ELSI NOTE
No. 0410 perspectives on COVID-19 ContactConfirming Application (COCOA) andethical, legal and social issues (ELSI)(English translation)
October 19, 2020Authors:
Atsuo Kishimoto: Research Center for Ethical, Legal and Social Issues, andInstitute for Datability Science, Osaka University
Fumiko Kudo: Research Center for Ethical, Legal and Social Issues, Osaka
University

This note is a translation of the original Japanese version into English. The original text
can be read at the following URL.

https://elsi.osaka-u.ac.jp/research/443

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Introduction
When emerging technologies such as contact tracing apps are introduced into society,they often do not meet existing social norms. As a result, ethical, legal, and social
issues (ELSI) may arise, and the use of technology may not be promoted due toexcessive fear, or the technology may be rejected by society due to the emergence ofproblems. Since many information technologies also have aspects as surveillance tools,
it is essential to deal with risks such as privacy and security. As a result, somecountries and regions have begun to involve data protection agencies. For example, inEurope, guidelines have been developed and toolboxes have been provided by them.
We believe it is possible to achieve both privacy protection and infectious disease
control rather than trade-offs.
In preparation for the introduction of the contact tracing app in Japan, we decided tosummarize from the user's point of view, from what perspective we would decide
whether to download the app. On April 30th, when there was almost no information
about the app, the first version of this "10 perspectives" document was published asver.0.8 on the website. Next, on May 12, "10 Perspectives" was updated based on theinformation provided by the government as ver. 0.9. Finally, this note was released asver.1.0 on June 18, the day before the release of the app called “COVID-19 ContactConfirming Application (COCOA)”.
In the original Japanese version, based on the materials posted on the official page ofthe Ministry of Health, Labor and Welfare, we have summarized each of the items
listed in ver.0.9 from the perspective of how they responded or did not. The overall
trends were as follows. As for the technology itself, there were many parts that havebeen addressed, but as for the background surrounding the app and issues after
release, there were still a considerable number of items that could not be dealt with.
Note that this English translation shows only the items included in the original “10perspectives”.

210 Perspectives
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1. Confirm the purpose of the technology (app)a. Is the purpose clearly stated?
i.

Is it an aid for health authorities to identify closecontacts, or is it to encourage informed individuals
to change their behavior?

ii.

Is it clear what the technology (app) is trying toachieve? How much uncertainty is involved in whether
it can be achieved?

iii.

Is it properly positioned in the national publichealth strategy? Is it part of an "exit strategy" thateases restrictions on movement and meetings?

iv.

Is it a complement or alternative to human contact
tracing?

v.

The required penetration rate (app usage rate) willvary depending on the purpose, but how much is it?

b. Is the mechanism of contact tracing technology explained inan easy-to-understand manner?

i.

Is it a “centralized” type or “decentralized” type?

ii.

Is the presence or absence of infection determined by
self-report or positive diagnosis?

iii.

How is it joined with “Health Center Real-time
information-sharing System on COVID-19 (HER-SYS)”?

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c. Do you think your benefits outweigh the risks you may have?

d. Do you think the benefits of society as a whole outweigh therisks that may exist?

2. Make sure that the use of the app is voluntarya. Are you in a situation where you actually have to downloadthe app?

i.

For example, are there any restrictions such as not
being able to go out, enter the store, receiveservices, or be hired without presenting the app?

ii.

Are there any cases where employees are forced todownload apps by their employers?

iii.

Are they at the same level as previously accepted
levels, such as when vaccinations are required whentraveling abroad?

b. Is the function set to be on / off even if the app isdownloaded or installed in the OS?

c. If the app keeps running, is the usability of other apps andbattery durability sufficiently guaranteed?

3. Know the meaning and accuracy of the notified"close contact"4

a. Is the basis for setting the interpersonal distance andELSI NOTE

contact period clear? What epidemiological findings are they
based on?

i.

Are important factors other than distance and time
considered (outdoor or indoor, well-ventilated or not,masks, protective clothing, etc.)? If not, is that
explained?

ii.

