Ethics and informatics in the age of COVID-19: challenges and recommendations for public health organization and public policy

Abstract

The COVID-19 pandemic response in the United States has exposed significant gaps in information systems and processes to enable timely clinical and public health decision-making. Specifically, the use of informatics to mitigate the spread of SARS-CoV-2, support COVID-19 care delivery, and accelerate knowledge discovery bring to the forefront issues of privacy, surveillance, limits of state powers, and interoperability between public health and clinical information systems. Using a consensus building process, we critically analyze informatics-related ethical issues in light of the pandemic across three themes: (1) public health reporting and data sharing, (2) contact tracing and tracking, and (3) clinical scoring tools for critical care. We provide context and rationale for ethical considerations and recommendations that are actionable during the pandemic, and conclude with recommendations calling for long-term, broader change (beyond the pandemic) for public health organization and policy reform.

Livestock plants and COVID-19 transmission

“…Understanding the public health risk posed by livestock processing is essential for assessing potential impacts of policy action. However, generating case data attributable to livestock plants is challenging: Contact tracing in the United States is decentralized and sporadic, and there may be incentives for companies and government bodies to obscure case reporting (1)(2)(3)(4)(5). Our study represents an attempt to address this gap in knowledge.…”

Towards Privacy Paradigm Shift Due to the Pandemic: A Brief Perspective

“…As these systems are designed to collect information like, where someone go, to whom someone meet, how often someone meet, at what time someone meet, what and from where someone buy daily usage things, what are someone plans regarding travel in near future, how often someone visit pharmacy or nearby clinic, what is the profession of someone, what are activities of someone in leisure time, in which infrastructure some data may go and for which purpose it will be used, and what is the religion of someone, to name a few are pertinent data collection items due to which people are concerned more about their privacy in the COVID-19 era [9,10]. Hence, the need for an in-depth understanding of what roles information systems and technology researchers can play in this global pandemic has become more emergent than ever [11,12]. The future systems should address the privacy challenges by collecting minimal data that is of paramount to deal with epidemic/pandemic, safe storage of personal data, secure processing, privacy preserving computing-based analytics, and distribution and use in a privacy preserving manner to augment people trust on such systems.…”

Identifying Barriers to and Opportunities for Telehealth Implementation Amidst the COVID-19 Pandemic by Using a Human Factors Approach: A Leap Into the Future of Health Care Delivery?

“…Information flow among these entities is often fragmented due to a plethora of regulations and laws such as the Health Information Technology for Economic and Clinical Health Act and Health Insurance Portability and Accountability Act (HIPAA) [ 34 ]. The multiple overlapping federal and state laws that intentionally protect health information located in different information systems now unsurprisingly also make it onerous for care providers and patients to use telehealth to exchange COVID-19–related information [ 35 ] Therefore, the difficulty of integrating patient health information across entities needs to be addressed for effective telehealth services. Improving interoperability between various information systems and enhancing electronic health record as a one-stop information hub may be one potential solution [ 34 ].…”