June 10, 2020 — The development of digital contact tracing solutions raises endless security issues: Where should data be stored and for how long? Should public health authorities have access? Should app adoption be voluntary or involuntary?
In a webinar hosted on Wednesday by the Center for Democracy & Technology, panelists contrasted the approaches to the development of COVID-19 contract tracing models in Asian versus European countries.
Dev Lewis, fellow and program lead at Digital Asia Hub, reported that over 10 East and South Asian nations have developed their own contact tracing apps.
South Korea has taken one of the most intrusive approaches to digital contact tracing, resulting in a successful reduction of the spread of COVID-19.
The country’s approach quickens the pace of manual contact tracing by utilizing GPS location data, which improves both efficiency and accuracy. It also plans to implement a QR program beginning June 10, logging entrances and exits to public locations.
In spite of their success, the South Korean government has faced heavy criticism for their aggressive approach.
In Singapore, a bluetooth-enabled contact tracing app called Trace Together was developed. However, drastically low adoption rates have rendered the app useless.
According to Lewis, less than a quarter of the population adopted the app. In order for contact tracing apps to be effective, that figure must reach 50 to 60 percent. The low adoption is surprising given Singapore’s high digital literacy levels and high internet penetration rates.
Lewis concluded that contact tracing apps that allow for voluntary adoption do not work, as they lack demand even in the most connected nations.
The QR code initiatives adopted by the Chinese government are not technically a contact tracing app, but rather what Lewis referred to as a “health passport”. The app attempts to reduce the chances of a resurgence of the disease by controlling who can access areas considered high risk. It relies on centrally stored medical data rather than data from individual phones.
As of yet, no Asian nations have adopted the Google-Apple contact tracing API, or application programming interface.
On the other side of the globe, “the European approach has been fragmented,” said Frederike Kaltheuner, a tech policy fellow at the Mozilla Foundation. While seven countries in the EU released apps based off of the Google-Apple API, revealing the vast influence these corporations have in the West, the U.K. and France developed apps based on centralized designs.
The centralized design adopted by the U.K. and France is not interoperable with Google and Apple’s decentralized API design that has been employed by other EU nations.
According to Kaltheuner, deployment of the U.K. and France’s centralized tracing apps were framed by the press as faceoffs between the countries and Silicon Valley.
But their pride may hurt them in the long run, Kaltheuner said, calling the U.K.’s approach a “really good example of how not to use technology in a pandemic.” The Bluetooth contact tracing app had severe problems and wide-ranging security flaws, resulting in major trust issues.
France’s contact tracing app, launched June 2, utilizes QR codes to notify individuals that have been in contact with those diagnosed with COVID-19. The invasive app has a centralized component, as all the people in contact with the person diagnosed are uploaded to a server. The government has been heavily criticized for this choice.
While, Germany initially wanted to use the centralized French design, they changed course after heavy public pressure in late April and are now planning to utilize the Apple-Google API.
All contact tracing apps adopted by EU nations must ensure compliance with General Data Protection Regulation standards.
Another $700 Million for 26 States Through the Rural Digital Opportunity Fund
Over 400,000 locations across the U.S. will get broadband in this funding wave.
WASHINGTON, November 12, 2021 – The Federal Communications Commission announced Wednesday that it will authorize $709,060,159 for 26 states through its Rural Digital Opportunity Fund.
These are disbursements of the $9.2 billion that were announced in round one of the RDOF reverse auction that took place in the fall of 2020.
The rural fund supports new broadband deployment efforts for 50 broadband providers in 400,000 locations across the U.S. Much of the funding will go to nonprofit rural electric cooperatives to deploy broadband in their service areas.
But others awarded funding under the auction have already defaulted on coverage that they said they would provide as part of their winning bids.
The 26 states ready to receive Wednesday’s funding include Arizona, California, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Montana, New Hampshire, New York, North Carolina, North Dakota, Oregon, South Dakota, Tennessee, Texas, Virginia, West Virginia, and Wisconsin.
FCC Chairwoman Jessica Rosenworcel said that the announcement “highlights the agency’s commitment to supporting even more opportunities to connect hundreds of thousands of Americans to high-speed, reliable broadband service while doing our due diligence to ensure the applicants can deliver to these unserved communities as promised.”
The Commission’s announcement comes after the FCC launched the second round of its COVID-19 Telehealth Program on Tuesday, granting $42.5 million for health care providers. This telehealth program and exceeds the FCC’s $150 million goal by reaching $166.13 million for telehealth funding.
