Saturday, 16 May 2020

Testing and tracing or big brother society? A test case.

A recent post of mine looking at post lockdown testing and tracing in S Korea needs a mini-update. At the time I noted that: 

"South Korea allowed nightclubs to open resulting in the infection of 50 people from a single infected person. That was in just one club and that was just one clubber! Their testers and tracers will be busy too."  


So what happened then and what have we to learn from this?


It seems that the index case had a good, but not in any way unusual night out. He actually visited five clubs in the evening before testing positive and setting the testers and tracers to work.

Using mobile phone and credit card data as well as CCTV footage, they pieced together what needed to be done and who needed to be traced, and tested. Here are the numbers:

  • I night out
  • 5 clubs visited
  • 5,517 close contacts of the 11,000 people in that area that night
  • 7272 additional tests done.
  • 119 new cases detected.

I presume that the clubbers are mainly young, so mortality might not arise directly but this cannot be said of vulnerable family and other contacts as the resultant outbreak spreads. 

This example does highlight just how transmissible the virus is and how rapidly it can spread in a normally functioning society. Skeptics might feel that it could just be that the 199 new cases were there anyway, but with such a low level of new cases in S Korea, this is unlikely. This was typical of how small outbreaks need to be managed.


Issues raised....


"Nerd" Immunity

Our self evident plan is to reduce the incidence to levels where we can 'extinguish' outbreaks like the one in S Korea. Here, we seem to be focusing of surveillance and technology to get this job done, backed up by yet to be appointed health workers. This will rely on our use of mobile phones, use of credit cards and uptake of new apps. If you like it can be called "Nerd Immunity". 

It's long term benefits require a vaccine, or effective treatment to be somewhere in the pipeline for success, or that the virus will die out in the summer. More on that later.

Herd immunity

There is also the view that the S Korea event is exactly what needs to happen if we are ever arrive at herd immunity. This happens when about 80% or more of the population have been infected and generated an antibody response, effectively hoovering up the virus with their antibodies, thus ultimately reducing its ability to spread to the vulnerable. 

For this to happen we need fit young people to become infected and their vulnerable friends, family and contacts to continue to isolate. There would of course be casualties. There will be from the lockdown too. This is the only alternative to the still uncertain development of a vaccine. 

It's also a debate that doesn't really seem to be happening much.

Revealing societies bigotry

Interestingly of the 5,517 people contacted, 1,982 (35%) have not replied, perhaps not wishing to reveal their identity as the clubs are in a gay nightlife district though also popular with tourists and the military. The event has  led to a sad but predictable anti-gay backlash in the homophobic sectors of a conservative society. In this case COVID19 might be used to highlight and perhaps magnify bigotry and hatred.

At the time of writing, I cant find anything to suggest that night life in Itaewon has been restricted as a consequence. 

Surveillance society

Does this offer a glimpse of the future here too perhaps? We are different from S Korea as they seek to keep their COVID genie in the bottle while ours flew away into the Cheltenham and Anfield air. Yet, one big wave later, if our cases drop to a manageable level, as they might be in London, and with the lockdown being eased we will enter our own phase of testing and tracing while awaiting vaccines or treatment. Thats the stated plan.

To achieve this, we already have the same level of surveillance tools used in S Korea, even without shiny new Apps, and similar follow up will have to happen here if we want to keep the pandemic at bay. Many questions remain as to our capability to achieve this, but we shall see.

Revealed also is the new level of "Big Brother" surveillance in the modern world. Clearly leaving your mobile phone at home and using cash would increase anonymity, but also make effective preventative work more difficult for health workers. 

Tyrants and dictators, and indeed any intelligence or even advertising or political organisations can directly or indirectly have their fingers on our individual pulses like never before. Increased persecution of minorities will be a real danger, highlighted and potentially heightened by the pandemic. 

Freedom..

Absolute freedom might be a noble concept but in reality is balanced by responsibility for our individual and collective actions. For many it remains little more than a distant dream, its very definition is being brought into sharp focus in this COVID19 age.

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