COVID19 - Why open and honest public dialogue is needed

Threats to public health workers

Media reports and data from public health professional membership organizations have demonstrated high levels of harassment experienced by public health workers throughout the COVID-19 response. We documented personal and political threats to public health workers across the first 12 months of pandemic response through a longitudinal survey completed in Fall 2020 and Summer 2021. The web-based survey was distributed to respondents using the Qualtrics survey platform. Survey items measured domains including demographic information, public health roles and training, mental and physical health, and work-life balance. Respondents were also asked if they had received any personal or political threats, from whom these threats were received, and completed an open-ended question describing the nature of the threats. Among the 85 public health workers completing both surveys, threats from members of the public and from elected and appointed leaders were most prevalent at both timepoints; however, as the pandemic response progressed, the nature of threats to public health workers changed. While those remaining in the public health workforce may be more resilient to these threats, increased prevalence of personal and political threats has the potential to deter new graduates from entering the field, impacting the public health system's future response capacity.

Digital Public Health Solutions in Response to the COVID-19 Pandemic: Comparative Analysis of Contact Tracing Solutions Deployed in Japan and Germany

BACKGROUND

In response to the COVID-19 pandemic, numerous countries, including the likes of Japan and Germany, initiated, developed, and deployed digital contact tracing solutions in an effort to detect and interrupt COVID-19 transmission chains. These initiatives indicated the willingness of both the Japanese and German governments to support eHealth solution development for public health; however, end user acceptance, trust, and willingness to make use of the solutions delivered through these initiatives are critical to their success. Through a case-based analysis of contact tracing solutions deployed in Japan and Germany during the COVID-19 pandemic we may gain valuable perspectives on the transnational role of digital technologies in crises, while also projecting possible directions for future pandemic technologies.

OBJECTIVE

In this study, we investigate (1) which types of digital contact tracing solutions were developed and deployed by the Japanese and German governments in response to the COVID-19 pandemic and (2) how many of these solutions are open-source software (OSS) solutions. Our objective is to establish not only the type of applications that may be needed in response to a pandemic from the perspective of 2 geographically diverse, world-leading economies but also how prevalent OSS pandemic technology development has been in this context.

METHODS

We analyze the official government websites of Japan and Germany to identify digital solutions that are developed and deployed for contact tracing purposes (for any length of time) during the timeframe January-December 2021, specifically in response to the COVID-19 pandemic. We subsequently perform a case-oriented comparative analysis, also identifying which solutions are published as open-source.

RESULTS

In Japan, a proximity tracing tool (COVID-19 Contact-Confirming Application [COCOA]) and an outbreak management tool (Health Center Real-time Information-sharing System on COVID-19 [HER-SYS]) with an integrated symptom tracking tool (My HER-SYS) were developed. In Germany, a proximity tracing tool (Corona-Warn-App) and an outbreak management tool (Surveillance Outbreak Response Management and Analysis System [SORMAS]) were developed. From these identified solutions, COCOA, Corona-Warn-App, and SORMAS were published as open-source, indicating support by both the Japanese and German governments for OSS pandemic technology development in the context of public health.

CONCLUSIONS

Japan and Germany showed support for developing and deploying not only digital contact tracing solutions but also OSS digital contact tracing solutions in response to the COVID-19 pandemic. Despite the open nature of such OSS solutions' source code, software solutions (both OSS and non-OSS) are only as transparent as the live or production environment where their processed data is hosted or stored. Software development and live software hosting are thus 2 sides of the same coin. It is nonetheless arguable that OSS pandemic technology solutions for public health are a step in the right direction for enhanced transparency in the interest of the greater public good.