(WORLDWIDE) FEATURED: #Coronavirus EFF Report: Governments Shouldn’t Use “Centralized” Proximity Tracking Technology As This Can Lead To Privacy & Exposure Of Data To Third Parties & Decentralised Apps Should Be Considered Looking Towards The Future Use Of Health Care Data #AceHealthDesk report

#AceHealthReport – May.17: Companies and governments across the world are building and deploying a dizzying number of systems and apps to fight #COVID19 Many groups have converged on using Bluetooth-assisted proximity tracking for the purpose of exposure notification. Even so, there are many ways to approach the problem, and dozens of proposals have emerged:

 #Coronavirus Report: Centralised OR Decentralised Apps Used To Track & Trace Vary According To How Data Is Shared To Third-Parties Now & In The Future EFF.Org/

One way to categorize them is based on how much trust each proposal places in a central authority. In more “centralized” models, a single entity—like a health organization, a government, or a company—is given special responsibility for handling and distributing user information. This entity has privileged access to information that regular users and their devices do not. In “decentralized” models, on the other hand, the system doesn’t depend on a central authority with special access. A decentralized app may share data with a server, but that data is made available for everyone to see—not just whoever runs the server. 

Both centralized and decentralised models can claim to make a slew of privacy guarantees: But centralized models all rest on a dangerous assumption: that a “trusted” authority will have access to vast amounts of sensitive data and choose not to misuse it. As we’ve seen, time and again, that kind of trust doesn’t often survive a collision with reality. Carefully constructed decentralized models are much less likely to harm civil liberties. This post will go into more detail about the distinctions between these two kinds of proposals, and weigh the benefits and pitfalls of each.

Centralized Models

There are many different proximity tracking proposals that can be considered “centralized,” but generally, it means a single “trusted” authority knows things that regular users don’t. Centralized proximity tracking proposals are favored by many governments and public health authorities. A central server usually stores private information on behalf of users, and makes decisions about who may have been exposed to infection. The central server can usually learn which devices have been in contact with the devices of infected people, and may be able to tie those devices to real-world identities. 

For example, a European group called PEPP-PT has released a proposal called NTK. In NTK, a central server generates a private key for each device, but keeps the keys to itself. This private key is used to generate a set of ephemeral IDs for each user. Users get their ephemeral IDs from the server, then exchange them with other users. When someone tests positive for COVID-19, they upload the set of ephemeral IDs from other people they’ve been in contact with (plus a good deal of metadata). The authority links those IDs to the private keys of other people in its database, then decides whether to reach out to those users directly. The system is engineered to prevent users from linking ephemeral IDs to particular people, while allowing the central server to do exactly that.

Some proposals, like Inria’s ROBERT, go to a lot of trouble to be pseudonymous—that is, to keep users’ real identities out of the central database. This is laudable, but not sufficient, since pseudonymous IDs can often be tied back to real people with a little bit of effort. Many other centralized proposals, including NTK, don’t bother. Singapore’s TraceTogether and Australia’s COVIDSafe apps even require users to share their phone numbers with the government so that health authorities can call or text them directly. Centralized solutions may collect more than just contact data, too: some proposals have users upload the time and location of their contacts as well.

Decentralized Models

In a “decentralized” proximity tracking system, the role of a central authority is minimized. Again, there are a lot of different proposals under the “decentralized” umbrella. In general, decentralized models don’t trust any central actor with information that the rest of the world can’t also see. There are still privacy risks in decentralized systems, but in a well-designed proposal, those risks are greatly reduced.

EFF recommends the following characteristics in decentralized proximity tracking efforts:

The goal should be exposure notification. That is, an automated alert to the user that they may have been infected by proximity to a person with the virus, accompanied by advice to that user about how to obtain health services. The goal should not be automated delivery to the government or anyone else of information about the health or person-to-person contacts of individual people.

A user’s ephemeral IDs should be generated and stored on their own device. The ephemeral IDs can be shared with devices the user comes into contact with, but nobody should have a database mapping sets of IDs to particular people. 

When a user learns they are infected, as confirmed by a physician or health authority, it should be the user’s absolute prerogative to decide whether or not to provide any information to the system’s shared server. 

When a user reports ill, the system should transmit from the user’s device to the system’s shared server the minimum amount of data necessary for other users to learn their exposure risk. For example, they may share either the set of ephemeral IDs they broadcast, or the set of IDs they came into contact with, but not both.

No single entity should know the identities of the people who have been potentially exposed by proximity to an infected person. This means that the shared server should not be able to “push” warnings to at-risk users; rather, users’ apps must “pull” data from the central server without revealing their own status, and use it to determine whether to notify their user of risk. For example, in a system where ill users report their own ephemeral IDs to a shared server, other users’ apps should regularly pull from the shared server a complete set of the ephemeral IDs of ill users, and then compare that set to the ephemeral IDs already stored on the app because of proximity to other users.  

