Tracking the Corona Virus with SSI

A way to prevent the spread of contamination among nations was to cut off all international flights. This specific measure could have been a considerable measure, wasn’t it be that it had come too late as the virus had already reached European countries. With Italy as the first victim, the arrival of the virus in the Netherlands was inevitable. Additional to the primary measure to prevent contamination, the overall agreement was that we had to cut off all social contact to reduce the spread of the virus. Several European countries chose for a temporarily ‘lockdown’ which has led to a ban on all physical, social gatherings. 

The cases

‘Social distancing’ has been the primary weapon of mass protection in the spread of COVID-19. In addition to minimizing physical contact with peers, countries such as China, Taiwan, and South Korea also took other measures to make sure they possessed the required information needed to protect its citizens. South Korea can already test more than 12,000 people a day on average, with a peak capacity of 20,000 citizens a day. By March 20, the country had tested more than 300,000 citizens of its population of 51 million people. 

The independent state of Taiwan is located just 130 kilometers off the coast of China and has more than a million citizens living or working in China, which should increase the risk of the spread. But Taiwan has been handling the problem quite well. The high success seems to be mainly due to the early recognition of the problem. Testing was followed by extensive tracking and tracing. Taiwan not only started checking air passengers from Wuhan but also got help from law-abiding citizens. In this collectivistic culture, citizens wholeheartedly shared their location data to track the contacts of infected people. Once a case was confirmed, the authorities tracked down the movement histories of the patient and traced the people they had contacted. In a BBC article, Milo Hsieh Described how the Taiwanese government is working on protecting society in response to this tweet. 

“My phone briefly ran out of battery at 07:30, and in less than an hour, four different local administrative units had called. A patrol was dispatched to check my whereabouts. A text was sent notifying that the government had lost track of me, and warned me of potential arrest if I had broken quarantine.”  

Which comes to notice is that the Taiwanese government is taking the health of its citizens very seriously. In the book ‘1984’ from George Orwell, people are constantly reminded of the slogan “Big Brother is watching you.” A lot of people will probably get a similar vibe. But these type of measures that the Taiwanese government has taken is contradictory of the privacy legislation that we have in European countries. However, even in European countries, we have seen exceptions being made with the sharing of records of patients who have fallen victim to the virus. 

Healthcare providers must take specific needs of patients into account. For this, they must know the complete treatment history of patients, especially to find out whether they are part of the risk group. When people that are part of the risk group are hospitalized, they need to receive specialized care. 

Although people already knew the importance of a good healthcare system, we, now more than ever, see how important a good functioning system is. The functioning of a healthcare provider such as a hospital not only involves sufficient capacity and good employees but also well-functioning systems.

Paul Elbers from the VUMC mentioned in the show ‘Op 1’: “By using machine learning, we want to come up with practical solutions for daily challenges in the workplace.”

At the Intensive Care, vital signs of patients are monitored and registered at any time of the day. “That amounts to about 30,000 data points a day. The quantitative bundle of information, as we see it (data), has been the fuel for more specific information, which has led to better and more personalized care for humans.

With the method of the Taiwanese government, hospitals would be able to share those private patient files with other caregivers who would gain specific knowledge with these numbers. They, in turn, can give better care to future patients who get sick but also patients that are declared healthy. All this data could be stored in a patient owned online medical file. The online medical file would give the patient complete autonomy and could, with the consent of the patient, be shared with caregivers if needed.

 The solution

The South Korean and Taiwanese governments have led by example in the reduction of the spread. To make those methods of control fit in European countries we have to give the power, to share secret and private data, back to patients. 

In this report, the Heal Information Technology for Economic and Clinical Health has been promoting digital patient data, to give every American access and insight into their file. This will most likely also happen to all European citizens in the coming two years. If this gets handled in the wrong way, this will give tremendous power to governments, owning all your personal information without your consent. Patients should have the right to know who does what with their data, and they should also be able to determine which parties have insight into their data. We’re creating a digital vault with your private goods. Everything that you put in the vault is yours until the moment that you choose to share the content with others. 

At Ledger Leopard we have created a solution in which data sharing is possible, but with the consent of the patient. We have created this solution with the use of Decentralized Identifiers which make it possible to share verifiable credentials. Decentralized identifiers (DIDs) provide a standard way for individuals and organizations to create permanent globally unique cryptographically verifiable identifiers entirely under the identity owners’ control. In this specific case, the patient would be the identity owner. If patients have completed a doctor’s visit because they have symptoms that the coronavirus entails, a patient must have access to this information in his file. 

Why? 

Due to overcrowded hospitals, patients that get transferred must be able to take their treatments to a new healthcare institution. The logged visits serve as proof that the patient has actually had a doctor’s appointment, and also show what type of care and history the patient has. The patient can then give the next caregiver insight to their data so they can then receive the necessary care from the new care provider. 

But how does this work with people who are not able to give consent due to their health situation or are not even in possession of a mobile phone? If someone has become unwell or has just had an accident, he is unable to permit to share data. 

It is possible with a DID to have multiple identity owners. In this way, you could mandate specific individuals (family) or organizations (caregivers) that you trust, and give them the right to provide consent for you in case of an emergency. 

The use of these DIDs comes with great advantages due to the privacy by default setting:

1. Pseudonymous by default. Usage of pairwise unique DIDs and public keys
2. Private agents by default. No private data is stored on the blockchain, which makes it GDPR proof. For more information, read the complete GDPR rapport by Sovrin.
3. Selective disclosure by default. The verifiable claims use cryptographic zero-knowledge proofs, so they can automatically support data minimization.

Since no personal data is stored on the blockchain, patients can share information more privately, with backing from verified institutions. Only so-called hashes and pointers are added to the transactions of each generated block. The hashes are used for logging events associated with events of specific users and roles. In this way, patients can share their data with institutions securely and safely. Institutions such as governments are then able to track how many people are infected with the virus and how many have received treatment for the virus without the people revealing their real identity. If they want to help the government one step more, they can decide for themselves if they’re going to share specific attributes, which will give the government insight into their personal information.

With this solution, Governments are able to:

• Measure how many people are sick and receiving treatment or are quarantined after a doctor’s visit.
• Measure how many citizens have had treatment against the coronavirus and are now healthy again.
• Check if incoming travelers are infected with the virus or already had treatment. 

With the fast spread of correct information, we can all help to prevent the spread of COVID-19 and flatten the curve. We cannot go back to counteract the origin of the problem, but we can take responsibility and work together to solve it. 

written by Raoul Esseboom