These funding programs provide reimbursements for telecommunication and information services and connected devices the providers have purchased to continue their telehealth services. The Commission also announced $421 million on Monday to keep over 10 million students connected across the U.S. as part of the Emergency Connectivity Fund.
Senate Subcommittee Hears Broadband Affordability, Regulatory Flex Key to Reducing Hospital Burdens
Health providers testified before a Senate subcommittee that Congress should be open to all forms of telehealth.
WASHINGTON, October 7, 2021 – A Senate subcommittee heard Thursday that affordability is the greatest barrier to broadband adoption and that lawmakers should exercise regulatory flexibility when it comes to the forms of telehealth to help reduce inessential hospital visits.
Covid-19 often brings about extreme shortness of breath, the severity of which is best assessed by a doctor, Deanna Larson, president of Avel eCARE, told the Senate Subcommittee on Communications, Media, and Broadband, which convened a hearing on the state of telehealth and removing barriers to access and improving patient outcomes.
Patients with affordable, high speed internet access can be monitored at home by doctors so that they don’t enter an emergency room or take up a hospital bed prematurely, she said.
Larson urged Congress to extend or make permanent their regulatory flexibility toward telehealth especially as it relates to being neutral on the kinds of telemedicine, such as phone-only care, asynchronous care, and remote patient monitoring. An economic benefit of which would be keeping medical commerce local, she said. Patients wouldn’t be required as often to move to a higher level of care out of town.
Physicians would have 24-hour access to the patient through video calls, monitoring patients in a way which significantly lightens the burdens of the healthcare system, added Larson. With telehealth, doctors can advise patients on exactly when and if they need to go to an emergency room.
Steps to improve telehealth
The committee also heard testimony from Sterling Ransone Jr., president of the American Academy of Family Physicians. Ransone, a strong proponent of telehealth, has found that the digital divide touches rural, tribal and urban communities alike and proposed a series of steps Congress could take to increase public health through broadband policy, including investing in universal affordable broadband service, digital literacy services, end-user devices, audio-only telehealth and data collection in the determinants and outcomes of telehealth as it relates to key factors such as race, gender, ethnicity and language.
Defining broadband as a social determinant of health, Ransone highlighted that affordability is possibly the greatest barrier to broadband adoption and that affordability and access disproportionately affect rural communities.
Sanjeev Arora, founder of Project ECHO and distinguished professor of medicine at the University of New Mexico, agreed: “expanding access to high-quality, high-speed broadband connectivity is critical. It’s a prerequisite for the success of any telehealth model in rural communities and urban underserved areas.”
Telehealth isn’t just vital and broadly popular, it is cost saving. Federal Communications Commissioner Brendan Carr, who also appeared before the subcommittee, shared an estimate that widespread telehealth availability could save the health care system $305 billion a year.
Carr, in an effort to reduce inessential hospital visits and decrease the risk of spreading Covid-19, endorsed the CONNECT for Health Act, the RUSH Act of 2021, the Telehealth Modernization Act, and the Protecting Rural Telehealth Access Act, which in combination would remove geographic restrictions to telehealth services, foster use of telehealth in skilled nursing facilities, grant the Secretary of Health and Human Services greater ability to reduce telehealth restrictions and more.
Craig Settles: Libraries, Barbershops and Salons Tackle TeleHealthcare Gap
Craig Settles describes the important role that community institutions have played in promoting connectivity during the COVID-19 pandemic.
Today, Senator Ed Markey, D-Mass., Senator Chris Van Hollen,D-Maryland, and Representative Grace Meng, D-N.Y., led 40 members of Congress to introduce the Securing Universal Communications Connectivity to Ensure Students Succeed (SUCCESS) Act. The bill would extend the Emergency Connectivity Fund by five years and provide $8 billion a year to schools and libraries for student connectivity off-campus.
Barbershops and hair salons are long-time anchor institutions in African-American communities that have shown promise for advancing telehealth. Their partnering with libraries (a broadband anchor institution), and the Biden Administration’s enlisting of 1,000 shops and salons to help combat COVID-19, telehealth and public health in these communities could go into overdrive.
Missing their July 4 COVID-19 vaccination goals, the Biden Administration raised money to transform the shops into mini-medical centers. This success is motivating shop owners to do more. As one of the targets for $7 billion in broadband funds, libraries are idea partners that can provide broadband services, digital content, and digital and health literacy shops’ customers.
Mike Brown manages a barbershop in Hyattsville, Maryland, and participated in the vaccination program. Brown and others owners talks with their customer about how the vaccines have been proven to work. “I use my platform to advocate for truth and dispel myths,” said Mr. Brown in an Wall Street Journal article, who has also held a vaccination clinic in his shop. “I’ve gotten about 60% of my clients to get vaccinated.”