Ephemeral IDs should not be linkable to real people or to each other. Anyone who gathers lots of ephemeral IDs should not be able to tell whether they come from the same person.

Decentralized models don’t have to be completely decentralized. For example, public data about which ephemeral IDs correspond to devices that have reported ill may be hosted in a central database, as long as that database is accessible to everyone. No blockchains need to be involved. Furthermore, most models require users to get authorization from a physician or health authority before reporting that they have COVID-19. This kind of “centralization” is necessary to prevent trolls from flooding the system with fake positive reports.

Apple and Google’s exposure notification API is an example of a (mostly) decentralized system. Keys are generated on individual devices, and nearby phones exchange ephemeral IDs. When a user tests positive, they can upload their private keys—now called “diagnosis keys”—to a publicly accessible database. It doesn’t matter if the database is hosted by a health authority or on a peer-to-peer network; as long as everyone can access it, the contact tracing system functions effectively.

What Are the Trade-Offs?

There are benefits and risks associated with both models. However, for the most part, centralized models benefit governments, and the risks fall on users.

Centralized models make more data available to whoever sets themselves up as the controlling authority, and they could potentially use that data for far more than contact tracing. The authority has access to detailed logs of everyone that infected people came into contact with, and it can easily use those logs to construct detailed social graphs that reveal how people interact with one another. This is appealing to some health authorities, who would like to use the data gathered by these tools to do epidemiological research or measure the impact of interventions. But personal data collected for one purpose should not be used for another (no matter how righteous) without the specific consent of the data subjects. Some decentralized proposals, like DP-3T, include ways for users to opt-in to sharing certain kinds of data for epidemiological studies. The data shared in that way can be de-identified and aggregated to minimize risk.

More important, the data collected by proximity tracking apps isn’t just about COVID—it’s really about human interactions. A database that tracks who interacts with whom could be extremely valuable to law enforcement and intelligence agencies. Governments might use it to track who interacts with dissidents, and employers might use it to track who interacts with union organizers. It would also make an attractive target for plain old hackers. And history has shown that, unfortunately, governments don’t tend to be the best stewards of personal data.

Centralization means that the authority can use contact data to reach out to exposed people directly. Proponents argue that notifications from public health authorities will be more effective than exposure notification from apps to users. But that claim is speculative. Indeed, more people may be willing to opt-in to a decentralized proximity tracking system than a centralized one. Moreover, the privacy intrusion of a centralized system is too high.

Even in an ideal, decentralized model, there’s some degree of unavoidable risk of infection unmasking: that when someone reports they are sick, everyone they’ve been in contact with (and anyone with enough Bluetooth beacons) can theoretically learn the fact that they are sick. This is because lists of infected ephemeral IDs are shared publicly. Anyone with a Bluetooth device can record the time and place they saw a particular ephemeral ID, and when that ID is marked as infected, they learn when and where they saw the ID. In some cases this may be enough information to determine who it belonged to. 

Some centralized models, like ROBERT, claim to eliminate this risk. In ROBERT’s model, users upload the list of IDs they have encountered to the central authority. If a user has been in contact with an infected person, the authority will tell them, “You have been potentially exposed,” but not when or where. This is similar to the way traditional contact tracing works, where health authorities interview infected people and then reach out directly to those they’ve been in contact with. In truth, ROBERT’s model makes it less convenient to learn who’s infected, but not impossible. 

Automatic systems are easy to game. If a bad actor only turns on Bluetooth when they’re near a particular person, they’ll be able to learn whether their target is infected. If they have multiple devices, they can target multiple people. Actors with more technical resources could more effectively  exploit the system. It’s impossible to solve the problem of infection unmasking completely—and users need to understand that before they choose to share their status with any proximity app. Meanwhile, it’s easy to avoid the privacy risks involved with granting a central authority privileged access to our data.

Conclusion

EFF remains wary of proximity tracking apps. It is unclear how much they will help; at best, they will supplement tried-and-tested disease-fighting techniques like widespread testing and manual contact tracing. We should not pin our hopes on a techno-solution. And with even the best-designed apps, there is always risk of misuse of personal information about who we’ve been in contact with as we go about our days.

One point is clear: governments and health authorities should not turn to centralized models for automatic exposure notification. Centralized systems are unlikely to be more effective than decentralized alternatives. They will create massive new databases of human behavior that are going to be difficult to secure, and more difficult to destroy once this crisis is over.

