Categories
COVID-19 Health Medicine Security State Surveillance

Podcast: COVID-19 in the history of biopolitics

By Nicolas Friden BA & Carlos Solsona Ribes BA & Camilla Wallner BA

This podcast episode discusses COVID-19 and the vaccination debate in the context of the history of biopolitics.

Categories
Asia China COVID-19 Ethnicity General Surveillance

How the Xinjiang crisis was made gloomier by the pandemic


Xinjiang detention centres in Onsu, Aksu, as identified by a technical journalist. Source: https://techjournalism.medium.com/open-source-satellite-data-to-investigate-xinjiang-concentration-camps-2713c82173b6

By anonymous author

In this blog post I want to talk about the plight the Uyghurs face in China since the beginning of the pandemic. A crisis like this puts the socially vulnerable in a more vulnerable spot, especially in a country with a sizable amount of its population living in poverty, and has no social welfare system like China.[1] During the various lockdowns in 2020 worldwide, most people were confined to home, many people lost their job or livelihood, with no employment payment, no income or savings, and many struggled to pull through. The Uyghurs and other ethnic minorities in Xinjiang suffered way more than that. The Uyghur communities in southern Xinjiang have much higher poverty rates than the Han communities, as a result of long-term discrimination policies against their Muslim identity. In recent years, their culture, language and religion have been further suppressed by the regime in the name of national security, many fell victim to the “re-education” camps or forced employment schemes.[2]

Xinjiang is a vast region located in the northwest of China, home to over 13 million Uyghurs and over 1 million Kazakhs, who are the ethnic and cultural minorities. News reports and investigations showed that since 2015, numerous ‘re-education camps’ were being built all around Xinjiang, and it is estimated that over 1 million Uyghurs and Kazakhs are being detained in such camps, facing brainwash, mental and physical abuse day by day.[3]

In the beginning of the pandemic, many migrant workers were eager to return to big cities for work, but were forced by the lockdown to stay home for more than two months. As a result, thousands of Uyghurs were being sent across the country, to fill up the vacuum of labour following the first lockdown. Many were forced to wear GPS bracelets to track their whereabouts.[4] According to a report by the Australian Strategic Policy Institute, Chinese government sent approximately 80,000 Uyghurs to other regions of China to work in factories, including for many international brands like Nike, Apple, BMW and Volkswagen.[5] In July 2020, a New York Times visual investigation found that Uyghurs were also included in a government-sponsored forced labour program to produce face masks, in order to satisfy the skyrocketed global demand of P.P.E.. Much of the mask production was for export.[6] Besides all of this, hundreds of thousands of Uyghurs and other minorities were forced to undertake hard and manual labour in Xinjiang’s vast cotton fields and the garment factories, where 20% of the world’s cotton is from.[7]

Another report by China Tribunal also reveals that the detainees in the “re-education camps” are victims of organ harvesting, a practice that is not at all uncommon in Chinese prisons.[8] China has one of the lowest voluntary organ donor rates in the world, with the spreading of Covid-19, there were concerns that the Uyghurs were being “killed-on-demand” for Chinese Covid-19 patients, as China announced its first double-lung-transplant for a Covid-19 patient, who waited only five days for a “consenting” donor to provide a perfectly matching set of lungs.[9]

There were two major lockdowns in Xinjiang in 2020, the first one was from mid-July to early September, when the rest of China reported almost no new cases every day. The same measurements like those in Wuhan were imposed there, people were not allowed to leave their home, some building gates were sealed with iron bars, and residents were forced to take unknown medicine every day.[10] Around this time it was also reported that a mass female sterilization campaign was being carried out among the Uyghur population,[11] similar to the one carried out nationwide in the 1980s and 90s, as a result of the one-child policy.

Being the most heavily policed area of the world, “covered by a pervasive network of surveillance, including police, checkpoints, and cameras that scan everything from number plates to individual faces”,[12] most people could never move freely before the pandemic. Many questioned the scale of the outbreak in the cities, and expressed their concern of possible outbreaks inside of the ‘re-education camps’.[13] Given that ‘[t]hose camps are especially vulnerable to contagious disease due to the cramped cells, lack of medical resources and generally dire conditions.’[14]

The second lockdown in Xinjian was carried out from late October to late November in the area of Kashgar, where most Uyghur communities and ‘re-education camps’ are located, harsh measurements were imposed on its residents again. According to the news reports and studies, the human rights violations in China continue to deteriorate during the pandemic. In January 2021, the U.S. government declared that the Chinese government has committed genocide on Uyghurs and other ethnic minorities of Xinjiang,’, it was by far the strongest condemnation by any government against the Xinjiang crisis,[15] hopefully more countries will take part in the joint effort to end such atrocities against humanity.

