Seoul’s Radical Experiment in Digital Contact Tracing | The New Yorker
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Jung has also been candid about the trade-off inherent in these measures. Under the terms of South Korea’s Infectious Disease Control and Prevention Act—passed after the 2015 MERS outbreak, during which the government’s withholding of critical information contributed to further transmissions and deaths—it is now required to publish information that can include infected people’s travel routes, the public transport they took, and the medical institutions that are treating them. As long as districts do not reveal the identities of confirmed patients, they have been free to decide levels of disclosure on their own. In a few instances, officials released enough information to make people with COVID-19 publicly identifiable, leading to cases of doxxing and online harassment. “Please don’t spread information about my identity,” one patient wrote on social media. “I’m so sorry to my friends and family that I’ve hurt, but more than the physical pain, it’s been very difficult mentally.” In February, a survey of a thousand people by researchers at Seoul National University found that respondents’ greatest fear about the disease was social stigmatization. The National Human Rights Commission of Korea issued a statement calling for stronger measures to protect individuals from being outed. Experts have also cautioned that over-disclosing can be counterproductive, as patients fearful of public censure may choose to hide instead of seeking treatment.
Still, he said, somewhat cautiously, “I think we should try to disclose as much information as we can, rather than holding back.” For Song, this has meant including patients’ age and gender, their neighborhood of residence, and the names of businesses and apartment complexes they had visited, which he sees as a way of assuaging other residents’ anxieties. “What most people ultimately want to know is whether their activities overlapped with patient routes,” he explained. In Mapo, this has also boosted testing. “A lot of people come in after seeing the published patient routes, concerned that they might have been in the same place,” one of the doctors at the local testing center, just outside Song’s building, said.
“It’s a double-edged sword,” Seong Han-bit, the thirty-six-year-old owner of Stance Coffee, a small, independent coffee shop in Seoul, told me. His café has nice lighting and copies of Kinfolk, the chic Danish magazine, at every table. On the morning of March 28th, Mapo’s Patient 15, a woman in her twenties, had briefly stopped by to order a drink. Song’s writeup for her, posted two days later, was unusually long. The woman had arrived at the airport—where she initially tested negative at a screening checkpoint—after visiting the United States. In Seoul, she had visited a cosmetics store, a fried-chicken joint, a hair salon, a post office, and multiple convenience stores and restaurants, before testing positive on March 29th. According to the report, she was believed to have caught the virus in America.
On a popular local Facebook group, someone had written a post denouncing her for being so irresponsible. “Just die alone, why would you cause other people harm,” one member said. Another remarked that the patient should have been hit with a giant hospital bill in the United States. The original poster, perhaps sensing that this conversation was bringing out people’s worst impulses, locked the comments.
On Monday, March 30th, after district officials fumigated Stance Coffee, and a major broadcaster mentioned the shop by name in a report about “re-imported” COVID-19 cases, Seong opened up his café. “Because I personally don’t keep up with patient routes, I assumed that other people wouldn’t either,” he said. “But, after the post went up yesterday, I felt it in my bones. From 5 P.M. to 11 P.M. that day, not a single customer showed up. I thought, ‘Ah, this really does have a big impact after all.’ ”
Sitting in his now empty café, Seong had also received a string of interrogatory phone calls from customers, demanding to know things like whether the barista working on the day in question had since been self-isolating. In reality, Seong told me, Patient 15 had been in the store for only a minute or two while she waited for her order. The barista, who had been wearing a mask during his shift, had interacted with her for just a moment. “It would be nice if the detailed circumstances of the encounter were listed alongside the other information,” Seong said.
When a patient tests positive here, Kim’s team retraces their movements based on their oral testimony, and then combs through relevant C.C.T.V. footage in order to locate others who might have been exposed. Restaurants, where people must take their masks off to eat, are the most common sites of exposure. “Say there’s someone who was within two metres of the patient at a restaurant, but we don’t know who that person is, except what they look like in the C.C.T.V. footage,” Kim said. “Then we ask the credit-card company to pull up that customer’s information and ask them to tell them to contact us.” That person is then put under monitored self-isolation for two weeks, using an app that tracks his phone to insure that he isn’t breaking quarantine.
Behind this model of contact tracing is a vast surveillance apparatus expressly designed for such outbreak scenarios. Under South Korea’s Infectious Disease Control and Prevention Act, health authorities, with the approval of the police and other supervising agencies, can make use of cell-phone G.P.S. data, credit-card payment information, and travel and medical records. As of March 26th, the government has also officially launched the Epidemic Investigation Support System, a data-analysis platform that automates the process, allowing investigators to get clearance and pull up patient trajectories in under a minute. (Previously, the process took about a day.)
Late last month, I experienced the outbreak-surveillance system for myself. Upon walking through the front door of Gachon University Gil Medical Center in Incheon, I was surrounded by a contingent of hospital workers wearing goggles, masks, face shields, and plastic gowns. After taking my temperature, a nurse asked me if I’d recently travelled to any high-risk areas. I said no. At the next checkpoint, another nurse took my driver’s license and entered my personal identification number into her computer, where a modified version of the Drug Utilization Review—a drug-prescription cross-referencing system widely used in South Korea—pulled up my travel history to check whether I was lying. I wasn’t, so I received a yellow sticker. Eom Joong-sik, an infectious-disease physician who is advising the government on COVID-19, was waiting at the end of the checkpoint.
“This is one of the benefits of having a universal health-care system,” Eom told me, gesturing behind us. “When they enter your personal identification number, they can review your travel history.”