Planning for the Next Pandemic: A Global, Interoperable System of Contact Tracing

Planning for the Next Pandemic: A Global, Interoperable System of Contact Tracing John Palfrey (bio) and Urs Gasser (bio) This article was contributed to Forum—the edition’s portfolio of thematic content—by GJIA’s Business & Economics section. The list of ways in which human beings have done poorly in responding to the COVID-19 pandemic is long and growing.1 Of the many shortcomings in our global response to the COVID-19 pandemic, our failure to coordinate efforts across geographic areas, within and between countries, ranks near the top of the list. Much of the blame can be placed at the feet of national governments. The federal government of the United States, for instance, refused to take full responsibility for the health and well-being of a nation’s people, deferring major decisions to the states in some cases and obscuring the truth in others. Some US governors and mayors have stepped up in their respective jurisdictions, but they lacked the mechanisms by which to coordinate what states, cities, towns, and regions are doing to stop the spread of disease. Around the world, few true global leaders emerged to address the crisis; the international institutions established to handle this type of work, including the World Health Organization, faced funding cuts when states should have been tripping over one another to fund and support them properly.2 We have learned, yet again, that there is no way forward during a pandemic such as the COVID-19 crisis of 2020 without a massive, well-coordinated testing regime plus a system of contact tracing, absent a widely distributed vaccine and prior to herd immunity. To keep people safe while getting everyone back to work and the economy running again, the testing and tracing systems need to work within and across geographic and political boundaries.3 Widespread testing is an absolutely necessary starting point.4 During the COVID-19 pandemic, there were too few reliable tests, they were poorly distributed, and cost and availability problems meant that there were terrible inequities in terms of who could take advantage of the benefits of testing in the United States and around the world. The Centers for Disease Control and Prevention in the United States, among many others, called for greater accessibility and more affordable access to testing.5 While a sound national strategy would be helpful, ramped up testing can presumably be managed locally and regionally.6 Unlike testing, contact tracing, by its nature, needs to be coordinated across geographic and political boundaries. Some number of people will travel outside their hometown, state, or country either as the pandemic is breaking or later in its spread. It is not enough to be able to track and trace a person within a limited jurisdiction. [End Page 5] It became clear very quickly that there was no coordination of contact tracing systems during the COVID-19 pandemic of 2020. This absence of coordination was one of the most glaring failures in a year characterized by many glaring failures in the public health system. What’s worse: despite the experiences of this year, we are in no way prepared to carry out an effective system of contact tracing in our deeply interconnected world. We learned during the COVID-19 pandemic that we are a long way from having systems that can work together to protect the public health while protecting individual privacy across the board. Even Pope Francis commented in an encyclical on our failure to coordinate in the interest of public health: “Aside from the different ways that various countries responded to the crisis, their inability to work together became quite evident. For all our hyper-connectivity, we witnessed a fragmentation that made it more difficult to resolve problems that affect us all.”7 While the system of contact tracing does not need to be the same in every area—and probably should not be the same everywhere, even within a region such as the European Union (EU)—the approaches we adopt need to be interoperable. That is to say, we will need a mechanism for the data to be shared from place to place and for the essential knowledge to flow from jurisdiction to jurisdiction...