Footnotes/bibliography

  1. CNBC. (2020, May 28). China has over 600 million poor with $140 monthly income: Premier Li Keqiang. CNBC TV18. Retrieved from https://www.cnbctv18.com/economy/china-has-over-600-million-poor-with-140-monthly-income-premier-li-keqiang-6024341.htm#:~:text=Economy-,China%20has%20over%20600%20million%20poor,monthly%20income%3A%20Premier%20Li%20Keqiang&text=China%20has%20over%20600%20million%20people%20whose%20monthly%20income%20is,Li%20Keqiang%20said%20on%20Thursday

2. Lee, Elizabeth.(2020, Oct 23). POVERTY IN XINJIANG, CHINA. The Borgen Project. Retrieved from https://borgenproject.org/poverty-in-xinjiang-china/

3. Uyghur Human Rights Project. (2020, February 18). “IDEOLOGICAL TRANSFORMATION”: RECORDS OF MASS DETENTION FROM QARAQASH, HOTAN. Retrieved from https://docs.uhrp.org/pdf/UHRP_QaraqashDocument.pdf

4. Dong, Han. (2020, March 12). 大批新疆维族人被强制送往内地工厂外出须戴定位. World Uyghur Congress. Retrieved from https://www.uyghurcongress.org/cn/%E5%A4%A7%E6%89%B9%E6%96%B0%E7%96%86%E7%BB%B4%E6%97%8F%E4%BA%BA%E8%A2%AB%E5%BC%BA%E5%88%B6%E9%80%81%E5%BE%80%E5%86%85%E5%9C%B0%E5%B7%A5%E5%8E%82%E5%A4%96%E5%87%BA%E9%A1%BB%E6%88%B4%E5%AE%9A%E4%BD%8D/

5. Xu, Cave, Leibold, Munro and Ruser. (2020, March 01). Uyghurs for sale. Australian Strategic Policy Institute. Retrieved from https://www.aspi.org.au/report/uyghurs-sale

6. Xiao, M., Willis, H., Koettl, C., Reneau, N., Jordan, D. (2020, July 19). China Is Using Uighur Labor to Produce Face Masks. The New York Times. Retrieved fromhttps://www.nytimes.com/2020/07/19/world/asia/china-mask-forced-labor.html

7. Sudworth, John. (2020, December). China’s ‘tainted’ cotton. BBC NEWS. Retrieved fromhttps://www.bbc.co.uk/news/extra/nz0g306v8c/china-tainted-cotton

8. Nice et al. (2020, March 01). The Independent Tribunal into Forced Organ Harvesting from Prisoners of Conscience in China. China Tribunal. Retrieved from https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf

9. Werleman, CJ. (2020, March 10). Are Uyghur Muslim Organs Being Illegally Removed to Save China’s Coronavirus Patients? Byline Times. Retrieved from https://bylinetimes.com/2020/03/10/are-uyghur-muslims-organs-being-illegally-removed-to-save-chinas-coronavirus-patients/

10. Kang, D. (2020, August 31). In China’s Xinjiang, forced medication accompanies lockdown. AP News. Retrieved from https://apnews.com/article/309c576c6026031769fd88f4d86fda89

11. Zenz, Adrian. (2020, June). Sterilizations, IUDs, and Mandatory Birth Control: The CCP’s Campaign to Suppress Uyghur Birthrates in Xinjiang. The Jamestown Foundation. Retrieved from https://jamestown.org/wp-content/uploads/2020/06/Zenz-Internment-Sterilizations-and-IUDs-UPDATED-July-21-Rev2.pdf?x12273

12. BBC NEWS. (2021, January 20). US: China ‘committed genocide against Uighurs’. BBC NEWS. Retrieved from https://www.bbc.com/news/world-us-canada-55723522

13. Dick, S. (2020, August 08). Dual threat: Coronavirus not the only battle in Uighur ‘re-education’ camps. THE NEW DAILY. Retrieved fromhttps://thenewdaily.com.au/news/coronavirus/2020/08/08/chinas-uighur-coronavirus/

14. Rogin, J. (2020, February 26). The coronavirus brings new and awful repression for Uighurs in China. Washington Post. Retrieved fromhttps://www.washingtonpost.com/opinions/2020/02/26/coronavirus-brings-new-awful-repression-uighurs-china/

15. BBC NEWS, 2021.

Categories
COVID-19 International Health Medicine Surveillance

Epidemiological Surveillance: A Little Guide to Monitoring Disease

Source: https://www.un.org/en/coronavirus

By Camilla Wallner, BA

What is epidemiological surveillance?

