Apps to track movements and limit infections: Italy's plan to curb the coronavirus

To appeal to the technology anddata analysis for contain the spread of the coronavirus, slowing infections and avoiding any new outbreaks, especially in the phase when we can ease the lockdown and try to return to our daily lives. This is also based on the example of South Korea, where infections have seen a significant slowdown thanks to widespread testing and the activation of a system based on digital technologies, including the Corona 100m application, which provide for the tracing, testing, and isolation of people who have come into contact with those who tested positive for Covid-19. This protocol has allowed the country (50 million inhabitants) to curb infections, without requiring the closure of entire cities, shops, bars, and restaurants, or other restrictive measures like those implemented in China and subsequently in Italy and the rest of the world.

APP TO TRACK MOVEMENTS

Thus, last March 23rd, the threshold of 50 thousand confirmed infections was exceeded (168.941 total cases, 106.607 currently positive, 40.164 recovered and 22.170 deaths, based on the latest data released by the Civil Protection and relating to April 16, 2020), the Ministry of Innovation, in support of the Ministry of Health and the Istituto Superiore di Sanità and in collaboration with the World Health Organization and the support of a multidisciplinary scientific committee has launched a call document To identify "the best available digital solutions for telemedicine apps and home patient care, and for technologies and technology-based strategies for actively monitoring the risk of contagion." The call is open to public administrations, companies, public and private research institutions and centers, as well as associations, cooperatives, consortia, foundations, and institutes, to coordinate the adoption of these tools nationwide to combat the spread of Covid-19. Over 800 applications were received: the call for applications lasted just three days due to the ongoing health emergency, and officially closed at 1:00 PM on March 26, 2020.

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APP TO TRACE INFECTIONS

Both in the case of telemedicine applications than those of "contact tracking”, technological obstacles are accompanied by doubts relating to the privacy protectionThis is a particularly pressing issue for healthcare data. A system capable of rapidly monitoring people's health conditions, allowing doctors to remotely check the data and, if necessary, intervene, should offer optimal guarantees regarding the security of the collected information.

TELEMEDICINE APPLICATIONS

Obviously, the use of an application would not replace the role of the doctor but would allow, for example, to help the patient to better self-assess your symptoms to determine whether or not it is Covid-19, thus also easing the workload of emergency numbers and health advice, both nationally and regionally.

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CONTACT TRACING APP

In particular, in relation to the monitoring citizens with a view to containing infectionsAnyone who tests positive for Covid-19 should download an app to their smartphone. This will allow authorities, through careful data analysis, to verify who else they have come into contact with, contact them, and subject them to any necessary testing, from a swab test to home isolation.

As also declared by the president of the Istituto Superiore di Sanità (ISS), Silvio Brusaferro: “The app will serve not only to track, but also to assist and will combine the values ​​of democracy and freedom with social distancing».

APP TO LIMIT INFECTIONS

The Ministry of Innovation led by Minister Paola Pisano has appointed the multidisciplinary group of experts with the task of evaluating and proposing data-driven technological solutions for management of the health, economic and social emergency linked to the spread of the SARS-CoV-2 virus. This is a technology task force consisting of 74 experts, divided into eight subgroups. As reported in the note from the Ministry for Technological Innovation and Digitalization, it will work free of charge to identify and evaluate, in compliance with privacy regulations, technological solutions based on data collection and analysis, suitable for containing the number of infections, facilitating the timely adoption of social distancing measures essential to stem the spread of the virus and address the ongoing crisis.

IMMUNI APP TO TRACE INFECTIONS

On the evening of April 16, 2020, the government chose theapp for tracing coronavirus infections based on the shortlist presented by the Ministry of Innovation's technology task force. The application will be called "immune” and will use the bluetooth to determine whether users have come into contact with people who tested positive for coronavirus.

The extraordinary commissioner for the health emergency, Domenico Arcuri, has signed the ordinance with which he orders the stipulation of the contract for the free transfer of the software license and the free service contract with the Milanese company Bending spoons who will also take care of any updates that may be necessary. The use of Immuni will be on a voluntary basis: the app can be downloaded from the App Store (Apple) and Google Play Store (Android). To be effective, it must involve the 60 percent Italians.

HOW THE IMMUNI APP WORKS

Immuni will include a sort of "clinical diary" where users can record their health status and any symptoms related to the coronavirus. Bluetooth technology will allow smartphones to recognize and save the codes of different devices on which the same app is installed. The use of GPS is not foreseen.

ALLERTALOM APPLICATION FOR THE LOMBARDY REGION

Meanwhile, on April 16, 2020, Lombard citizens received a text message asking them to download the app on their mobile phones. LOM AlertAs Fabrizio Sala, vice president of the Lombardy Region, explained, the message was sent free of charge by telephone companies (Vodafone, TIM, Wind 3, and Iliad) and authorized by the Civil Protection Department. It is a text message sent in the event of emergencies or disasters. In these situations, institutions do not acquire or process citizens' data but simply provide operators with a text message to send to users.

