Vaccines for All: Expert Roundtable, Covid-19 and Citizen Centric Tech

Vaccines for All: Expert Roundtable, Covid-19 and Citizen Centric Tech

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Ramesh: So for the next 45 minutes, we're going to bring in some expert speakers who are working in this areas of vaccine distribution and [Bramish 03:16:53] Roscoe here at MIT Media Lab. Next slide. Ramesh: And this morning we saw that the challenges in equitable vaccine distribution, whether it's in the reach of prioritization or health outcomes, symptoms of effectiveness and safety monitoring, citizen engagement for two doses of vaccine passport or communication, next slide. And then we also have discussed for the last three hours various approaches using broadcast media, even using simple paper cards that could have QR codes on them, web based system from software companies or CDC and FDA and state agencies, as well as smartphone apps that are either used for SMS alert or privacy preserving.

Next slide. Ramesh: I'm going to show this video one more time, just for 60 seconds on a type of decentralized solution, one could see starting with the challenges that we have seen. Making sure it's decentralized, making sure it's privacy preserving, it builds trust, allows employers to provide eligibility coupons, to their employees. You get the first dose, let them understand where they are in the tiers, schedule appointments, the appointments completely anonymously, record their doses using QR code readers on their phone.

Their first dose, get reminders for the second dose. What? 21, 28 days later, record the second dose. So now you have your vaccination record. Ramesh: Remind that it's still going to take 14 days for immunity to kick in.

Use that for verifiable credentials, also stay engaged with the local community of how people are getting vaccine in the neighborhood, report any symptoms, look at dashboards of are there any challenges with the batch or the dosage that they have received recently. Report the symptoms completely anonymously, but in a verified manner to CDC or the state agencies and so on. So next slide.

So let me start with some of our experts. I invite Noel Hara from NTT to give his short two minute presentation and to keep it on the clock. I'll remind everybody at the two minute mark. Noel Hara: All right, thank you.

Thank you Ramesh. So here at NTT data, what we've been doing is we've been looking at a portfolio of public safety technology that we have and how to adapt that to the new mission of pandemic response. And that's taken several different formats, from looking at smart cities technology and how we can take technology that looks at crowd capacities and preventing overcrowding in public spaces to were running on a large public transit system right now we can tell how many people are in every train, bus and station and predict when you should take a public transit to work without having overcrowding. One of the things when it comes to vaccine that I'm very excited about is we've looked at some social media monitoring technology that we have that was originally implemented to help schools look at things like cyber bullying or God forbid prevent the next school shooting. And we've turned that to look at the sentiment around the vaccine and Ramesh, if I get the next slide. Noel Hara: So here we've been looking at sentiment across social media postings and one of the things I have a couple of different groups here, but if you look at the gray box, that's all retweets and likes and things like that.

So the actual post, if you look at the center, healthcare practitioners. Over 58% of healthcare practitioners are posting social media with a negative sentiment. So what does that mean when you have a negative sentiment out there from your doctor, as far as people adopting the vaccine or being willing to get it? Next slide, please. Noel Hara: And then here, when we look at minority populations, the negative sentiment within the minority populations is really immense. It's really an issue where you have here in Chicago where I live, 30% of the population's black, but 60% of the deaths and the minority populations are saying "No way am I getting a vaccine." And some of the words that come out in the word cloud are, "Guinea pigs", and there's reference in the post to the Tuskegee experiments.

So this is data that has to go back to the health department so that they could do on the ground local interventions and education to really get the most vulnerable populations to be willing, to go out and get that vaccine. Next slide. Noel Hara: One positive I did want to point out is that overall, of the posts that say yes or no, I'm willing or not willing to get the vaccine, 74% of the posts say, "Yes, I'm willing to get the vaccine." However, if you look at that trend line, it trends drastically with the local media cycle or the daily media cycle. So we really have to watch what the pundits are saying and what the news cycle is around getting people to adopt this vaccine because we're seeing massive swings in the data.

Thank you. Ramesh: Thank you. Thank you Noel and thank you for staying within your time. I would like to invite [Anil Sherma 00:27:35], who's a longtime partner working on many social impact efforts at data consultancy and also leading the efforts [inaudible 03:22:42] on vaccine distribution. Anil, your two minutes. Anil Sherma: Okay, next slide.

Yeah, I think all of this was said earlier as well. I think there's one area which worries me is this whole notion of adverse event and the serious adverse event. Now this has potential to become a big issue and then I think a lot of these, whatever had been talked about the ability to create digital journeys for citizens and then giving their first or second dose requires creating new digital systems. But I think the hope was only few countries today have a robust immunized information system. Now and this whole process of creating this very quickly, very fast, we want to make mistakes. I think privacy security is certainly an issue.