The program has opened shop owners’ eyes to the power they have to make a difference in the healthcare of their communities. It’s a logical transition from the vaccination program to hypertension screening. Urban Kutz Barbershops in Cleveland have been screening customers for 12 years, recently with telehealth assistance from the famed Cleveland Clinic’s.
Owner Waverley Willis says “Barbers and hairdressers are part-time marriage counselors, psychiatrists, spiritual advisers, and expert listeners. So many customers listen to our medical advice.” He has made a noticeable impact on many of his customers’ healthy eating habits as well.
Think differently about broadband, public health and telehealth
On July 1, the Federal Communications Commission began a 45-day Emergency Connectivity Fund of $7.1 billion in broadband and digital technology funding to support libraries and schools. By August 13, libraries interested in grants from the program must present a proposal on how they plan to spend money for libraries laptops, hotspots, Internet services, and other resources to advance education and remote learning.
A generous interpretation of “education“ enables libraries to serve any patrons with broadband. If libraries are situated in areas in which there are no ISP services, they can request money from ECF to build their own broadband infrastructure for unserved patrons. Unlike traditional E-rate proposals, ECF doesn’t require a competitive bid for services, meaning libraries can present a quote from the first vender they contact.
Libraries partnering with shops and healthcare organization could give shops laptops, telehealth software, and portable hotspots to provide hypertension screening and other healthcare services that are suited to their customers’ needs up to three years. Shop owners often don’t have computing devices or Internet access in their shops. Telehealth devices such as portable digital blood pressure monitors and digital scales will have to be provided separately and possibly through funds from another government agency such as Health & Human Services.
For hypertension screening, for example, shops can take customers’ blood pressures digitally. The healthcare provider takes that data through telehealth and recommends treatment when necessary or advisable. The partner likely would have established rates for their healthcare services. Shops can then decide on additional telehealth services they want to provide.
The shops could work with libraries to develop health information and interactive Web content to reduce hypertension and other medical issues through healthier living, plus the libraries can provide telehealth services beyond what the shops can do.
Libraries and shops can also designate customers who need a laptop, hotspots and telehealth software for chronic illnesses such as severe hypertension, diabetes, heart disease, mental health treatments, and so forth. However, these devices in this scenario would need to be given out for longer periods then just a couple of weeks. For occasional medical appointments, libraries can loan out laptops and hotspots for limited times such as two or three weeks. Libraries are good at delivering digital training and literacy programs.
Why barbershops, hair salons and libraries?
Facilitating telehealth and healthcare does have an educational element for barbershop and hair salon customers as well as for general library patrons. These health services and information help both groups of people learn more about their own health, enables them to react effectively to medical issues, and be more proactive in taking care of their health.
The ability for shops and salons to reach and impact African-American communities is legendary. “This type of barbershop health initiative has been shown to be effective,” said Cameron Webb, a senior White House health equity adviser on the coronavirus. Willis adds, “On more than one occasion, a guy’s blood pressure would be so high we would urge him to skip the haircut and go straight to the emergency room.”
Libraries have years of experience introducing new technology such as broadband to underserved populations. Matt McLain, Associate Director for Community Engagement at Salt Lake County Library, said, “We’ve had a pretty good amount of success reaching Hispanic populations at their markets. We have Asian markets out here too. And our health initiatives are quite important with the church leadership in these communities.”
The healthcare and broadband gaps are real and they are deadly! So many elements of the COVID pandemic reiterates the deadliness of those gaps. According to the Centers for Disease Control, of the data collected as of June 14 nearly two-thirds of people who got at least one dose of the vaccine were White. Only 9% were African-Americans. 14 million urban household cannot get any broadband, without which you cannot get telehealth, and 75% are Black or other people of color.
There may never be as many federal broadband and health-related grant programs as we are seeing now. Partnership potential between libraries and haircare shops are many. Will public health practitioners and advocates, broadband builders, and community leaders step up?
Craig Settles conducts needs analyses with community stakeholders who want broadband networks to improve economic development, healthcare, education and local government. He hosts the radio talk show Gigabit Nation, and is Director of Communities United for Broadband, a national grass roots effort to assist communities launching their networks. He recently created a guide to help librarians uncover patrons’ healthcare needs, create community health milestones and effectively market telehealth. This piece is exclusive to Broadband Breakfast.
Broadband Breakfast accepts commentary from informed observers of the broadband scene. Please send pieces to firstname.lastname@example.org. The views expressed in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC.
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