Epidemiological surveillance is defined as the ongoing systematic collection, analysis, and interpretation of health data that is essential to the planning, implementation, and evaluation of public health practice.[1] The aim is to observe, study and analyze any given infectious disease in order to get a better understanding of its spreading and its impacts on a given population.

It is the foundation for immediate action as well as long-term strategies in order to keep a disease at bay. Epidemiological surveillance falls under the competence of national authorities. However, international agencies and organisations such as the World Health Organization (WHO) play an increasingly important role ever since the SARS breakout in 2003 and even more so in the light of recent events and the outbreak of the Covid-19 pandemic. A rapid communication on an international level, the collection of background data as well as data interpretation of climatic variations are important tools in controlling and predicting the outbreak of diseases including zoonoses. Satellite surveillance of vegetation growth, for instance, is used as an indicator of rising vector numbers, thus enables the prediction of vector-borne diseases. There are different strategies for monitoring diseases, such as passive and active surveillance.

Active surveillance vs. passive surveillance

In order to collect data the different surveillance strategies draw their information directly from the source, notably health care workers. Passive surveillance is the most commonly used surveillance strategy and relies on surveillance forms filled out by health care personnel, which are periodically collected from health care facilities. The aim is to draw an approximate picture in order to assess current trends. However, it is a very shallow method as it is based on minimal data and does not offer many incentives to health care providers to actively engage in the process of data collection. It is common for health care workers to only partially fill out those forms, to neglect certain aspects or to stay vague in the description of symptoms.

One example that illustrates this problem is vaccines. Vaccines are known for being very cost-effective. In other words: the benefits outweigh the risks by far. However, clinical trials for vaccines are very costly, which is why post-licensure evaluations (for vaccines or drugs that are already licensed and allowed on the market) are often based on the results of passive surveillance in order to detect and monitor adverse events. Unfortunately, the results drawn from passive surveillance are often unreliable due to an insufficient proof of causality between the vaccine or drug in question and specific symptoms.  However, passive surveillance is still used for the evaluation of contraindications to diphtheria-tetanus-pertussis (DTP) vaccine and also for evaluating the risks of combined or simultaneous vaccinations. In essence, in the case of vaccine adverse events, unwanted symptoms or side-effects of a vaccination, there appears to be a significant trend of underreporting coupled with adverse event reports that lack precision and specification.[2]

In contrast, active surveillance institutions such as healthcare providers, work places, laboratories, nursing homes, or schools etc. are directly contacted by state authorities in order to obtain more detailed information. Both strategies have their advantages as well as their drawbacks. On the upside, passive surveillance can effortlessly be conducted on an on-going basis and reaches a broader population pool. On the downside, passive surveillance is known to provide incomplete data due to underreporting and is therefore suited for routine surveillance tasks. Active surveillance has the benefit that data is collected in a more inquisitive way and therefore requires a more intense mobilization of resources. It therefore provides more accurate data and is primarily used to investigate serious diseases, which display a potential risk to public health.

Other surveillance methods also exist, such as behavioral risk factor surveillance, outbreak surveillance, sentinel surveillance and syndromic surveillance but to name a few. Behavioral risk factor surveillance is based on an ongoing and systematic surveillance of data in order to identify possible risk factors for the outbreak of a disease, whereas outbreak surveillance is used to find the source of the outbreak via active surveillance methods. Sentinel surveillance focuses on identifying disease trends and which groups of a population are at a greater risk of contracting a disease. The aim of syndromic surveillance is to identify illness clusters in their early stages in order to limit a potential outbreak.

Alternative surveillance modi

On top of the classic surveillance methods, countries such as China are using modern technology in the battle against disease. For example, the China Infectious Diseases Automated-Alert and Response System (CIDARS) is an early warning model and a new epidemiological surveillance method. CIDARS is based on a mobile phone network which has a list of all relevant phone numbers of the epidemic staff on all levels from the national level down to the provincial level in order to inform the key personnel involved by SMS providing any given health facility reports a case.[3]

Another big data pool or complementary channel of information is social media. An increasing number of organizations including scientific institutions seek to use data from social media platforms. However, regulations relating to the protection of personal data are at the source of major challenges in this field – which calls upon legal and ethical guidelines establishing a threshold that should not be overstepped. [4] Putting modern technology at use for epidemiological surveillance appears a pertinent path in the future, although there are a few more practical and ethical obstacles to overcome in order to replace present day surveillance tools.

