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We’re at the dawn of medical surveillance

The past year has been dominated by the consequences of a new coronavirus that has spread rapidly to every corner of the globe. New legislation and emergency regulations have allowed nearly every country to implement strict border controls, travel restrictions, quarantine procedures, mandatory testing schemes, and other limitations.

This event is proving to be the defining moment of the coming decade, and we have reasons to fear that the trends put in motion by Covid-19 will define legislation and civil life like no others.

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Surveillance has been on the rise since 2001

So far, one of the top political trends of the 21st century has been increased technological surveillance. Driven mainly by the War on Terror following the terrorist attacks of September 11, 2001, we have seen surveillance agencies empowered with new laws and vast resources to collect and generate digital information on all parts of our lives.

Nowhere has this been as apparent as in travel. Where 20 years ago you would be able to show up at an airport with cash and board a plane shortly after without being searched, today you will wait in line multiple times, show identification, boarding passes, and see yourself and your belongings searched with millimeter electromagnetic waves, X-ray, metal detectors, and explosives detectors. Booking your ticket too closely to departure or without a return journey may raise flags that result in additional questioning and searches.

Financial transfers, too, have dramatically changed. Numbered bank accounts that do not record the identity of the holder do not exist anymore. High denomination bills are phased out, while consumers are being discouraged from making cash payments altogether through legislation and tax rebates. So-called “know your customer” rules have made it difficult to remit money overseas, open accounts for small businesses, and allow more people to participate in e-commerce.

The only sector that has somewhat been able to escape this capture is communications. While attempts have been made to register mobile phones and surveil broadband connections, users can today enjoy private and secure access to the world’s trove of information through the use of Tor and VPNs. Encrypted messaging has become the norm for billions of users, and nearly all sites are protected with HTTPS.

Medical surveillance is the next wave

In the coming years, the medical system will be under similar pressures as the travel, financial, and communications industries have been to implement strict controls, gather as much data as possible and make itself available to the state.

4 ways health concerns are raising surveillance

1. Immunizations

The Carte Jaune, the yellow booklet officially known as the “International Certificate of Vaccination,” is a companion for some during travels and doctor visits. But the wide reach of Covid-19 has led countries to introduce or plan digital vaccination passports—certification that would allow inoculated individuals to travel more freely. And it’s created an ethical minefield surrounding health-data collection and medical privacy.

2. Tests for diseases

The flu does kill an awful lot of people, and the tolerance of many health care systems to viruses, bacteria and microbes will likely become far lower than in the past. The emerging SARS-CoV-2 has created a big infrastructure for tests of pathogens, which will continue to be used to detect their spread wherever somebody is feeling unwell.

3. Sewage surveillance

To detect toxins, viruses and even illegal drugs, authorities might begin to test for their residues in the sewage of buildings and city blocks. While this can help detect outbreaks of transmissible diseases and even contamination of drinking water or food supply, it is easy to imagine how this data can be used to encroach on civil rights as well as identify fugitives and illegal behavior.

4. Police to get access to fitness and health data

Your fitness apps, wristbands, and smart T-shirts are collecting a large variety of personal data, including your whereabouts, behavioral patterns, drug use, and whether you prefer horror movies over romantic comedies (or surveillance-themed films). All this data will find its way to your local police station, legally and without much controversy.

A brave, health-seeking new world

Like with so many other restrictions on our daily life, it is difficult as of yet to determine just how much a war on disease would endanger civil liberties. 

As much as we value security and health, how much of our freedoms are we willing to sacrifice for a bit more security, and how many freedoms will we be willing to give up for better health and longer life spans? How much of a say will voters have in these processes to either drive or resist change? Can health care resist these attempts to surveil and control, and will people opt into privacy-preserving technology and structures? How much will the future of health care resemble the history of communications versus for instance finance or travel? It will take time before we have clear answers.

Read more: Go incognito: 6 ways to avoid surveillance in real life