Blockchain Is The PPE (Personal Protective Equipment) We All Need
In this time of crisis we face a choice between digital surveillance and citizen empowerment. This is why Blockchain really matters.
Dr. Bernard Rieux heads a small hospital in the coastal town of Oran and works long hours treating patients. He was the first to urge authorities to take action to stop the spread of the disease that if left untreated, could kill half his town’s population. Even when a quarter of the city was dying, Dr. Rieux still kept doing his job, because decency redeems not just the individual, but all of humanity.
“It may seem a ridiculous idea”, he said, “but the only way to fight the plague is with decency [and decency is]… doing my job,”.
Dr. Beranard Rieux is the main character in Albert Camus’ 1947 existentialist classic “the Plague” (La Peste) and just like Camus imagined, our doctors, nurses and medical professionals are all like Dr. Rieux, decent.
However the virus isn’t.
We have learned that COVID-19 presents in four periods: (1) infected, but not contagious and not symptomatic; (2) infected and contagious, but not symptomatic; (3) infected, contagious, and symptomatic; (4) recovering (assuming survival), where you may still have symptoms but are no longer contagious. It is therefore possible to reliably predict peak morbidity and mortality rates (e.g. the IHME model) contingent of course on accurate tracing, testing and tracking of everyone (including those who do not come to the hospital).
Also we have learned about the exponential growth of the COVID-19, and the importance of social distancing (or as elegantly put by David Siegel, stay the f*cK home, STFH), so that we can keep uninfected people from becoming infected, by preventing them from coming into contact with (potentially) infected individuals. (see below)
However doctors, nurses and everyone involved in patient care do not have the luxury of social distancing. That is why they need PPE!
#1 Healthcare professionals need physical PPE
As the COVID-19 projected fatality rate is estimated to be in the range of 60,000–240,000 people (which puts it in par with annual death rates of cancer and heart disease, 252,200 and 269,583, respectively), healthcare professionals are at extreme high risk of infection.
Beyond the personal sense of danger (CDC does not know how many healthcare professionals are actually infected), at least 3000 physicians died in China and 14% of the deaths in Spain were medical professionals. Doctors and nurses also fear they could transmit the virus to their patients, transforming hospitals into viral incubators, or bring the disease home to spouses and children .
Since inadequate provision of PPE has become a reality in the US, the CDC has come out with extended use and re-use guidelines, which unfortunately do not provide medical professionals the necessary protection from infection. But not just PPE are missing. Testing equipment, ventilators, essential anesthetic and resuscitation drugs are underused or short in supply.
So it is not surprising that calls to develop blockchain-based solutions to improve tracing, tracking, auditing and managing supply chains have surged (below).
#2 Healthcare professionals need free speech PPE
As doctors and nurses fall sick and die, some came out to speak about their safety and lost their job, even if they were just trying to raise funds to buy PPE. These type of retaliations, combined with pay cuts, furloughs, and layoffs while some hospital executives continue to stay at their vacation homes, has inflicted deep moral injury upon our healthcare professionals.
As elegantly put by Dr. Wendy Dean:
…”Furthermore, despite clear evidence from China and Italy, of the existence of a highly transmissible virulent respiratory illness, with a period of asymptomatic infection and viral shedding, consuming PPE continued in most US hospitals at unprecedented rates”…
The reason for this is simple. As Dr. Dean adds: “Elective surgeries are the cornerstone of our hospital system’s operating model — and the negative impact due to the cancellations of these procedures cannot be overstated”.
…”Hospitals continued to perform elective procedures — burning through PPE that would soon be critical to protect healthcare workers — for weeks after the first alarms sounded, and proceeded to schedule elective surgery despite recommendations from many organizations to cease. There were clear predictions of worldwide demand for PPE and consequent supply chain challenges, just-in-time as purchasing readily failed”...
Simply said: profit preceded provider’s safety.
So as economists are calculating the cost of the pandemic and the cost/benefit of social distancing, it is clear that we are failing our doctors and nurses and need to stop and ask ourselves: what happens if healthcare workers simply stop showing up?
Therefore physicians, just like Dr. Li Wenliang who died from COVID-19 and was threatened not to speak about the virus, need a secure and anonymous platform* where they can speak freely and feel safe to report what is happening within the hospital corridors, without censorship and the existential fear of job loss and professional retaliation.
*Dr. Wenliang’s hidden message was delivered at block height 9648876 on the Ethereum blockchain
Blockchain is able to provide this security and privacy because although the network is open for users to come and leave, it does not require participants to register. Users on blockchain networks are pseudonymous (they do not have to disclose their real name or credentials) and transactions are secure because each transaction is cryptographically signed by the originator to prove its authenticity (details and blockchain security and privacy can be found here).
#3 Blockchain will provide ALL of us free speech PPE
I have recently published that not all COVID-19-related things are bad. We are building coalitions and collaborating at an unprecedented scale in research, developing vaccines (below), offering diagnostic and telehealth tools for free, and even looking at waste water to detect viral clusters.
However with the call for collaboration, there is a dangerous call for centralization.
We are centralizing data, creating a National Research Cloud, a National Coronavirus Surveillance system, considering vaccination cards, and Governors are allowing state and local health department officials to disclose information about those who have tested positive for COVID-19, in the interest of public safety.
The slippery slope is self evident. Tracking people and tracking equipment are not the same.
Availing geolocation data to governments, without applying privacy-preserving technologies risks vulnerable populations to censorship. Tracking at zip code granularity, using mobility reports and contact tracing via bluetooth signal (below), may facilitate discrimination against racial minorities, people living in poverty, and other marginalized populations, whose needs and lived realities may be obscured or misrepresented in these datasets.
We cannot allow the COVID-19 pandemic to further increase the gap in the enjoyment of human rights between different groups in society.
At the moment most Americans are wary of giving up data to fight COVID-19. They do not wish to have to trade their privacy for public health needs and there are states that are currently banning geolocation technology. Americans in fact abhor this infodemic of disinformation and prefer Dr. Fauci’s accurate reporting (below).
Final thoughts:
We are normalizing the deployment of mass surveillance tools in pandemic speed, without knowing exactly who is tracking us and how we are being tracked. We are allowing the Government to monitor us, and punish those who break the “rules”.
But centralized monitoring is not the only way. There are decentralized ways that encourage individuals to behave safely and responsibly. We can for example create social distancing tokens (below), enhanced with decentralized self-sovereign identity and zero-knowledge proof cryptography.
COVID-19 pandemic is a global public health emergency that requires a coordinated and large-scale response by governments worldwide. However, efforts to contain the virus must not be used as a cover to usher in a new era of greatly expanded systems of invasive digital surveillance.
The coronavirus epidemic is thus a major test of citizenship… If we fail to make the right choice, we might find ourselves signing away our most precious freedoms, thinking that this is the only way to safeguard our health. (Yuval Harari)
The ethical, moral and philosophical decisions we are taking now will shape not just our healthcare systems, but also our economy, politics and culture.
Blockchain technology can help us with these decisions.
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