The WHO – a global response to a global threat

The World Health Organization (WHO) plays a crucial role in epidemiological surveillance and disease prevention worldwide. Its principles for the implementation of mass vaccinations as well as the WHO’s guidelines in the case of a pandemic are an important basis for the prevention and control of illness on an international level. Ever since the outbreak of the covid-19 pandemic, the recommendations of the WHO have gained unprecedented importance, notably in terms of surveillance strategies as well as strategies in combatting the new virus. As the topic of mass vaccinations has turned into an issue of major controversy, the organization recommends carrying out a risk assessment in order to evaluate whether the potential benefits of a mass vaccination outweigh the risks (risk-benefit criteria). Furthermore, the WHO proceeds with recommendations related to the coordination and planning of such mass vaccination campaigns.[5]

More generally, the WHO plays an important role in shaping the actions of major decision-makers, such as governments, independent laboratories, health care institutions or pharmaceutical companies in surveillance. However, the type of disease surveillance used to detect an illness or the type of remedy deployed in order to eradicate a disease are at the discretion of national actors. Public health policies are still a national matter and, even if international organizations play a role in shaping those policies, state sovereignty cannot be violated. The WHO plays a central role in coordinating global health threats – yet its capacities are purely advisory and it has no enforcement power. [6]

It should also be emphasized that there is a major asymmetry when comparing the scope of action of developed countries to the possibilities of developing and underdeveloped nations. While global surveillance initiatives as well as WHO recommendations may be efficient in developed countries, developing countries struggle from the additional pressure put on their already fragile health systems. It may lead to an undue shift of resources and commitment from already highly prevalent and preexisting diseases, which should however not be left unattended.

Conclusion

The aim of this blog post was to create a better understanding of the existing mechanisms in the field of disease prevention by presenting its central tools and most important actors, such as different types of epidemiological surveillance and the modus operandi of the WHO. Nevertheless, it is also important to outline the limits of the above-mentioned strategies as well as to show new potential analytical tools that are on the rise. To conclude, it is crucial to create awareness of the difficulties developing countries might have in following the WHO’s recommendations when combatting an infectious disease and that many countries lack the trained personnel as well as the medical equipment to meet international health standards.


[1] Richard J. Wolitski et al., “The Public Health Response to the HIV Epidemic in the U.S.,” in Aids and Other Manifestations of HIV Infection, ed. Gary P. Wormser, 4th ed (Amsterdam: Academic Press, 2004), 983–1000.

[2] S Rosenthal and R Chen, “The Reporting Sensitivities of Two Passive Surveillance Systems for Vaccine Adverse Events.,” American Journal of Public Health 85, no. 12 (1995): 1706–9.

[3] Weizhong Yang et al., “Chapter 7 – China Infectious Diseases Automated-Alert and Response System (CIDARS),” in Early Warning for Infectious Disease Outbreak, ed. Weizhong Yang (Amsterdam: Academic Press, 2017), 133–61.

[4] M. A. Mayer, L. Fernández-Luque, and A. Leis, “Chapter 5 – Big Data For Health Through Social Media,” in Participatory Health Through Social Media, ed. Shabbir Syed-Abdul, Elia Gabarron, and Annie Y. S. Lau (Academic Press, 2016), 67–82.

[5] WHO, Framework for decision-making: implementation of mass vaccination campaigns in the context of COVID-19. Interim Guidance May 2020 (Geneva: 2020), https://www.who.int/publications/i/item/WHO-2019-nCoV-Framework_Mass_Vaccination-2020.1, accessed February 17 2021.

[6] Eduardo Lazcano-Ponce, Betania Allen, and Carlos Conde González, “The Contribution of International Agencies to the Control of Communicable Diseases,” Archives of Medical Research 36, no. 6 (November 2005): 731–38.

Categories
Diplomacy Geopolitics Medicine Security State Surveillance

Podcast: The Practice of Quarantine in History

A 1883 cartoon depicting members of the New York Board of Health trying to contain immigrants suffering from Cholera. © Corbis Images

By Anna Dyshlevaya BA, Viviana Espinosa BA & Ksenia Shibaeva BA

The podcast discusses the emergence of quarantine as a historical practice.

Categories
COVID-19 Social Media Surveillance Technology

Thinking about Contact Tracing Apps

Photo by Markus Winkler on Unsplash

By Charlotte Fleischmann, BA

The following thoughts on contact tracing apps try to give a new perspective on their purpose. They question the trend in society not wanting to share private information with the government while sharing it at the same time publicly through social media.