#AceHealthDesk report ……………..Published May 12, 2020 at 11:10PM

#acenewsdesk

(WORLDWIDE) #Coronavirus Vaccine Trials Report: Scientists across the world in a search for a vaccine are looking at deliberately infecting people with #COVID19 as an answer in vaccine development and calling it ethically justified despite the potential risks to volunteers according to new #WHO guidance #AceHealthDesk report

#AceHealthReport – May.09: Controversial trials in which volunteers are intentionally infected with Covid-19 could accelerate vaccine development, according to the World Health Organization, which has released new guidance on how the approach could be ethically justified despite the potential dangers for participants: So-called challenge trials are a mainstream approach in vaccine development and have been used in malaria, typhoid and flu, but there are treatments available for these diseases if a volunteer becomes severely ill. For #Covid19 , a safe dose of the virus has not been established and there are no failsafe treatments if things go wrong:

#Coronavirus Report: #WHO conditionally backs #Covid19 vaccine trials that infect people ‘ Challenge’ studies would deliberately give #coronavirus to healthy volunteers Hannah Devlin – Last modified on Fri 8 May 2020 20.30 BST: Guardian.Com/

Scientists, however, increasingly agree that such trials should be considered, and the WHO is the latest body to indicate conditional support for the idea: “There’s this emerging consensus among everyone who has thought about this seriously,” said Prof Nir Eyal, the director of Rutgers University’s Center for Population-Level Bioethics in the US.

The prospect of infecting healthy individuals with a potentially deadly pathogen may sound counterintuitive, but according to Eyal the risk of death from Covid-19 for someone in their 20s is around one in 3,000 – similar to the risk for live kidney donation: In this case, the potential benefits would extend not to a single individual, but to thousands or millions who could be protected by a vaccine………………..“Once you give it thought, it is surprisingly easier to approve than dispatching volunteers as part-time medical workers and other practices that we’ve already accepted,” he said.

In new guidance issued this week, the WHO said that well-designed challenge studies could accelerate Covid-19 vaccine development and also make it more likely that the vaccines ultimately deployed will be effective: The WHO lists eight criteria that would need to be met for the approach to be ethically justified, including restricting participation to healthy people aged 18-30 and fully informed consent. Strikingly, the guidelines do not rule out challenge trials in the absence of an effective treatment, instead stating that the risk could fall “within acceptable upper limits” for such research: “The big news is that WHO doesn’t say challenge trials are forbidden. It specifies reasonable steps on how they can be deployed,” said Eyal.

Vaccines are typically tested using a large group of people whose infection rates are compared with a separate group of unvaccinated controls: Waiting for enough people to be exposed to an illness, however, can take months and require thousands of participants. In a fast-moving pandemic situation, there is a risk of trials grinding to a standstill as infection rates fall in some regions. Challenge trials sidestep this problem, allowing efficacy to be established within weeks using just 100 or so volunteers.

A safe dose for Covid-19 would need to be established – enough to cause illness, but not severe illness, which could be a very fine line – through initial dose escalation studies: Such studies would need to be conducted in secure facilities to avoid unintentionally infecting anyone outside the trial and would pose uncertain levels of risk to participants.

Prof Andrew Pollard, who is leading the trial of the vaccine developed by the team at the University of Oxford’s Jenner Institute, said there is “huge interest” in the possibility of challenge trials among those working on vaccines against coronavirus: “At the moment, because we don’t have a rescue therapy we have to approach challenge studies extremely cautiously,” said Pollard. “But I don’t think it should be ruled out because, particularly in a situation where it’s very difficult to assess some of the new vaccines coming along because there’s not much disease around, it could be one of the ways we could get that answer more quickly.”

Others are more cautious and say it would be impossible to launch such a trial in the absence of robust treatments…..

#AceHealthDesk report …………Published: May.09: 2020:

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(LOS ANGELES, Calif.) Coronavirus Report: Los Alamos National Scientists Say a Now-Dominant Strain of the #Coronavirus Appears To Be More Contagious Than Original: The new strain appeared in February in Europe, migrated quickly to the East Coast of the United States and has been the dominant strain across the world since mid-March, the scientists wrote #AceHealthDesk report

#AceHealthReport – May.05: Scientists have identified a new strain of the coronavirus that has become dominant worldwide and appears to be more contagious than the versions that spread in the early days of the #COVID19 pandemic, according to a new study led by scientists at Los Alamos National Laboratory:

#Coronavirus Report: Scientists say non-dominant strain of #coronavirus appears more contagious than original and a large-scale: Drug Repositioning Survey for SARS-CoV-2 Antivirals:

From a report: In addition to spreading faster, it may make people vulnerable to a second infection after a first bout with the disease, the report warned: The 33-page report was posted Thursday on BioRxiv, a website that researchers use to share their work before it is peer reviewed, an effort to speed up collaborations with scientists working on COVID-19 vaccines or treatments:

That research has been largely based on the genetic sequence of earlier strains and might not be effective against the new one: The mutation identified in the new report affects the now infamous spikes on the exterior of the coronavirus, which allow it to enter human respiratory cells.