Is it based on simple thresholds (“distance” and“exposure time” with positives)? Is the risk value
calculated by some algorithm?

b. How accurate is the detection of close contact? How likely
are you to be falsely notified or not notified?
i.

Using data collected by health center staff to improvealgorithms for tracing and notifying close contacts
will improve the accuracy of close contact
determinations, but may also increase privacy risks.

c. Is the app automatically judging and notifying the close

contact, or is there a mechanism for people to check in thefinal judgment?
i.

In the former case, is there a mechanism to ensure theappropriateness of the algorithm (such as the absenceof bias)?

ii.

In the case of "decentralized” type, the staff of thehealth center cannot know who was judged to be a"close contact". Therefore, is it recommended that theperson who receives the notification contact thehealth center when making the notification?

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iii.

In that case, it would be desirable for health center
staff to provide advice and appropriate care to "closecontacts," but this would increase privacy risks.

d. Is the notification that there was close contact just a
notification that there was, or does it include the date andtime?

i.

If you know the timing of close contact, you canremember whether you wore a mask or had a conversation
at that time, so there is an advantage that you canjudge the magnitude of the risk, but on the otherhand, it will increase the chances of knowing who thepositives are.

e. Is there a mechanism to readjust the "close contact" settingwith expert advice in a changing situation? Will users be
notified if they readjust? Will be the rationale shown?

4. Understand what your app can and cannot do
a. Is it explained that the "close contact" that can be tracked
by the app is only a part of the potential for infection?

b. Is it explained that the percentage of people who have asmartphone with the app installed changes the percentage ofpeople who have close contacts?

c. Is it explained that the lack of notification does not meanthat there is no potential for infection.

6d. Does the app have Interoperability?
For example, if different apps are adopted for each

ELSI NOTE

i.

municipality, it may not make sense as acountermeasure.

ii.

If the Japanese app is not interoperable with those ofother countries, will it continue to be restricted byoverseas movement in the future?

e. Is there any possibility that it will be linked to anotherapp or medical health database in the future?

i.

If the accuracy of close contact judgment is low, it
may be necessary to link with location data and PHR asa countermeasure against infectious diseases.

5. Understand how your data is used
a. Is the data stored in the terminal and the log provided tothe server when an infection is found to be the minimum
necessary for the purpose?

b. Is the identity of the app user unknown?
i.

Are measures taken to avoid personal identification,
including conducting a risk assessment ofreidentification when matched with other data?

ii.

Is the temporary ID of the terminal generated pseudorandomly and changed regularly?

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c. Is there a mechanism that it is not possible to know who ispositive when notified that there has been close contact
with a positive person?

i.

If it is recommended that the notified person contact
the health center, is there a risk of discovering who
was positive in the interaction with the staff?

d. Is there a system in which consent is obtained each time

contact information is provided to the government?

e. Is it specified when the terminal data or the data provided
to the server will be deleted?

i.

How many days is it supposed to be automaticallydeleted?

ii.

Will the app be disabled after the end of theinfection? Will it be removed from the OS?

6. Make sure your data is securely managed
a. When is the terminal data provided to the central server?

b. Are security measures in place throughout the life cycle?
i.

Are effective cybersecurity measures in place toprotect data availability, reliability, andconfidentiality?

ii.

Is cybersecurity verified by a third party?

7. Know who is supposed to have access to what data8

a. Who is responsible for the development and operation of theELSI NOTEapp?

b. Who approves the app and what kind of procedure?

c. What is the role of the government in treating personal dataof positive individuals?

i.

Coordination with health centers will be needed toensure that “positives” are positive and prevent
false notifications.

d. Is it a purpose-specific treatment of data?
i.

For example, in order to prevent false notifications,
are there any considerations such as sending a onetime password for positive declaration to positive
persons when cooperating with the public healthcenter?

e. Will data be shared with third parties? Is there a mechanism
to obtain consent each time it is shared with third parties?

i.

