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4.
PLoS One ; 16(1): e0245740, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33481877

RESUMEN

The nature of the COVID-19 pandemic may require governments to use privacy-encroaching technologies to help contain its spread. One technology involves co-location tracking through mobile Wi-Fi, GPS, and Bluetooth to permit health agencies to monitor people's contact with each other, thereby triggering targeted social-distancing when a person turns out to be infected. The effectiveness of tracking relies on the willingness of the population to support such privacy encroaching measures. We report the results of two large surveys in the United Kingdom, conducted during the peak of the pandemic, that probe people's attitudes towards various tracking technologies. The results show that by and large there is widespread acceptance for co-location tracking. Acceptance increases when the measures are explicitly time-limited and come with opt-out clauses or other assurances of privacy. Another possible future technology to control the pandemic involves "immunity passports", which could be issued to people who carry antibodies for the COVID-19 virus, potentially implying that they are immune and therefore unable to spread the virus to other people. Immunity passports have been considered as a potential future step to manage the pandemic. We probe people's attitudes towards immunity passports and find considerable support overall, although around 20% of the public strongly oppose passports.


Asunto(s)
COVID-19/epidemiología , Trazado de Contacto , Privacidad , Adulto , Anciano , COVID-19/prevención & control , Trazado de Contacto/legislación & jurisprudencia , Trazado de Contacto/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aplicaciones Móviles , Distanciamiento Físico , Privacidad/legislación & jurisprudencia , SARS-CoV-2/aislamiento & purificación , Encuestas y Cuestionarios , Reino Unido/epidemiología
5.
Ann Intern Med ; 174(3): 395-400, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33076694

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic has challenged the traditional public health balance between benefiting the good of the community through contact tracing and restricting individual liberty. This article first analyzes important technical and ethical issues regarding new smartphone apps that facilitate contact tracing and exposure notification. It then presents a framework for assessing contact tracing, whether manual or digital: the effectiveness at mitigating the pandemic; acceptability of risks, particularly privacy; and equitable distribution of benefits and risks. Both manual and digital contact tracing require public trust, engagement of minority communities, prompt COVID-19 testing and return of results, and high adherence with physical distancing and use of masks.


Asunto(s)
COVID-19/prevención & control , Trazado de Contacto/ética , Trazado de Contacto/métodos , Pandemias/prevención & control , COVID-19/epidemiología , COVID-19/transmisión , Trazado de Contacto/legislación & jurisprudencia , Sistemas de Información Geográfica , Humanos , Máscaras , Grupos Minoritarios , Aplicaciones Móviles , Distanciamiento Físico , Privacidad , Medición de Riesgo , Teléfono Inteligente , Confianza , Estados Unidos , Tecnología Inalámbrica
6.
J Am Med Inform Assoc ; 28(1): 193-195, 2021 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-32584990

RESUMEN

Recently, there have been many efforts to use mobile apps as an aid in contact tracing to control the spread of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) (COVID-19 [coronavirus disease 2019]) pandemic. However, although many apps aim to protect individual privacy, the very nature of contact tracing must reveal some otherwise protected personal information. Digital contact tracing has endemic privacy risks that cannot be removed by technological means, and which may require legal or economic solutions. In this brief communication, we discuss a few of these inherent privacy limitations of any decentralized automatic contact tracing system.


Asunto(s)
COVID-19 , Trazado de Contacto/legislación & jurisprudencia , Aplicaciones Móviles/legislación & jurisprudencia , Privacidad , COVID-19/epidemiología , Canadá , Trazado de Contacto/ética , Trazado de Contacto/métodos , Humanos , Aplicaciones Móviles/ética , Estados Unidos
7.
Med Leg J ; 89(1): 19-22, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33200668

RESUMEN

At the early stage of an emerging disease, information is often insufficient for governments to determine what actions are necessary to contain its transmission. Taiwanese society was not prepared when the SARS epidemic hit in 2003. After the SARS epidemic, Taiwan began to overhaul its Communicable Disease Control Act authorising the government to act in a murky situation without the fear of violating due process. In hindsight, the new law has contributed a large part to the effective containment of Covid-19 in Taiwan. However, a new issue emerged concerning the conflict between an individual's freedom of confidential communication and the government's use of cell phone positioning to monitor self-quarantine. Although Taiwan's Council of Grand Justices previously resolved the concern over potential breaching of due-process, the legislature may have to strike a balance between public health emergency and the use of an electronic footprint to trace individual activities.


Asunto(s)
Derechos Civiles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Epidemias/prevención & control , COVID-19/epidemiología , Teléfono Celular/legislación & jurisprudencia , Trazado de Contacto/legislación & jurisprudencia , Epidemias/historia , Sistemas de Información Geográfica/legislación & jurisprudencia , Historia del Siglo XXI , Humanos , Cuarentena/legislación & jurisprudencia , Síndrome Respiratorio Agudo Grave/epidemiología , Taiwán/epidemiología
10.
Am J Trop Med Hyg ; 103(6): 2400-2411, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33124541