"LOM Alert“, is an application that can track a contagion risk mapThe app, developed by the regional holding company Aria Spa and created in collaboration with doctors and researchers from San Matteo Hospital and the University of Pavia, collects data anonymously through a questionnaire requiring individuals to indicate their age, habits during lockdown (office or smart working), any symptoms, and contact with people who tested positive for Covid-19. A sort of remote triage To try to identify potential infections and stop the spread of the virus. Responses to the questionnaire are not linked to a phone number, and users receive no feedback on the information they provide, but the data allows them to monitor the evolution of infections. The app, of course, does not replace a swab test or medical checkups, but it is an additional tool for locating potential outbreaks or identifying a resurgence of the infection in areas considered less at risk.

Serological tests to find out who is immune

Phase two, the gradual reopening of Italy, could also coincide with mass testing to reveal those who are already immune to the SARS-CoV-2 virus and are not yet aware of it. This would involve rapid blood tests Capable of identifying the presence or absence of coronavirus antibodies. Currently, however, there are no truly reliable serological tests: the Ministry of Health and the Civil Protection Technical Scientific Committee are working to validate rapid tests.

THE SYSTEM FOR CONTROLLING MOVEMENTS IN LOMBARDY

Previously, around the middle of March, the Lombardy region, announced the use of a work for Measuring population movements during the Coronavirus epidemic This will ensure compliance with the restrictions established by the government to contain the spread of the virus. The data, provided to the Lombardy Region by the main mobile operators and collected in aggregate and anonymous form, is used to visualize the flow of people, not to monitor individuals. This "quantitative" system for analyzing cell-to-cell cell phone movements has become necessary due to the high number of movements within Lombardy, despite the measures adopted by the government, namely staying home and traveling only for proven work needs, health reasons, or other absolutely urgent situations.

The space between cells is 300-500 meters, meaning that this does not include anyone walking out into the garden or going to the local grocery store. However, it does include those authorized to move around for work, health, or family reasons.

DRONES FOR MOVEMENT CONTROL

Meanwhile, precisely to "ensure the containment of the coronavirus epidemiological emergency", theNational Civil Aviation Authority (Enac), following requests from local police commands, has authorised, until 3 April, the use of drones for monitor citizens' movements within municipal areas, and "even in urban areas where there is a small population exposed to the risk of impact." The use of drones allows for the detection of areas where there are potential gatherings of people or prohibited behavior, thus allowing the municipal police to intervene.

While in certain cases, telephone companies may provide this type of data (always in aggregate and anonymous form) to certain companies, such as those that deal with traffic statistics or applications, it is extremely rare for this information to be used by governments, regions, and other institutions.

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CONTACT TRACING AND PRIVACY

The "contact tracing" issue also received intervention from Privacy Guarantor, Antonello SoroIn an interview with Repubblica, he explained that "it's not about suspending privacy but about adopting effective tools to contain the infection, while always respecting citizens' rights." Soro also specified that "a measure like contact tracing, which impacts a very large number of people, requires a regulatory provision that complies with these principles. A decree-law could combine the timeliness of the measure with parliamentary participation. It goes without saying that its duration must be closely linked to the duration of the emergency."

Yes to contact tracing then, but through a temporary decree law also to avoid an "unconscious slide from the Korean model to the Chinese one, mistaking the renunciation of all freedom and the blind delegation to the algorithm for the saving solution for efficiency".

HOW CHINA DEALED WITH THE CORONAVIRUS EPIDEMIC

In China, as we know, the fight against Coronavirus has been carried out through very drastic containment measures Starting with the total quarantine of the entire city of Wuhan, with its nearly 15 million inhabitants, and the blocking of all forms of private transportation not only in the epicenter of the coronavirus outbreak but also in other major cities in Hubei. But that's not all: in parallel with the quarantine, the Chinese government has launched a campaign to identify citizens affected by Covid-19, using a highly technologically advanced solution: an application capable of assessing individuals' risk by assigning each citizen a different level of epidemic danger. After registration and the release of certain data, the system is able to track people's movements and encounters, assigning a code green, yellow or red depending on your own health state o risk of infectionIt is impossible to move without first showing the code stored on the app. The fear now is that, once the emergency phase is over, certain tools, including facial recognition software, could remain in use.

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SOUTH KOREA'S STRATEGY TO STOP THE CORONAVIRUS

A lot of technology also in the response to the coronavirus by the South Korea, albeit less invasively than the Chinese model. Simply download the Corona 100m app to your smartphone, on a voluntary basis, to find out if there are any outbreaks within a 100-meter radius of your location. Those who cannot download the app can still view the location of infected people and their movements by consulting the online map "Coronamap." Instead of quarantine, the Korean government has focused heavily onidentificationand, theexam (through blanket testing) and theisolation of citizens who have come into contact with infected peopleThis data monitoring and analysis system is also made possible by the fact that Korean law allows the health authority access to surveillance camera data, GPS tracking of phones and cars, and credit card transactions. Security camera images were also used to reconstruct the movements of people who tested positive for coronavirus. All this information was then shared anonymously on a dedicated app, allowing everyone to be aware of potential risk situations in real time. In addition to contact tracing, as previously mentioned, South Korea has implemented a very high number of tests: i swabs They were also carried out on people with mild or asymptomatic symptoms but who had come into contact with infected patientsAdded to this is the fact that this action plan was implemented with a relatively low number of infections. A strategy that, according to the WHO, has made South Korea one of the leading models for dealing with the coronavirus epidemic.

