The pandemic surveillance state: an enduring legacy of COVID-19

Containing the spread of pandemic transmission tends to go hand in hand with a surveillance regime that tracks movement, transmission and those who contract the virus or disease. An enduring legacy of the COVID-19 crisis will be the incremental development of surveillance technologies, ostensibly purposed to identify the threat and spread of a pandemic, giving birth to what amounts to the pandemic surveillance state. Whether this is seen as an undesirable outcome depends very much on the field of expertise and the relevant slant. Health professionals and epidemiologists favor more surveillance; privacy and data security advocates fear a further denuding of protections. This paper examines the dangers of such technologies and efforts to seek a middle ground on app technologies designed to protect privacy. Such designs may, in time, seem more hopeful than actual.

In anticipation of the post-COVID-19 world, bold statements were made on how humanity might be wiser, kinder, cautious and reflective. Unequal economic practices might be addressed; healthier forms of living could be pursued. "Across the globe," noted Robin Wright in the New Yorker, "a coronavirus culture is emerging, spontaneously and creatively, to deal with public fear, restrictions on daily life, and the tedious isolation of quarantine." 2 The vision put forth by Vice itemized what needed to be done in a post-coronavirus world. "From arbitrary data caps being suspended by internet providers, to eviction bans, to suddenly-implemented protections for workers, we are seeing that things we have long been told are impossible or unfeasible are suddenly OK." 3 The Indian novelist Arundhati Roy was even more forthright in her assessment of this particular viral legacy. The virus had "made the mighty kneel and brought the world to a halt like nothing else would." This pandemic impressed upon humans the need to "break with the past and imagine their world anew." 4 One enduring legacy of the novel coronavirus is the incremental development of surveillance technologies, ostensibly purposed to identify the threat and spread of a pandemic, giving birth to what amounts to the pandemic surveillance state. Whether this is seen as an undesirable outcome depends very much on the field of expertise and the relevant slant. For public health officials, the use of surveillance, testing and tracking were three indispensable features for coping with infectious conditions. 5 Saving life and preserving a well-functioning health system subordinated other aims and liberties. The gathering and disseminating of data on infections are priorities over and above the specifics of privacy and the preservation of solitude. Technologies, even with invasive propensities, could be adapted to that end, minimizing intrusions and softening the invasions of the state.
For privacy advocates and civil liberty defenders, the prospects of all intrusive state surveillance fuelled by intrusive technologies risks banjaxing fundamental rights. Nestled in between the dystopia of total surveillance focused upon the site of the body -effectively another form of biopolitics using the criteria of public or global health, a third option could also be discerned: developing technological surveillance that minimized intrusions and the unnecessary accumulation of personal data while ensuring that any data gathered would be secure.

Epidemiology as surveillance
The epidemiologist, Bryan Walsh tells us in Axios, was arguably the first species of data scientist. He cites, by way of example, John Snow's discovery of the source of London's cholera epidemic in 1854. 6 Their contribution is that of using "rapid contact tracing to track an outbreak from its source to its spread in an effort to contain it." But doing so is a taxing labor, placing the emphasis on doctors and health practitioners to identify suspect patients and plot their previous movements. To that end, surveillance and detection are considered essential features of combating pandemics. A list of achievements involving the use of surveillance systems is outlined by Ronald Bayer and Amy Fairchild: the link between the cause of paralytic polio and the manufacturer of Salk vaccine; the bridge between toxic shock syndrome and tampons in 1979; the identification of AIDS cases on the US East and West Coasts during the early 1980s; ditto that of West Nile Virus, SARS and avian flu at the turn of the twenty-first century. 7 The authors note surveillance as the invaluable means of giving sight to public health, assisting in planning, intervention and disease prevention, which is vital to epidemiological research into morbidity and mortality patterns. This leads to a certain, seemingly intractable problem: that the "history of surveillance has been bounded by a promise of disease control and a spectre of intrusion." 8 That intrusion risks running foul of declarations and covenants in international law that stress the autonomy of the individual, the privacy of self, not to mention certain laws specific to a State. 9 Pioneers of this field of pandemic surveillance had reasons to be optimistic. They were mindful about the uses such accumulated data would be put to. They believed, for the most part, in the nobility of cure rather than the transgressions of privacy. Doctors and health professionals were not the same as desk clerks and bureaucrats, having different aims. Herman Biggs, the foremost figure of US public health surveillance in the late 19th and early 20th century, made the claim that the names of the diseased were never gathered "in order to keep the clerks or adding machines busy". 10 But the 21st century ushered in another development, one emphasizing the biopolitics of global health. Such health could be observed, measured, calibrated, aggregated. As Katherine E. Kenny posits, "The opening years of the 21st century have witnessed the rise of 'global health' as the preferred label to govern the health of the global population." Kenny argues that the use of health metrics such as the Disability Adjusted Life Year (DALY) by the World Bank saw the "economization of life by disaggregating lifetimes into component units of time and reassembling life as a revenue stream." 11 Kenny's arguments are useful when dovetailed with pandemic surveillance: the need to monitor populations for the sake of global health and, it followed, economic health.