RESUMEN

We studied sources of variation between countries in per-capita mortality from COVID-19 (caused by the SARS-CoV-2 virus). Potential predictors of per-capita coronavirus-related mortality in 200 countries by May 9, 2020 were examined, including age, gender, obesity prevalence, temperature, urbanization, smoking, duration of the outbreak, lockdowns, viral testing, contact-tracing policies, and public mask-wearing norms and policies. Multivariable linear regression analysis was performed. In univariate analysis, the prevalence of smoking, per-capita gross domestic product, urbanization, and colder average country temperature were positively associated with coronavirus-related mortality. In a multivariable analysis of 196 countries, the duration of the outbreak in the country, and the proportion of the population aged 60 years or older were positively associated with per-capita mortality, whereas duration of mask-wearing by the public was negatively associated with mortality (all P < 0.001). Obesity and less stringent international travel restrictions were independently associated with mortality in a model which controlled for testing policy. Viral testing policies and levels were not associated with mortality. Internal lockdown was associated with a nonsignificant 2.4% reduction in mortality each week (P = 0.83). The association of contact-tracing policy with mortality was not statistically significant (P = 0.06). In countries with cultural norms or government policies supporting public mask-wearing, per-capita coronavirus mortality increased on average by just 16.2% each week, as compared with 61.9% each week in remaining countries. Societal norms and government policies supporting the wearing of masks by the public, as well as international travel controls, are independently associated with lower per-capita mortality from COVID-19.


Asunto(s)
COVID-19/epidemiología , COVID-19/mortalidad , Máscaras/provisión & distribución , Pandemias , Cuarentena/organización & administración , SARS-CoV-2/patogenicidad , Factores de Edad , COVID-19/diagnóstico , Prueba de COVID-19/métodos , Frío , Comorbilidad , Trazado de Contacto/legislación & jurisprudencia , Salud Global/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Modelos Lineales , Análisis Multivariante , Obesidad , Distanciamiento Físico , Índice de Severidad de la Enfermedad , Factores Sexuales , Fumar/fisiopatología , Análisis de Supervivencia , Urbanización
18.
Am J Public Health ; 109(11): 1576-1579, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31536402

RESUMEN

In November 2018, the Centers for Disease Control and Prevention distributed guidance to funded agencies under its Integrated HIV Surveillance and Prevention Programs Initiative to support the implementation of the program's third strategy: HIV transmission cluster investigation and outbreak response efforts. Cluster detection seeks to identify persons infected with HIV (diagnosed and undiagnosed) who are linked to infections in single or related sexual and injection drug networks. Identifying expanding clusters allows public health personnel to intervene directly where active HIV transmissions occur.However, in the context of HIV infection where most US states have enacted criminal exposure laws, these efforts have sparked concerns about the protection of HIV surveillance data from court order or subpoena for law enforcement purposes. The Centers for Disease Control and Prevention calls for funded agencies to evaluate relevant confidentiality laws to ensure that these are sufficient to protect the confidentiality of HIV surveillance data from use by law enforcement.We present four often overlooked factors about the criminalization of HIV exposure and HIV surveillance data protections that should be considered in statutory assessments.


Asunto(s)
Trazado de Contacto/legislación & jurisprudencia , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Centers for Disease Control and Prevention, U.S. , Confidencialidad/legislación & jurisprudencia , Confidencialidad/normas , Derecho Penal , Infecciones por VIH/prevención & control , Humanos , Aplicación de la Ley/ética , Política , Estados Unidos
20.
Ned Tijdschr Geneeskd ; 1622018 May 18.
Artículo en Holandés | MEDLINE | ID: mdl-30040313

RESUMEN

OBJECTIVE: Effective partner notification and partner treatment are essential to prevent reinfection with Chlamydia trachomatis. For this reason we investigated the possibilities for patient-initiated partner therapy (PIPT) in the Netherlands. DESIGN: Database research, questionnaires and interviews. METHOD: The current practices of partner notification and partner treatment were assessed by means of databases and questionnaires. Facilitators of, and barriers to, the introduction of PIPT were qualitatively explored among professionals at GP practices and sexual health centres. In addition, we interviewed chlamydia patients and their notified partners. Finally, the legal possibilities for PIPT in the Netherlands were explored. RESULTS: At sexual health centres, regular partners were treated pending test results in 97% of chlamydia cases. Professionals were reluctant to hand out medication to patients for their partners; GPs indicated that they did this in 6% of cases of chlamydia. Patients also saw barriers. The interviewees indicated that the process of partner notification could be improved. Both professionals and patients had a clear preference for combining PIPT with the offer of a (home) test. If those partners notified about chlamydia were not tested, 10% of all gonococcal infections would be missed. CONCLUSION: Currently, the widespread introduction of PIPT does not seem to be a good option for the Netherlands. PIPT could be implemented for current regular partners and those who would otherwise not be tested. The combination of a home test kit with PIPT is then preferable. Taking current legislation into account, sexual health centres run by local public health departments are probably the best starting position for PIPT. We recommend that this be further explored.


Asunto(s)
Infecciones por Chlamydia/prevención & control , Chlamydia trachomatis , Trazado de Contacto , Servicios de Salud Reproductiva/organización & administración , Parejas Sexuales , Adulto , Trazado de Contacto/legislación & jurisprudencia , Femenino , Humanos , Masculino , Países Bajos , Servicios de Salud Reproductiva/legislación & jurisprudencia , Encuestas y Cuestionarios
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