Recently, there has been cheering in Hong Kong as the arrival of multiple vaccines seemingly heralds the beginning of the end of the pandemic. But the vaccine is a fig leaf that barely covers the cracks, as many scientists argue that this is unlikely to be the last pandemic in our lifetime.
Before the pandemic leaves us for good, the question of how to conduct effective contact tracing continues to steal the limelight. In Hong Kong, the digital platform ‘Leave Home Safe’ is a government-endorsed solution that manages pre-symptomatic infections by alerting users of nearby exposures.
Putting aside any privacy concerns, we question the overall efficacy and equity of the app. Despite their intuitive appeal, such large-scale technological and social experiments might fail to accurately detect infected individuals while creating an added burden for marginalized sectors in society.
Like any other contact-tracing tools, the efficacy of the platform is highly correlated with users’ buy-in. Citizens can opt out of Leave Home Safe even if they own a smart phone. If people boycott the application due to their distrust of law enforcement, any contact-tracing operation by health authorities might be stymied by a dearth of data. Moreover, depending on the locale and individual resources, access to devices that can run the application smoothly might differ from place to place.
Digital tool may lead to disadvantaged groups bearing the uneven distribution of its social costs and the economic ill-effects of being quarantined.
The effectiveness of Leave Home Safe also depends on users’ self-discipline. The app might send electronic ‘nudges’ to remind users of nearby exposure. But it cannot force the recipient to seek medical help speedily and report any symptoms truthfully. In a time of high volatility in the employment market, there is a risk of losing income or even jobs if people call in sick. A positive coronavirus diagnosis continues to carry deep stigma in Hong Kong.
Further, compliance with the perceived moral norms to act responsibly is not a given, since the application alerts the user only privately. We doubt that users will show the requisite discipline.
Moreover, contact-tracing technology threatens to create a false sense of security, especially when the government promotes its use alongside a relaxing of social distancing orders. To call for log-in before entering public places does not protect individual users from infections, but only to notify them when they may have been exposed after the fact. While the employment of technology carries epidemiological benefits, it also leads to unwelcome results. Some users may feel that having such a tool on their phones means that they can prematurely relax their vigilance before the impact of the pandemic finally tapers off. If the history of the infection can shed light on any future pattern, it is likely that the highly contagious disease will most often recur as the public lets their guards down.
Encouraging the use of a digital tracing tool poses a risk of inequity. Such digital tool may lead to disadvantaged groups bearing the uneven distribution of its social costs and the economic ill-effects of being quarantined. Recent research in the United States finds that the types of jobs that can be done from home differs substantially across industries, with those associated with lower salaries and precarious work arrangements least likely to be done from home.
We should expect that in Hong Kong the market landscape exhibits similar characteristics. People in lower socioeconomic status groups are more likely to be at the front lines of the workforce, engaging in jobs such as delivering online orders, stocking shelves, or delivering groceries. They are more likely than their wealthier demographic counterparts to live in crowded living quarters or subdivided flats, to commute using public transport, and to have underlying health conditions. Some, such as non-Cantonese speakers and the elderly, may have a difficult time understanding what the application does and does not do.
The findings on work-from-home arrangements are informative. As manual low-income workers are less likely to be able to work from home, engaging in on-site work means that they are at higher risk of becoming infected. A positive test result means that those most socioeconomically vulnerable will have to stop working, losing paychecks, which in turn can spiral into risking their jobs and causing social, psychological, and educational disruptions. There is a danger of false positives associated with ‘Leave Home Safe’, which may compel marginalized groups to take costly action based on inaccurate warnings.
Jobs that cannot be undertaken from home are unequally distributed across our social networks, a reality that has its roots in the overall fiscal construct of any capitalist society such as Hong Kong.
There is reason to suspect that adoption rate of the app may be lower in poorer communities. If proven true, it will not only impact the overall effectiveness of contact tracing, but it will also mean that it may be least useful to the communities where it is most needed. In addition, ‘Leave Home Safe’ relies on technology that people in lower social strata are less likely to have, such as Bluetooth-enabled phones and stable internet access.
The workers’ situation would not be worse than a situation in which the whole population is in a semi-lockdown. But their relative situation would worsen because the more affluent sector of society will benefit more from the implementation of the application. Someone with the flexibility of working from home can enjoy the benefit of contact tracing because they can now enjoy the more relaxed social distancing rules. This negative consequence is not unique to ‘Leave Home Safe’, but it concerns any preventive measure aiming to apply to all cross sections of the population indiscriminately.
Digital proximity tracing is not a cure-all in crisis response, but it can be a valuable component in any precautionary measure.
Therefore, there is urgency in addressing the equity problem as we rely on digital platform to alleviate the effects of the pandemic. Policymakers ought to avoid drifting into blanket adaptations that might perpetuate existing societal inequalities. Jobs that cannot be undertaken from home are unequally distributed across our social networks, a reality that has its roots in the overall fiscal construct of any capitalist society such as Hong Kong.
The fact that digital tracing solutions are hastened to adoption betrays our underlying overreliance in technological solutions. Digital proximity tracing is not a cure-all in crisis response, but it can be a valuable component in any precautionary measure.
The pervasive presence of risks necessitates a well-thought approach. Hong Kong government policy in combating the pandemic has been met with deep skepticism. Any new strategies must therefore be agile and justifiable. Public trust requires taking into account the ethical complexities relating to the implementation of the app, as well as being transparent about the trade-offs that are being made. If Leave Home Safe is to be widely used, it must first make people want to use it.
(An abridged version of this article first appeared in the South China Morning Post)
