human-driven approaches in controlling the virus transmission. Government Information Quarterly. 2020:101481. [go to source](https://www.sciencedirect.com/science/article/pii/S0740624X20301003) 5. Ishida T, Isbister K. Digital cities: technologies, experiences, and future perspectives: Springer Science & Business Media; 2000. [go to source](https://books.google.de/books?hl=de&lr=&id=c8N89LbQsTQC&oi=fnd&pg=PP2&dq=Ishida+T,+Isbister+K.+Digital+cities:+technologies,+experiences,+and+future+perspectives:+Springer+Science+%26+Business+Media%3B+2000.&ots=Rg8EhIFV3G&sig=xh16YURlgjTgo6L5IXne6ELFr7o#v=onepage&q=Ishida%20T%2C%20Isbister%20K.%20Digital%20cities%3A%20technologies%2C%20experiences%2C%20and%20future%20perspectives%3A%20Springer%20Science%20%26%20Business%20Media%3B%202000.&f=false) 6. Dameri RP, Benevolo C, Veglianti E, Li Y. Understanding smart cities as a glocal strategy: A comparison between Italy and China. Technological Forecasting and Social Change. 2019;142:26-41. [go to source](https://ideas.repec.org/a/eee/tefoso/v142y2019icp26-41.html) 7. Scale of China’s Wuhan Shutdown Is Believed to Be Without Precedent. The New York Times. [Internet]. 2020. [go to source](https://www.nytimes.com/2020/01/22/world/asia/coronavirus-quarantines-history.html) 8. As China lifts its coronavirus lockdowns, authorities are using a color-coded health system to dictate where citizens can go. Here’s how it works. [Internet]. 2020. [go to source](https://www.businessinsider.com/coronavirus-china-health-software-color-coded-how-it-works-2020-4?r=DE&IR=T.) 9. Pan X-B. Application of personal-oriented digital technology in preventing transmission of COVID-19, China. Irish Journal of Medical Science. 2020:1. [go to source](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7100464/) 10. Mello MM, Wang CJ. Ethics and governance for digital disease surveillance. Science. 2020;368(6494):951-4. [go to source](https://science.sciencemag.org/content/368/6494/951.summary) 11. Kevin Chang. How the Coronavirus Will Transform Healthcare in China [Internet]. 2020. [go to source](https://www.bain.com/insights/how-the-coronavirus-will-transform-healthcare-in-china/.) #### Verwandte Artikel - [Crowdhealth und Pandemien wie COVID-19](blog/2020/04/01/crowdhealth-und-pandemien.md) - [Einsatz digitaler Register in der COVID 19 Impfstoffforschung](blog/2020/06/24/einsatz-digitaler-register-in-der-covid-19-impfstoffforschung.md) - [Fieber?! – Keine Durchreise](blog/2020/06/24/fieber-keine-durchreise.md) ##### **Autoren:** Dennis Belsky , Dr. Katharina Pilgrim **Kategorien:** Big Data, Public Health ## Bilder auf dieser Seite - shutterstock_651685186-min-1320x792.jpg: ../mensch/assets/bilder/wp-content/uploads/2020/06/shutterstock_651685186-min-1320x792.jpg --- Diese Seite ist für KI-Systeme optimiert. Version für Menschen: [Virtual Quarantine](../mensch/virtual-quarantine/)