The risk that COVID-19 poses to individuals and society has suspended the usual balance of rights and freedoms, justifying an incursion on liberty and curtailment of rights for the sake of public safety.
An emerging aspect is the development of a ‘public health identity’ (PHI), a system for verifiably sharing private health data relevant to public health concerns. These can come in the form of a health status app, digital immunity certificate or vaccination/testing records, which could be used to stream society based on an individual’s health or risk of COVID-19 infection or transmission.
Streaming could formally or informally shape how citizens access parts of society, with possible employment, spaces, travel or interaction contingent on bringing personalised private health data into the public sphere.
The risk that the virus poses to individuals and society has made the development of PHIs a possibility across the political spectrum, with work underway in China, Germany, the UK and Chile. As well as governments, private actors are already trialling apps to manage return to work and safe travel, including Ernest and Young and PwC.
Modern digital technology plays a critical role in these questions, as it allows the real-time integration and verification of health-related data and sharing of that data with others, at a speed and scale not previously possible.
Promising news of vaccinations makes the question of how vaccinations might be cascaded through the population, and whether certification might be required, urgent.
In the face of a crisis and the sweeping restrictions imposed across society, the case may be made that the creation of a public health identity is justifiable, but it will have to demonstrate its benefit to public health to justify its deployment.
Sociotechnical issues of public health identities
Beyond efficacy, any form of PHI will need to grapple with the profound issues and societal risks raised across three sets of sociotechnical issues:
- The issues arising from any form of biometric identity – the loss of privacy, the power and permanence of the information, the safety and security issues, and its underexplored future implications.
- The issues arising from sharing personal health data – sensitive in itself and particularly so in the context of COVID-19 where long-term implications and correlates of contracting the virus are not yet understood.
- The issues arising from ‘streaming society’ – whether through social nudges or legal requirements – around a health status that may generate or exacerbate existing inequalities, or lead to stigma or discrimination which may be hard to undo.
The complexity and richness of these issues highlight the need for serious thought before any system is rolled out, and the evidence, policy, practice and social implications need monitoring and careful shaping.
Tracking public and private applications of public health identity systems
To support that the Ada Lovelace Institute is running ongoing work tracking public and private applications of public health identity systems and collating and monitoring as details emerge into the public domain.
See more in our International monitor of vaccine passports and COVID status apps and our public event series to explore in greater depth the evidence and uncertainties, technical questions, legal concerns, governance requirements and social issues arising from any use of a public health identity.
Event series: public health identities
Testing immunity certificates: do the new antibody tests open the door to the creation of a ‘public health identity’?
The first in our new series of virtual events addressing health identity systems developing in response to COVID-19.
The societal impacts of introducing a public health identity system: legal, social and ethical issues
The second in our series of events addressing the nascent ‘public health identity’ systems developing around the world.
The third in our series of events addressing the nascent ‘public health identity’ systems developing around the world
A tracker collating developments in policy and practices around vaccine certification and COVID status apps as they emerge around the world
Report with recommendations and findings of a public deliberation on biometrics technology, policy and governance
Findings from a rapid expert deliberation to consider the risks and benefits of the potential roll-out of digital vaccine passports