The institutional nature of global health surveillance can be located in the deliberations of the World Health Organization, and particularly through its decision-making body, the World Health Assembly. A sense of its effectiveness could be gathered in the elimination of small pox, celebrated in the World Health Assembly resolution declaring "solemnly that the world and its peoples have won freedom from smallpox, which was a most devastating disease sweeping in epidemic form through many countries since earliest time, leaving death, blindness and disfigurement in its wake and which only a decade ago was rampant in Africa, Asia, and South America." 12 As Jeremy Youde notes, the collaborative effort brought States of every ideological persuasion together to create "an extensive health surveillance system" ostensibly identified with achieving the common good. 13 Youde does not shy away from the implication of this celebrated effort. It came with its fair share of ethical violations: vaccination without consent; break-ins and trespassing on property by authorities; a repudiation of local custom and beliefs. 14 The success of the smallpox eradication program also brought its concerns of surveillance and overstep, with its correlation that health would become a determinant in exercising full citizenship and rights.
In 2005, the World Health Assembly expanded the scope of the International Health Regulations (IHR) on reportable diseases, requiring member states to have permanent offices to facilitate contact between national governments and the World Health Organization. A set of public health priorities, including surveillance, were prioritized. 15 The World Health Organization, in assessing the threat posed by swine flu (the A(H1N1)pdm09 epidemic) in 2009, described its purpose in alignment with such provisions: "Successful containment or control of pandemic influenza will rely on early detection of sustained human-to-human transmission which requires a system for outbreak detection, rapid data collection, analysis, assessment and timely reporting. Early detection of the start of a pandemic is crucial to rapidly implement measures to stop the pandemic at its source and prevent millions of deaths, social disruption and economic loss." 16 In 2017, the WHO published a second report building on its recommendations made in response to the 2009 influenza epidemic. The report added a note of professional urgency to the monitoring of potential outbreaks, emphasizing the unpredictable behavior of viruses, be it in terms of transmission or severity. "This highlights the need for pandemic influenza surveillance to provide data and analyses to clarify the characteristics of the pandemic." 17 Information sharing on outbreaks is heralded as an essential aim. "Sharing of information and virus isolates at the global level will be of benefit to all." 18 The report notes that each country will have to develop its own regime of pandemic surveillance "that suits the local context, is flexible, and, ideally, is built on existing influenza surveillance systems." 19 Notable here is the obligatory nature of such a regime: that each state "must have the capacity to undertake the assessments and to notify, report and verify to WHO as required by the IHR (2005)." 20 At no point does the WHO recommend forms of invasive technology that might be used in this context; the emphasis, rather, is upon states to initiate their own methods as to how they will conduct surveillance. "Surveillance activities at this stage focus on verifying reports of sustained human-to-human transmission and detecting first cases of the virus in other Member States." 21 The methods outlined seem more laborious: the documenting of rumors and ad hoc reports; active case finding, including contact tracing and chart reviews; investigating clusters of outbreak; the generating of epidemic curves; and collecting clinical data of confirmed cases. 22 In the vanguard of WHO suggestions on public health surveillance have been an able and aggressive fraternity of epidemiological expertise. In recent years, those studying, identifying and tracking viral outbreaks have urged the creation of vigorous detection and surveillance regimes as part of the biopolitics of global health. In 2018, Edward C. Holmes, Andrew Rambaut and Kristian G. Anderson urged "those working on infectious disease to focus funds and efforts on a much simpler and more cost-effective way to mitigate outbreaksproactive, real-time surveillance of human populations." 