Is it possible that information will be provided by
the requests from the Police or the Bar Associations?

ii.

Is it possible that the data will be retained forresearch purposes?

f. Is there an immediate and irreversible method of erasing
misprocessed data?

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8. Check if there is consideration for people whocannot use the appa. Are there alternatives for those who can't or don't want touse the app?

i.

Is care taken so that they do not suffer any
disadvantages?

ii.

Is it guaranteed that they will not be penalized fortesting or treatment?

iii.

Is it possible to consider alternative means (forexample, wristbands) to those who wish?

b. Is there an age limit for using the app? (For example,children under the age of 18 cannot use the app)c. Is there any substitution for those who cannot avoid (close)
contact with potentially infected people? Is it possible todisable notifications if they are properly protected?

d. Is there a safeguard to ensure the prevention of prejudiceagainst positives, close contacts, people living or doing
economic activities in high-risk areas?

9. Know what to do after knowing your own "closecontact" with positives
a. Is there a mechanism to prevent false notifications?

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contact?

i.

Is the action to be taken clearly instructed at thetime of notification?

ii.

ELSI NOTE

b. Is it clear what action to take when notified of close

If it is recommended to contact the health center when
notified, are the advantages and disadvantages ofcontacting clearly stated?

iii.

Will the informed people rush to medical institutions
and put pressure on medical resources?

c. Is there a contact point for anyone to consult if in doubt?

10. Check if there is a mechanism for third party
experts to review
a. Is there an expert organization that supervises and advises
on application development and operation from the standpointof a third party?

i.

If an expert organization is set up, does it supervise
only the development stage of the app or continuously
supervise the operational stage?

ii.

How much authority is given to that expertorganization?

b. Was there a process to identify opinions and concerns fromdiverse stakeholders before the download began?

c. Before the download starts, is data policy and privacy

guideline formulated and privacy impact assessment published11

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not only for the app but also for systems to be linked andthe entire network?

d. Is there a mechanism for users and experts to regularly
evaluate and verify whether the app achieves its original
purpose through certain information disclosure?

e. After the situation is over, is the ex-post evaluation /verification conducted by a third party and the results areto be published?

12•Jessica Morley, Josh Cowls, Mariarosaria Taddeo & Luciano Floridi, Ethicalguidelines for COVID-19 tracing apps, Nature (28 May 2020)
https://www.nature.com/articles/d41586-020-01578-0●UK Parliament, Human Rights Joint Committee, Report: Human Rights and theELSI NOTE

References (Arranged in chronological order)

Government’s Response to Covid-19: Digital Contact Tracing (7 May 2020)
https://committees.parliament.uk/committee/93/human-rights-jointcommittee/news/146351/report-on-the-contact-tracing-app-published/●Privacy and Ethics Recommendations for Computing Applications Developed toMitigate COVID-19 White Paper Series on Pandemic (7 May 2020)
https://drive.google.com/file/d/1m0AT21dS2XJ6JIGMgo7SuLSLveWIO8WK/view●

Data Protection Impact Assessment NHS COVID-19 App PILOT LIVE RELEASE
Isle of Wight (6 May 2020)
https://faq.covid19.nhs.uk/DPIA%20COVID19%20App%20PILOT%20LIVE%20RELEASE%20Isle%20of%20Wight%20Versio
n%201.0.pdf●Tom Chivers, Pandemics and privacy: COVID-19, contact tracing apps andprotecting our privacy, Imperial College London, (4 May 2020)
https://www.imperial.ac.uk/stories/pandemics-and-privacy/●

Marion Oswald, Towards a Trustworthy Coronavirus Contact Tracing App, Royal
United Services Institute (4 May 2020)
https://rusi.org/commentary/towards-trustworthy-coronavirus-contact-tracing-app●

ICO, COVID-19 contact tracing: data protection expectations on app development(4 May 2020)
https://ico.org.uk/about-the-ico/news-and-events/news-and-blogs/2020/05/covid19-contact-tracing-data-protection-expectations-on-app-development/●