The majority of people criticising contact tracing apps do not want to share private information, or in concrete words do not want to share their location and by consequence their daily routines or habits.

This is understandable in a way: location or spatial data provides really delicate information and various types of knowledge can be derived from one’s location. From movements, we know where a person works, lives, shops, and visits friends. We are able to learn a lot about a person but also about communities by “just” having knowledge about their location.

If you now think: “Well, I will never gonna get this tracing app on my phone”, I invite you to remember what other sources of information as delicate as spatial data within a tracing app is publicly accessible of you. Maybe you have a Facebook-, Instagram-, Google Mail- or WhatsApp- or LinkedIn-Account. Social Media and so many other sources are publicly providing a mass of spatial-, and other types of data from the majority of people.

If it is not from social media, there are still other ways to find aggregated information such as official statistical data from governments, data from insurance companies, or data from news media.

These channels of data often do not provide personalized information about people. But we should not forget the bigger picture of data analysis. The objective of data analysis is finding meaning and correlation in incredibly huge amounts of data. Findings derived from so called big data are not about that one certain person, it is about finding patterns in an aggregate of “digitalized reality” concerning activities, opinions, circumstances, and habits of people. I am not saying that personalized data is not playing a huge role in data analysis, but this is mostly the case when an analysis has the purpose to explain a company what advertisement best fits for a certain person. To make it more concrete: personalized information is mostly used from companies for the purpose of marketing.

Let us also remember that what is now called data is digitalized information. Information has always been important for societies and will always be. The main difference between then and now is the capacities of storage, the amount of data and the speed in which data can be processed. Of course, these differences bring up new consequences for society, which should be considered, but still the principles of the impact of information and knowledge on society is as important as it has always been. As Francis Bacon once said: knowledge is power.

But back to the criticism of contact tracing Apps: not wanting to share spatial data, even if it is for the purpose of public health, illustrates that it is important for our society that personal data is not used without consent even if it is for a society’s own good.

Why is there a tendency to think that data will be used against us? And why do we fear this on the one hand, but on the other proudly share family photos on various social media platforms? This matter seems irrational for me and brings me to the conclusion that our global society is in need for an open discourse regarding the subject of data collection, analysis, and use. We need to inform ourselves, so that we do not start sticking to irrational fear, when it comes to the matter of data. But I also call upon institutions, NGOs, governments, organizations, and companies to speak openly about this subject and share aims and objectives concerning the matter of data analysis in a transparent and explicable manner.

If this will not soon be the case, stories like failed attempts to introduce a contact tracing app in order to tackle the COVID-19 pandemic will repeat over and over. We need to be clear about both sides of the coin: There are negative impacts in every innovation, in every new trend. But there are also good intentions, good reasons, and eventually good outcome from innovations if we are just able and ready to use it right. The good side of the coin cannot be realized, however, if we live in the bewildering situation of on the one hand sharing loads of data on social media and on the other being afraid of sharing data within an app that would help us to tackle the pandemic.

This blog-post does not only want to question the view on data related matters in our society. It also wants to take an effort in informing about the potential of contact tracing apps for the solution of this crisis in line with this recent statement by the WHO:

“COVID-19 has heavily emphasized how contact tracing is crucial for managing outbreaks, and as part of the strategy for adjusting, and eventually lifting, lockdowns and other stringent public health and social measures. As the pandemic develops further, it will be a core measure to manage further waves of infection”

Sources:

The sources below contain further articles about functioning, purpose, objectives, outcome of contact tracing apps and about the on-going debate. I hope this blog post is providing an incentive to read and think further about data analysis in relation to contact tracing apps, but also in terms of other topics.

Budd, J., Miller, B.S., Manning, E.M. et al. Digital technologies in the public-health response to COVID19. Nat Med 26, 1183–1192 (2020). https://doi.org/10.1038/s41591-020-1011-4

Ienca, M., Vayena, E. On the responsible use of digital data to tackle the COVID-19 pandemic. Nat Med 26, 463–464 (2020). https://doi.org/10.1038/s41591-020-0832-5

World Health Organization. Public health surveillance for COVID-19 Interim guidance (2020)

World Health Organization. Online global consultation on contact tracing for COVID-19 (2020). COVID-19: Surveilllance, case investigation and epidemiological protocols

Siffels, L.E. Beyond privacy vs. health: a justification analysis of the contact-tracing apps debate in the Netherlands. Ethics Inf Technol (2020). https://doi.org/10.1007/s10676-020-09555-x

Lanzing, M. Contact tracing apps: an ethical roadmap. Ethics and Inf Technol (2020). https://doi.org/10.1007/s10676-020-09548-w