COVID-19 contact tracing apps and the governance of collective action: social nudges, deliberation, and solidarity in Europe and beyond

ABSTRACT

During the COVID-19 pandemic, Digital Contact Tracing (DCT) tools were deployed by governments in Europe and beyond as a novel mobile technology to assist traditional manual contact tracing to track individuals who have come in close contact with an infected person. The public debate on this topic focused strongly on the protection of individual privacy. While this debate is important, it fails to address important governance questions – such as, for example, that DCT tools took on the role of social nudges, namely, tools of soft regulation that calibrate information flows so as to “push” people to act in ways that promote collective purposes. Social nudges include a range of norms and values that, however, are built into the technological and social features of the nudge, rather than rendering them open to public scrutiny and debate. Although the use of contact tracing apps is being phased out, the digitization of contact tracing can be seen as a case study of the broader trend towards digitization of the provision of health services. Debates of their governance thus have broader implications for the governance of data driven tools deployed for public health purposes in times of crisis.

KEYWORDS:

• Governance
• social nudges
• solidarity
• deliberative institutions
• collective action

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 QR codes are a type of machine-readable, two-dimensional matrix barcode that triggers an app that records information such as venue and time of visit.

2 Apps store individuals’ “encounter history” with BLE in smartphones that can be used to establish whether a user was close to an infected person (for example if they were 2 m apart for 15 min although countries could adopt more or less stringent criteria). Data collection remained limited to randomly generated and periodically deleted Bluetooth IDs. For differences between Bluetooth and GPS tracking see Chen and Kimberly (2021).

3 The background of this is that proximity tracing tools such as DCT can either process and store contact history centrally, typically by a health authority (centralized architecture), or on individual devices (decentralized architecture). Centralized proximity tracing provided health authorities with more control because it allowed them to integrate proximity tracing with manual contact tracing. If data is stored centrally, health authorities have access to the list of contacts when a user tests positive, enabling them to inform other users who are at risk (Riemer et al. 2020). The downside of centrally stored data, of course, is a concentration of data with government, fuelling concerns about oversurveillance (see also Guillon and Kergall 2020). After fierce debates on these aspects in many European countries such as the UK, Germany, Switzerland, Italy, Ireland, and Latvia, most governments opted for decentralized solutions, often relying on commercial solutions (by Apple and google). Some countries, such as Australia, New Zealand, Singapore, and France retained the centralized model. The French government explained that that the centralized model was essential to maintain high standards of privacy. Adopting a decentralized architecture would amount to giving away their “digital sovereignty” given that data could flow to US based corporations (Blassime and Ferretti Vayena 2021).This includes critiques about the closed nature of API development among these parties (Meaker and Tokmetzis 2020), which goes against the central tenets of the open software movement, and address larger questions about the outsourcing of digital infrastructure to commercial entities; importantly the distinction between the two groups is becoming more and more blurred see Ciucci and Gouarderes (2020).

4 For example, Payne and Moyer (2019) mention affinities with social cognitive theory, theory of planned behaviour and social ecological model.

5 For social influence theory see seminal paper by Kelman (1958) who suggested that a person's attitudes, beliefs, and behaviours are influenced by the social processes of compliance (tied to rewards or avoidance of punishment or disapproval), identification (with a leader), and internalization of norms to (through a reflective process building one’s identity). Mols et al. (2015) argue that nudges can be classified in the following manner:

nudges that tap into people’s propensity to choose options that demand the least (physical or intellectual) effort (i.e., the path of least resistance); nudges that tap into people’s propensity to conform or succumb to prevailing group norms and peer pressure; and interventions that harness people’s eagerness to identify with peer groups or valued groups that provide them with positive self-esteem.

6 This point can be criticized from the perspective of cognitive theories of emotion which stipulate that emotion also embeds a “think” strategy. According to these theories emotions are not blind forces but connected to cognition (Nussbaum 1996a). They embed forms of valuation underpinning the framework of rational inquiry. Although they do not take the form of articulated propositions, they trigger action. A full discussion falls outside the remit of this article due to space limits.

7 Hinch et al. (2020) found that for contact tracing apps to be effective, the user rate needed to be at least 56% of the overall population.