Ada Lovelace Institute, Provisos for a Contact Tracing App （4 May 2020）
https://www.adalovelaceinstitute.org/our-work/covid-19/provisos-for-a-contacttracing-app-4-may-2020/●Jessica Morley, Josh Cowls, Mariarosaria Taddeo and Luciano Floridi, EthicalGuidelines for SARS-CoV-2 Digital Tracking and Tracing Systems (1 May 2020)
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3582550

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ELSI NOTE●

Graham Greenleaf and Katharine Kemp, Australia’s ‘COVIDSafe App’: An
Experiment in Surveillance, Trust and Law (2020) University of New South Wales
Law Research Series 999, 17 Pages Posted: 30 Apr 2020
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3589317●

Nature Editorial, Show evidence that apps for COVID-19 contact-tracing are
secure and effective (29 April 2020)
https://www.nature.com/articles/d41586-020-01264-1●

Anne Kerr Twenty questions about the NHSX contact tracing app, (Nuffield
Council on Bioethics（28 April 2020）
https://www.nuffieldbioethics.org/blog/twenty-questions-about-the-nhsx-contacttracing-app●

Joint Statement on Digital Contact Tracing by Alessandra Pierucci, Chair of theCommittee of Convention 108 and Jean-Philippe Walter, Data Protection
Commissioner of the Council of Europe (28 April 2020)
https://rm.coe.int/covid19-joint-statement-28-april/16809e3fd7●

OECD：Tracking and tracing COVID: Protecting privacy and data while using
apps and biometrics (23 April 2020)
https://www.oecd.org/coronavirus/policy-responses/tracking-and-tracing-covidprotecting-privacy-and-data-while-using-apps-and-biometrics/●

EDPB, Guidelines 04/2020 on the use of location data and contact tracing tools in
the context of the COVID-19 outbreak (21 April 2020)
https://edpb.europa.eu/news/news/2020/european-data-protection-board-twentythird-plenary-session-edpb-adopts-further-covid_en●

European Parliament, EU coordinated action to combat the COVID-19 pandemic
and its Consequences (17 April 2020)
https://www.europarl.europa.eu/doceo/document/TA-9-2020-0054_EN.pdf●

European Commission, Coronavirus: An EU approach for efficient contact tracing
apps to support gradual lifting of confinement measures (16 April 2020)
https://ec.europa.eu/commission/presscorner/detail/en/ip_20_670●

EFF, The Challenge of Proximity Apps For COVID-19 Contact Tracing (April 10,2020)
https://www.eff.org/deeplinks/2020/04/challenge-proximity-apps-covid-19-contacttracing

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European Commission, Coronavirus: Commission adopts Recommendation to
support exit strategies through mobile data and apps (8 April 2020)
https://ec.europa.eu/commission/presscorner/detail/en/ip_20_626●

Wojciech Wiewiórowski (EDPS), EU Digital Solidarity: a call for a pan-European
approach against the pandemic (6 April 2020)

ELSI NOTE●

https://edps.europa.eu/sites/edp/files/publication/2020-0406_eu_digital_solidarity_covid19_en.pdf●European Group on Ethics in Science and New Technologies (EGE), EGE
Statement on European solidarity and the protection of fundamental rights in theCOVID-19 pandemic (2 April 2020)
https://ec.europa.eu/info/research-and-innovation/strategy/support-policymaking/scientific-support-eu-policies/ege_en

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ELSI NOTEELSI NOTE No. 04
10 perspectives on COVID-19 Contact-Confirming Application(COCOA) and ethical, legal and social issues (ELSI) (Englishtranslation)
October 19, 2020

Research Center on Ethical, Legal and Social Issues (ELSI)Osaka University
Techno-Alliance Building C 6th floor
Osaka University
Yamadaoka 2-8, Suita, Osaka 565-0871 JAPANTEL +81-6-6105-6084
https://elsi.osaka-u.ac.jp

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