23 The 2013-16 Ebola epidemic, for instance, saw a tardy response, though it did see the use of aggregated mobility information drawn from telecom data. 24 "Making promises about disease prevention and control that cannot be kept," warn the authors, "will only further undermine trust." 25 Epidemiologists have been at the forefront of a new surveillance push in response to COVID-19, one that is motivated by considerations of safety and efficiency. This has aroused interest from the technical specialists keen to ameliorate the problem of rapid spread by ensuring more accurate monitoring. "A multipronged surveillance strategy," recommend the authors of a study published in the Morbidity and Mortality Weekly Report (MMWR), "could lead to enhanced case detection and reduced transmission of highly infectious diseases such as COVID-19." 26 Such views have been duly realized. The rapid spread of COVID-19 saw a fierce boom in surveillance technologies dedicated to monitoring whole populations. Companies dedicated to artificial intelligence ventures became participants in a mass health surveillance complex. This move has also been characterized by specific cultural connotations regarding attitudes to gathering data and their subsequent use. In North East Asia and China, as technology lawyer Carolyn Bigg noted, data is a matter of mass utility rather than "something to be locked down." 27 Epidemiologist Li Lanjuan of the Chinese Academy of Engineering did not disagree. "In the era of big data and [the] internet, the flow of each patient can be clearly seen. So we are different from the SARS time now," she explained to CCTV, China's state broadcaster, in February. "With such new technologies, we should make full use of them to find the source of infection and contain the source of infection." 28 In February, China Mobile promoted a specific tracking service by sending text messages to Beijing residents informing them they could trace their movements over the previous 30 days. As Reuters noted, "It did not explain why users might need this, but it could be useful if they were questioned by the authorities or their employers about their travel." 29 Chinese Internet giant Baidu also added its contribution, developing a specific AI program in February 2020 identifying individuals not wearing protective masks. The company proceeded to market the program as an open source tool. As the company described it, employers needed to check if staff were abiding by directives to wear masks at work; authorities needed to identify masked faces and check temperatures at busy transport hubs; and daily face check-ins needed to still take place even while masks were worn. 30 Such companies as Megvii, a facial recognition firm, were also enlisted in the pandemic monitoring enterprise. The company prided itself as "a world class AI company with core competency in deep learning," responding to the government call in battling coronavirus by developing a new "AI temperature measurement system" designed to identify temperatures using thermal cameras and relevant body and facial data to identify individuals. 31 "The system," according to a company announcement, "is designed to help staff working at locations with high-density passenger flows, such as train stations, bus stations, railway stations and airports, to swiftly identify people who may have elevated body temperatures." 32 Megvii's announcement is also significant in showing how integrated it is in the state surveillance system, having "assembled a team of nearly 100 R&D staff to devise and implement an efficient temperature detection system" with the generous assistance of state and city links, including the Haidian district government and the Ministry of Industry and Information Technology.
The pattern of integrated cooperation and innovation was repeated in the development of the "Close Contact Detector," an app telling users if they had been in proximity to an infected subject or someone suspected of being infected. Users could scan a Quick Response (QR) code on smartphones using further apps such as Alipay, a payment service, or the Chinese social media platform WeChat. As a summary of the use of the app by the BBC described it, "Once the new app is registered with a phone number, users are asked to enter their name and ID number. Every registered phone number can then be used to check the status of up to three ID numbers." 33 The bodies involved in the creation of the app spanned the China Electronics Technology Group Corporation and various government departments with data drawn from health and transport authorities.