8 Indeed, different countries have integrated these proximity apps in different degrees within the wider system of testing, tracing and isolating (UK Independent Sage 2020a). For example, in the UK the system was centralized in that it did not use local capacity of manual contact tracing, privatized contact tracing, and did not integrate the app effectively within primary care, and the report by the UK Independent Sage (2020a, 2) explains. “..local authorities are disempowered and sidelined. GPs are ignored. Volunteer scouts remain largely unused. No person asked to isolate by this centralised privatised system was followed up” (on this point also see Gaskell et al. 2020). Countries such as Germany and Australia on the other hand, arguably had these apps integrated better within a community response and primary care system, and with a central role for manual contact tracing and local authorities, many times deploying people who were volunteers (Lewis 2020).

9 The SwissCovid and NHS Covid-19 apps were registered as Class I medical devices (Blassime, Ferretti and Vayena 2021).

10 Even when they were not triggering a contact-tracing response (due to too many cases that could not be possibly investigated) aggregating data made it possible was to inform the community about where cases were, identify risky venues and thus relied on personal responsibility see Tammy Mills, Mary Ward and Cameron Houston “Doubts over usefulness of QR codes as cases spread, close contact rules change” story published in January 3, 2022 available at https://www.theage.com.au/politics/victoria/doubts-over-usefulness-of-qr-codes-as-cases-spread-close-contact-rules-change-20220102-p59lch.html.

11 Citizens’ juries and citizens’ assemblies can be designed so that randomly selected lay people participate, chaired by a judge or other figure that people trust. Citizens deliberate during a series of weekends, hear evidence and the lived experience of affected parties. The event and any discussions is publicized widely so that citizens at large are informed about the proceedings. At the end of each round of deliberation, the government can conduct online citizen polls on priorities identified by the deliberative forums. Participatory democracy mechanisms, enabled by ICT technology can also be deployed to collect citizen feedback and data regarding institutional response, in order to both inform and validate subsequent citizen action (Peixoto 2013; Peixoto and Fox 2016). The outcomes from the assemblies and citizen polls would then be forwarded to the Parliament, where it will be presented alongside other positions, and measures to mitigate harms can be discussed and debated.

Additional information

Funding

This work was supported by European Commission [grant number Biased AI DLV-794604].

Notes on contributors

Katerina Sideri

Dr Sideri Katerina is assistant professor of political science at the Department of Political Science and History, Panteion University in Athens, Greece and a founding member of TECHNIS, an interdisciplinary platform that organizes online research seminars open to the public since 2014. Previously she was a Marie Curie Individual Fellow based at the Bioethics Institute Gent, Belgium, associate research fellow Centre for SocioLegal Studies, University of Oxford, and lecturer in law at the University of Exeter, UK. Dr Sideri's research interests include the link between innovation and democracy, technoscience, Intellectual property law, governance and strategy with a focus on algorithms, biotechnology and pharmaceuticals. She has published in journals such as Science and Public Policy. Journal of Law and the Biosciences, Journal of Technology Transfer, European Law Journal. Her more recent monograph is Patents as Discourse on Life: Bioproperty, Biomedicine and Deliberative Governance. (Routledge; 2014). She is now working on a new monograph with the title ‘Innovation for Whose Good?’

Barbara Prainsack

Barbara Prainsack is a professor at the Department of Political Science at the University Vienna, where she also directs the Centre for the Study of Contemporary Solidarity (CeSCoS), and the interdisciplinary Research Platform “Governance of Digital Practices”. Her work explores the social, ethical, and regulatory dimensions of genetic and data-driven practices and technologies in biomedicine and forensics. She holds honorary positions at the School of Social and Political Sciences at the University of Sydney, at the Department of Global Health & Social Medicine at King's College London, at the Centre de recherche en éthique (CRE), University of Montreal, Canada, and at the Centre for Health, Law, and Emerging Technologies (HeLEX) at the University of Oxford. Her latest books are: Personalized Medicine: Empowered Patients in the 21st Century? (New York University Press, 2017), and The Pandemic Within: Policy Making for a Better World (with H. Wagenaar, Policy Press, 2021). Barbara is also involved in policy-related work, e.g. as a member of the Austrian National Bioethics Commission, and as Chair of the European Group on Ethics in Science and New Technologies which advises the European Commission.