The report’s authors said they felt an “urgent need for an early warning” so that vaccines and drugs under development around the world will be effective against the mutated strain: Wherever the new strain appeared, it quickly infected far more people than the earlier strains that came out of Wuhan, China, and within weeks it was the only strain that was prevalent in some nations, according to the report.

The new strain’s dominance over its predecessors demonstrates that it is more infectious, according to the report, though exactly why is not yet known:
#AceHealthDesk report …………………Published on May 05, 2020 at 07:45PM

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(NEW YORK STATE) #Coronavirus Report: Gov.Cuomo Orders Nursing Homes to accept infected patients and allows employees infected with #coronavirus to continue to work and to treat residents at the Hornell Gardens facil ity in rural Steuben County, according to a New York Post report #AceHealthDesk report

#AceHealthReport – Apr.30: Gov. Andrew Cuomo has come under increasing scrutiny for a March 25 directive ordering nursing homes to accept #coronavirus patients: The text of the directive stated (original emphasis): “No resident shall be denied re-admission or admission to the NH [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19. NHs are prohibited from requiring a hospitalised resident who is determined medically stable to be tested for #COVID19 prior to admission or readmission.”

#Coronavirus Report: Gov.Cuomo orders nursing home to take infected patients after recently allowing employees to work and treat residents with #cornavirus at Hornell Gardens

“Cuomo has since said that nursing homes could tell the state Department of Public Health they could not accept such patients, or transfer them to other facilities: However, some homes have said that the state was unresponsive when they reached out, and that they felt intense pressure to accept the patients — despite the unique risk coronavirus generally poses to elderly people.”

The state Health Department allowed nurses and other staff who tested positive for the coronavirus to continue treating COVID-19 patients at an upstate nursing home, The Post has learned: State officials signed off on the move during an April 10 conference call that excluded local officials from Steuben County, who protested the move, according to a document provided by the county government’s top administrator, Jack Wheeler. At least 15 people have died at the Hornell Gardens nursing home in the tiny town of Hornell since the outbreak, according to county tallies. State records show just seven deaths across the county and include no data about this home.

“Roughly one third of the staff and residents at the home have contracted the virus, the New York Post added.”

#AceHealthDesk report …………..Published: Apr.30: 2020:

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#pandemic

(WASHINGTON) #Coronavirus CDC Report: Announced the first confirmed cases of SARS-CoV-2 (the virus that causes COVID-19) infection in two pet cats in New York State both had mild respiratory illness and expected to make a full recovery: No persons were found to be infected in the household #AceHealthDesk reports

#AceHealthReport – Apr.22: U.S. Centers for Disease Control and Prevention (CDC) and the United States Department of Agriculture’s (USDA) National Veterinary Services Laboratories (NVSL) today announced the first confirmed cases of SARS-CoV-2 (the virus that causes COVID-19) infection in two pet cats. These are the first pets in the United States to test positive for SARS-CoV-2.

#Coronavirus Report: Two pet cats have tested positive for #COVID19 in New York State CDC.Gov/

At this time, routine testing of animals is not recommended: Should other animals be confirmed positive for SARS-CoV-2 in the United States, USDA will post the findings. State animal health and public health officials will take the lead in making determinations about whether animals should be tested for SARS-CoV-2.

SARS-CoV-2 infections have been reported in very few animals worldwide, mostly in those that had close contact with a person with #COVID19: At this time, routine testing of animals is not recommended: In the NY cases announced today, a veterinarian tested the first cat after it showed mild respiratory signs. No individuals in the household were confirmed to be ill with COVID-19:

The virus may have been transmitted to this cat by mildly ill or asymptomatic household members or through contact with an infected person outside its home: Samples from the second cat were taken after it showed signs of respiratory illness: The owner of the cat tested positive for COVID-19 prior to the cat showing signs.
Another cat in the household has shown no signs of illness: Both cats tested presumptive positive for SARS-CoV-2 at a private veterinary laboratory, which then reported the results to state and federal officials.

The confirmatory testing was conducted at NVSL and included collection of additional samples: NVSL serves as an international reference laboratory and provides expertise and guidance on diagnostic techniques, as well as confirmatory testing for foreign and emerging animal diseases: Such testing is required for certain animal diseases in the U.S. in order to comply with national and international reporting procedures.

The World Organisation for Animal Health (OIE) considers SARS-CoV-2 an emerging disease, and therefore USDA must report confirmed U.S. animal infections to the OIE: Public health officials are still learning about SARS-CoV-2, but there is no evidence that pets play a role in spreading the virus in the United States.

#AceHealthDesk report ……………Published: Apr 22, 2020 at 19:26: Read Full CDC Report Here:

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