Such technology was promoted as virtue, utility and merit. Zhu Jiansheng of the China Academy of Railway Sciences, in an interview with the state news agency Xinhua, was glowing about how surveillance methods used on passengers would be invaluable as a detection tool. "We will retrieve relevant information about the passenger, including the train number, carriage number and information on passengers who were close to the person, such as people sitting three rows of seats before and after the person." Once extracted, such information would be supplied to "relevant epidemic prevention departments." 34

COVID-19 and the privacy debate
Since the 19th century, the practice of effective public health has involved identifying the ill person for reasons of treatment and cure, interrupting transmission where relevant and eventually eradicating the cause. 35 This process, as Dennis Deapen notes, has tended to include the dissemination of some private information, be it through a generated medical chart in a clinic or hospital, through systems dedicated to disease reporting or during the course of research into causes and cures. 36 To that end, galloping pandemics can spell doom for the identities of those who contract illnesses or suffer contagious infection. Given the mobilization of concern against COVID-19, with the more than enthusiastic embrace of technologies of surveillance and detection, a civil liberties and public health debate was bound to take place. 37 As Harvard University's legal doyen Alan Dershowitz noted, the civil libertarian will be concerned that those who have tested positive for coronavirus should still have their privacy respected. "But the costs of anonymity for a highly contagious virus," he rues, "must be taken into account," conceding that US courts have been inclined towards approving "mandatory disclosure laws" in such cases, accepting that there "is no absolute right to medical confidentiality." 38 In Deapen's words, "The individual's rights must be weighed against the rights and welfare of the population -often described as 'the greater good' ." 39 Considerations of such a greater good, at least in the public health context, have engendered a sense of acceptance in some communities: intrusion in the name of safety. 40 The privacy debate regarding responses to COVID-19 has tended to be simplified by a clash of systems. What they have involved are differing approaches that shine light on specific attitudes, not merely towards privacy and data security as norms but the way technology has been used to either achieve or undermine such ends. The Taiwanese example, for instance, focused on "the free flow of information"; the Chinese effort to combat the infectious outbreak by restricting public access to information, in contrast, was seen as selfdefeating. 41 In the United States, a strain of commentary condemning authoritarianism as "the greatest public health risks" came to the fore, suggesting that combating the transmission of disease effectively within the rule of law was the preserve of liberal democracies. 42 Such arguments ignored the common ground occupied by all states irrespective of political persuasion. The identification of political systems as authoritarian or democratic obscures the core problem central to any public health system and infectious diseases: how detection is to take place, and how data is duly used and protected.
Protecting health information poses a dilemma. An over vigilant protection might hinder health research and public health practice. The argument about medical and health information vis-à-vis the state is an important one, marked by debates about the role of centralized medical records, ostensibly to make identification and cure easier. Such systems have been said to be faulty, have few safeguards, and depend on a high degree of technological literacy. 43 A glaring feature of the problem of dealing with the spread of coronavirus has been an absence of data, be it on testing, identifying those who might be infected and those who have been in contact with suspected cases. Fighting the coronavirus pandemic, writes David Meyer, "means getting an idea of who is infected and the opportunities those people had to unwittingly pass on the virus to other people." 44 States found short in the planning and containment departments set about developing a pandemic monitoring regime that genuinely risks doing away with any pretence of privacy.
The muscular Chinese effort has found analogues. Thermal imaging equipment deployed to identify potential COVID-19 carriers are being assimilated into a global regime.
Russian CCTV networks, coupled with digital passes on mobile phones, keep watch on transmission. 45 In India, facial recognition software systems have found use in the cities of Pune and Pimpri-Chinchwad, part of a surveillance regime for "Home Quarantined" persons. 46 All of these bring with them the application of "false positives." Infrared imaging equipment can be used sloppily; human reviewers and automated processes can fall into error in assessing the gathered material. 47 Facial recognition is also notorious for having unreliable data sets. 48 But countries have tended to adopt local variants, suggesting that pandemic surveillance states are neither uniform nor monolithic. South Korea, with an experience colored by the 2015 outbreak of Middle East Respiratory Syndrome, might have been praised for having an expansive testing programme, but this was deployed alongside an aggressive surveillance effort authorized by public health legislation. 49 The presence of a highly developed infectious disease surveillance system did not stop a range of commentary from the public health perspective praising such efforts as those achieved "under democratic transparency and rule of law." 50 Under the Infectious Diseases Control and Prevention Act (IDCPA), as amended after the MERS outbreak, the ROK minister of health has powers to collect private data without warrant from confirmed and potential patients. Specific reference is made to the power mandating the sharing of the "location of patients . . . and [of] persons likely to be infected" by the National Police Agency and private telecommunications with health authorities. 51 The provision re-enforced the powers vested in the health minister and the Korea Centres for Disease Control by Article 76-2(1) requiring "medical institutions, pharmacies, corporations, organisations, and individuals" to furnish "information concerning patients . . . and persons feared to be infected." 52 Mobile phone usage and bank cards have been tracked as part of the endeavor. 53 CCTV technology has also been used to triangulate location and movement. From Lawfare also noted the sheer variety of detail that might be disclosed in government reports, be it lingerie purchases or the plastic surgery that might have been visited. 55 According to Gye Cheol Kwon, chairman of the Korean Society for Laboratory Medicine, "we believed that if the government did not post extensive details about infected people on social media, COVID-19 would have spread even more quickly." 56 Israel has also made a conspicuous contribution to pandemic surveillance, co-opting in a rather aggressive fashion its domestic intelligence agency in dealing with COVID-19 pursuant to the country's Basic law "to defend the state, public safety and the provision of essential products and services." 57 Their weapons have included clandestine testing kits and anti-terrorism phone-tracking software. Israeli residents have received text messages directing recipients suspected of being in proximity to someone sick with coronavirus to "immediately isolate at home [14 days] to protect your relatives and the public." 58

Striking a troubling balance
In his 2010 text reflecting on norms of health surveillance, Youde was confident that the instrumental nature of health surveillance could be reconciled within "a framework that informs all parties and offers them avenues for registering any violations." 59 This was a confident assertion, and one expressed before the almost desperate technological revolutions triggered by the Coronavirus pandemic. But the inexorable push for increasingly accurate surveillance technologies has not taken place in an ethical vacuum hostile to human autonomy, at least in several notable cases. Human rights norms have featured in some strands of discussion, with technology advocates mindful of data management protocols.