However, let's not forget that South Korea, compared to Europe, has greater knowledge and capabilities in managing a coronavirus epidemic, having already dealt with SARS and MERS. The 2015 MERS outbreak, in particular, prompted South Korea to further strengthen its efforts to combat epidemics.

Then, Can the South Korean model be replicated in Italy?

As the professor explained to Adnkronos Henry Bucci, professor of systems biology at Temple University in Philadelphia: "By fully following South Korea's strategy, that is, even using tools that invasively affect personal privacy, it is possible to track epidemic outbreaks early; provided, of course, that the sampled area is in the initial phase of an epidemic (that is, when we can actually speak of epidemic outbreaks and not of a widespread epidemic)."

We might still be in time, then, for track and slow infections in Italian regions where numbers are still low (the real-time map, created by Corriere della Sera). Adopting the Korean model could also prove important for avoid a second wave of infections at the time of the gradual return to normality.

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UMBRIA AND THE SOUTH KOREA MODEL

Meanwhile, while a Bva Doxa research conducted on a sample of five thousand individuals reveals that the 93 percent of Italians declares himself ready to "sacrifice some fundamental rights if this helps prevent the spread of the virus",Umbria It is a candidate to become the first Italian region to follow the "South Korea model" in combating the spread of COVID-19. The region has fewer than 900 inhabitants and currently has 802 total cases, of which 770 are currently positive, 12 have recovered, and 20 have died (data released by the Civil Protection Department, as of March 26, 2020).

STOP COVID-19 APP

An experiment that could act as a trailblazer at a national level, carried out through the use of the app Stop Covid-19, developed by the Italian company Webtek. Just like the Corona 100m app, also Stop Covid-19 It can reconstruct the network of people who may have come into contact with an infected citizen and report the data to health authorities. Using the GPS location of each user's smartphone, the app collects information, monitors the movements of those who decide to download it, and alerts them if they have come into contact with people who have tested positive for coronavirus. This mechanism allows reconstruct the chain of infectionsAll those involved will always remain anonymous and can only be contacted by the health authority, without knowing the name of who may have infected them.

Obviously, the choice to use the app is absolutely voluntary and the citizen, at any time, can decide to suspend the dissemination of data or permanently delete it, as required by the European regulation on the protection of personal data (GDPR).

Already available in the iOS App Store and the Android Play Store, Stop Covid-19 requires significant user collaboration to be useful. Otherwise, data collection would be incomplete and would not allow for the accurate tracing of other exposed individuals.

To “contact tracing”, in Umbria it would be joined by a increase in the number of swabs and quick tests.

CONTACT TRACING PLANS

Meanwhile, also the Massachusetts Institute of Technology in Boston has developed "Private Kit: Safe Paths," a specific app that allows users to reconstruct the chain of infection. The system alerts users if they have come into contact with a positive person without revealing who they are. Those who test positive can choose whether or not to share their diagnosis on the app. This helps slow the spread of the infection without sacrificing privacy.

Singapore Instead, it is relying on a tracking system entirely based on Bluetooth and storing data only on the user's smartphone, while still providing healthcare workers with the information needed to reconstruct the infection chain in the event that a citizen tests positive for coronavirus.

In Spain, however, at the moment only in the area of Madrid, citizens can use an application supported by Telefonica and Google that helps identify symptoms and perform self-diagnosis, easing the overload of requests received by emergency telephone lines.

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ANALYZE INSTAGRAM TO SLOW THE SPREAD OF CORONAVIRUS

According l 'Economist, me too'Social Network Analysis and, in particular, of Social media coordinator, can prove to be an important tool for understand the advance of the coronavirusAnalysts at the British weekly identified more than 20 users who posted on the platform by geolocating themselves in cities that initially had at least 50 confirmed cases of Covid-19. By tracking their movements, based on subsequent posts in which they indicated their location, and based on over 50 photos posted in over 2 cities across 125 countries, they discovered that "the movements of Instagram users identified as potential carriers of the coronavirus tended to track the movement of the virus itself, as revealed by cases reported by official sources. Some users—the Economist explains—traveled to virus-free locations that were subsequently hit by an outbreak, raising the possibility that they themselves brought the virus there. Others offered clues to possible transmission routes, such as a trip back from a holiday in a Swiss ski resort.

The analysis of movements through Social media coordinator, could therefore provide a Support in an attempt to contain the spread of the virus and limit infections.