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Personal Digital Twins role in Epidemics control – III

A smartphone is brimming with sensors and their mumber keeps growing. The data generated by these sensors can be used to identify and analyse the person’s activity and the person health status with a growing sensitivity and precision. These data become useful in the monitoring of an epidemics and in enacting control protocols. Image credit: B.Cheung

As the epidemics in Italy keeps growing to an alarming rate (and so it does in several other Countries) measures have been taken to limit the mobility of people, thus decreasing the chance of contact and spread. Yet, it seems that a few Italians keep moving around. How many?

Well, it is yesterday’s news that authority in Milan has requested the telecom operators to provide information on the mobility of cellphones (in an anonymous way) and it turned out that 40% of Milan cellphones moved around in a radius exceeding 300m. That is quite bigger than the average home where people have been requested to stay! If you want to look at the bright side you can say that actually 60% of people in Milan complied with the government order, but the problem is that 40% is way too large of a percentage to effectively contain the spread of the virus.

Notice the adjective “anonymous”. European regulation (GDPR) forbid the use of smartphone data to track people movement, unless there is an explicit consent. This was not an issue in China that actually leveraged on smartphone software to impose, and monitor, movement restriction to people (with a yellow/red code that was restricting/forbidding movement).

Privacy is highly valued in Western culture. I am not going into a discussion of comparing this value with the societal value of complying with restriction orders. Rather, I would like to discuss, and solicit your comments on, the use of personal digital twins as a bridge across the personal space and the societal space.

The following thoughts have been, in part, stimulated by the comments I received on my first two posts, some of them very detailed, more in shape of a draft article than of a comment. I encourage all readers to make public their feedbacks and ideas as I see them very much valuable to foster a discussion and awareness on this topic.

This graphics shows the timeline of contagion versus the awareness of contagion in the Hubei region, China. The availability of Personal Digital Twin could have anticipated the detection of an incipient epidemic making containment actions much more effective. Image credit: Tomas Pueyo

So, let me first relate some of these comments before wrapping it up with my personal take on this subject.

  1. Personal Digital Twins (PDT) are a must if we are serious in detecting and containing an epidemic because they offer the possibility of effective micro management, taking actions well before an epidemic can be detected by the authority using normal channels (i.e. by analysing the growing number of cases reported through hospitals where people seek help). Evidence to this is provided in a very nice analyses of the awareness growth in China.
    The grey bars are based on interviews of sick patients, as they reported to a hospital, on when their symptoms started. The orange bars show the growth of confirmed cases. The “delay” between the insurgence of symptoms and the awareness of contagion by the authority is obvious. The availability of a PDT, triggered by the healthcare institution to look for specific symptoms would have resulted in a much quicker detection of cases. More than that, a personal digital twin can have a sensitivity that is far greater than the one of its physical twin. What can be disregarded initially by a person as an incipient cold or a mild flu can be identified by a PDT as a potential contagion, with the resulting raising of a red flag. Hence, the importance of PDT in early awareness of a developing situation.
    The value of a PDT in early detection is not just for the specific Covid-19 case, rather it can be applied to many diseases and can be a very useful service to the person. This latitude of application can also provide the business incentive for their deployment.
    The privacy aspect surface when the red flag is not directed to the physical twin, rather to the healthcare institution or (possible more critical) to a third party (government, employer, insurance company…). It is also a privacy issue when the red flag is communicated to other PDTs in the surrounding so that they can inform their physical twin to take protective actions. In the Middle Ages, leprosy sufferers where required to ring a bell as they walked around to let other people know of their condition. The communication among PDTs of a potential health risk would be a modern way of warning and I am not sure we would be all in agreement with this. This may well have a finger-pointing effect that can lead to harassment, bullying and further isolation of the infected person.
    Again, I am no expert in these societal issues. Several countries have legislation that impose a person suffering from a contagious disease to ensure other people are not put at harm but I am not aware of the obligation of declaring one’s situation publicly. Also, there is quite a big latitude between black and white. Where is the point when one has to inform another person or take evasive actions? If you have a cold should you behave in such a way to avoid spreading it around (YES!!!) otherwise you get fined (???). Who is instructing the PDT on what to disclose, what can the entity receiving the data entitled to do? The general approach in Europe has been quite protective of personal data but there are now discussion, prompted by the current situation, that exceptions may be acceptable for the greater society good. A statement has been issued  on March 16th the the EDPD Chair on this very issue.
    This is an issue today. Even without a PDT there are ways to get personal data. Can the Municipality of Milan request the identity of the people moving around and follow up on them (fine and jail are possibilities)?
    One comment I received pointed out part of the above issues and seemed orientated to keep the data, and the decision on what to do with them, under the control of the physical twin (the person) giving the healthcare institution only the permission to direct the PDT analyses in such a way to detect early signs, informing the person and leaving the person the responsibility to act on them. It would then be a responsibility of the person to act according to the request of the institutions, failing that would be a crime.
    The comment also pointed out that this could actually be a service provided (and charged) to the person (early detection service).

About Roberto Saracco

Roberto Saracco fell in love with technology and its implications long time ago. His background is in math and computer science. Until April 2017 he led the EIT Digital Italian Node and then was head of the Industrial Doctoral School of EIT Digital up to September 2018. Previously, up to December 2011 he was the Director of the Telecom Italia Future Centre in Venice, looking at the interplay of technology evolution, economics and society. At the turn of the century he led a World Bank-Infodev project to stimulate entrepreneurship in Latin America. He is a senior member of IEEE where he leads the Industry Advisory Board within the Future Directions Committee and co-chairs the Digital Reality Initiative. He teaches a Master course on Technology Forecasting and Market impact at the University of Trento. He has published over 100 papers in journals and magazines and 14 books.