Various technology entities and developers have shown an awareness for reconciling privacy concerns and health benefits. Companies such as Flowminder have argued that, "Anonymised mobile operator data can support interventions against COVID-19 by improving our understanding of population movements." 60 But it also argues that aggregated, anonymous data can be used to assist "mobile network operators with the production of mobility indicators, whilst preserving the privacy of mobile network subscribers." 61 Degrees of intrusion, and therefore the relevant threat to privacy, have also varied. In Singapore, the TraceTogether app utilizes Bluetooth signals between mobile phones to identify potential coronavirus carriers and their contact with others. In March, the country's National Development Minister Lawrence Wong insisted that, to be effective, "we need something like three-quarters -if not everyone -of the population to have it. Then we can really use that as an effective contact tracing tool." 62 Typically, the issue of compromising privacy weighed less heavily on Wong than the harm that might arise to the economy. Damage to such liberties, he argued, could be sustainable. 63 A central feature of TraceTogether is its focus on proximity without deploying location data. Temporary tokens are exchanged via Bluetooth from other relevant devices which are, in turn, associated back to a phone number to be notified of potential COVID-19 exposure. In contrast to the South Korean example, only those details of the person having COVID-19, and those he or she is in contact with, become known to the state authorities. 64 The development of a similar digital tracing app by Seattle-based software engineers Dudley Carr, Wes Carr and Josh Gummersall did not pass muster for Apple; the company's privacy restrictions placed in its App Store had restricted the scope of the software's application. A few exceptions to this were made: COVID Trace was deemed a permissible app for use in universities, hospitals and non-profit organizations. 65 The developers are aware that a central "massive registry operated by either the government or by an organisation, becomes particularly attractive to law enforcement or hackers." They propose keeping contact tracing private and specific to each individual's phone. 66 Emphasis is placed on the importance of clarity: explaining the app's exclusion of recording home data and revealing to the user all captured locations. "The messaging in the app aims to be clear about what it's currently doing." 67 While the software developers from Seattle struggled to convince Apple, the company did join Google in attempting to create a bluetooth-based contact tracing platform to be built into the Android and iOS operating systems. 68 Unique cryptographically generated codes would be generated, eschewing identifying information and location data, deracinating the code from its user. Analysts proffered lukewarm, qualified praise from the perspective of privacy. "The system is Blue-tooth only, fully opt-in, collects no location data from users, and no data at all from anyone without a positive COVID-19 diagnosis." 69 For all that, the very efficacy of such a system was questioned, its success depending, first and foremost, on mass deployment. There was also that matter of false altruism, a tendency all too common in the technology sector of Silicon Valley. As Albert Fox Cahn and Evan Selinger warned, "helping the disenfranchised can seem like beneficent philanthropy, we should be wary of technological corporations claiming to be altruistic." 70 Technology experts have also seen privacy protections as very much dependent on the model of data generation: does it follow a centralized system, which is inherently riskier to a compromise of information, or it is it decentralized in terms of tracing apps? "The primary advantage of decentralized exposure notification, such as the Google/Apple API," note cyber security experts Chris Culnane and Vanessa Teague, "is privacy of the contact graph against the central authority -that is, the government, NHS, or its contractors and service providers (or whoever gains authorised access to their databases)." 71 The use of "mix networks" would use cryptography to relay "hashed" contact tracing location data, making use of decentralized servers. Apps such as Singapore's TraceTogether, as Hyunghoon Cho, Daphne Ippolito and Yun William Yu remark, do have one drawback, stressing the "use of relatively high trust in the government in its design." GPS location information might not be used in the design but that is a moot point. Bluetooth is sufficient in finding contacts. The app does little to "try to hide anything from the Singaporean government." 72 Similar discussions and concerns have also been registered on the Australian COVIDSafe application, which collects mobile numbers, names (permitting the use of pseudonyms), age range and postcodes. 73 According to the Australian government, state and territory officials would only be able to access information drawn from the app "if someone tests positive and agrees to the information in their phone being uploaded." Such information would only be used for the specific purpose of alerting "those who may need to quarantine or get tested." 74 Sceptics were vocal in suspicion, as, for that matter, have been members of the Australian public. A Guardian poll of 1054 respondents suggested that 57% were "concerned about the security of personal information collected" via the app. 75 First came the issue of use. Some suggested it was not only unnecessary but ineffective in detecting and coping with viral spread, a point generally made about many tracing apps. 76 Even the Digital Transformation Head Randall Brugeaud had to admit that the app's effectiveness, notably on iPhones, "deteriorates and the quality of the connection is not as good" on locking the phone. 77 By using various means of collecting data, the app had the inadvertent effect of also triggering other apps in the process of gathering user data. As COVIDSafe makes use of Bluetooth technology, collecting anonymous IDs from those also utilizing the app and coming into range with their smartphone for a minimum period of 15 minutes, the risk of enabling other apps to also hoover information unbeknownst to the user was also a risk. Whatever the pretentions of COVIDSafe, having Bluetooth technology automatically triggered the use of tracking locations. "To avoid apps using Bluetooth without your knowledge, you should deny Bluetooth permission for all apps in your phone's settings, and then grant permissions individually." 78 Whatever pride and confidence expressed by the Australian government on the issue of data security, the salient question remained: as the program was itself commissioned by the government, the keys lay with such functionaries. "If the government did covertly obtain access to the data" note Kang and Haskell-Dowland, "it's unlikely we would find out." 79 Electronic Frontiers Australia also expressed concern about the integrity of the storage facility. There was the nagging issue of experience in this field. The Australian government had "a woeful record of tech and data privacy disasters including My Health Record, Census Fail, Robodebt, the Data Retention Scheme and My Gov crashing when Australians needed it most." Accessibility by foreign powers, notably the United States, was also an open and unanswered question, given that the data is retained in the cloud on Amazon Web Services, "a US-incorporated business subject to the US Cloud Act." 80 In some cases, singular efforts have been made to challenge the scope of legal powers in implementing the pandemic surveillance regime. A petition to halt efforts on the part of the Israeli state by Adalah, an advocacy group defending the rights of Palestinians in Israel, along with the Joint List, a coalition of Palestinian parties based in Israel, assured a delay in the activities of the domestic intelligence service Shin Bet, at least till various reassurances were given. The Israeli Supreme Court issued a temporary injunction in halting Shin Bet from using various surveillance technologies, including a mobile phone geolocator, against coronavirus sufferers and potential patients. 81 The order did not permanently suspend Shin Bet's tracking of the locations of coronavirus patients. According to the court, the tracking of the locations of coronavirus could only continue with the establishment of a parliamentary oversight committee by March 24, 2020. Not doing so would see the immediate banning of the program. The rebuke by the court, while not entirely stinging, suggests that those propelling the health surveillance regime will not have it all their way.

Reluctant conclusions
The COVID-19 crisis confronts policy and law makers with a testing point on how to reconcile privacy and human autonomy with a regime that combats COVID-19 infection. A healthy world resistant to pandemics might also come at the price of severely reduced privacy protections. That said, the extensive debate in the development of tracing apps suggest a technical disagreement on what best can be done, much of this dependent on the political and social orientations of those involved in the workings of the pandemic surveillance state. One thing is certain: the implications of the pandemic surveillance state will survive the pandemic itself. It promises to become an enduring global fixation of policy makers and health professionals. The danger here is that technologies enlisted for surveillance, implemented with inconsistent protections, threatens to undermine one set of rights in favor of others. The warnings of civil liberty advocates risk becoming those of a Cassandra whose calls are drowned by the stern and sagacious advice of the public health advisor.