I think what I look at is, although we are thinking about equitable distribution of vaccine, we should also, as technologists across the world also should create open initiatives in the world, make technology equally offer to all emerging world, right? Next slide. Anil Sherma: Yeah, we can skip this. Next slide. I think one area which we have looked at in this technology here is to provide decision support to State government here. And I think this was additional time for the city, which we created in [inaudible 03:24:21] to look at whether you should unlock on a weekend, not in a period of time.

And then these are very complex problems with a lot of parameters, demographic parameters, the virus characteristics, the interventions you could do. And this model worked very well. So we are extending this model to essentially make the decisions around making choices, the whole selection.

There's a lot of parameters like demographic quality. The vaccine itself has its own efficacy, the supply chain depends on the vaccine type, right? And so we are modeling this so that the decisions can be made on a rational manner. So there's again, work based on what experience which we did at home.

Next slide? Ramesh: In the interest of time, let's move on to our next presenter. And Anil, we'll have plenty of time to discuss during the presentation. So we have Sanjay and we have Nicholas. Sanjay? Sanjay Sherman: Let me just jump right in to take some time here. My name is Sanjay [Sherman 03:25:31], I'm a professor at MIT, I want to talk about a couple of things.

I think we're entering an era of bio-mistrust, obviously we know that. There is the history that when we clink glasses, before we take a drink- Ramesh: I just want to say, you video is not visible. Just trying to kind of turn on your video. We still trust you.

Sanjay Sherman: You want me to keep talking? Ramesh: Let's go to Dakota and come back to you in that. Go ahead, Dakota is a director at ID2020 as a [inaudible 03:26:08] high in the morning session. We have a short talk to ID2020. Go ahead. Dakota: Thank you, Ramesh.

So I wanted to pick up on the closing comments from the panel that proceeded this one and the panelists were talking about digital vaccination certificates, a modern portable means or credential that would allow people to prove that they had been vaccinated. And with that, the ability to facilitate the safe return to workplaces, schools, universities, global travel, public venues, et cetera. And what we've seen and what was being discussed is that there are both technical and policy level challenges associated with such a proposal. And yet we, I think all recognize this is a vital piece and perhaps sort of one of the last pieces, if you think through the sort of journey of a vaccine to ensure that we can recover fully. And what we've been thinking about really over the last many years, but particularly in light of the COVID-19 pandemic is how do we build on existing technology and ensure that there is a standards-based approach to these digital certificates? Dakota: So I think I heard reference to the W3C to trust over IP, a handful of organizations who've done important work on laying the technical foundations. And what we think is critical is that beyond just the technical foundations, we need to ensure that each of the solutions being brought to bear on that they're interoperable with one another, that they have necessary guardrails for privacy, for user management and portability.

And so the ID2020 certification is a tool that we've developed and developed before the COVID pandemic to assess the appearance of solutions to a set of 41 outcomes based requirements that we think are as germane here, as generally. And then I think the question is one of policy and adoption. And what I think is very interesting when it comes to vaccination and this is I think, quite distinct from the test credentialing landscape for example, is that there's a very small group of organizations, [Gavi 03:28:07] , the WHO partners and [Kovacs 00:33:11], who are thinking through what it will take to effectively roll out the COVID-19 vaccines. Dakota: And so what is I think vitally important is from a policy perspective, how do we go about generating the necessary data on the cost, the complexity of a digital vaccination certificate? So that countries and States, as they consider adopting something like this, know what they need to know in order to do so effectively. So you start with principles that gets translated I think, into the sort of series of requirements, you ensure that those solutions are interoperable, it was a standards based approach and then you go, "How do we inform people so that governments are not positioned to take it to scale?" Ramesh: Absolutely.

And on that note, let me also bring in Sanjay Sherman, who's thinking about this since his spectacular launch of auto ID lab, that transformed how we think about barcodes and RFID, Sanjay. Sanjay Sherman: Thank you, Ramesh. What I was saying earlier was when entering this era of bio-mistrust, and I'll remind you that when we clink our glasses, when we have a drink on say, cheers, that's partly because of bio-mistrust. Because one of the stories behind it is you're worried about the other person poisoning and then mutually poisoning each other if you're taking that risk and this is the world that with COVID, we're in, and it's creating very complex requirements.

For example, if you live in Massachusetts and you want to go to New York and you're drive through Connecticut, precisely how you handle the quarantine, where you get tested, when do you get tested, how soon, how long is the test valid? It's like reading a computer program. And this complication even shows up in families. For example, what is the routine for Thanksgiving? What is the routine for Christmas? Who's going to quarantine for how long? Who's going to take a test? But then if you take it across institutions, across nations, it's becoming quite a mess. And so what we really need is a technique and a standard for social interoperability. And in the absence of that, the fear is that society ...

Sanjay: So interoperability. And in the absence of that, the fear is that society is going to become this mistrustful morass of requirements, where you never know if you meet the requirements to enter a building. It's like getting a visa. So with that in mind, there was more talk about COVID passports and things like that. The problem is a lot of them are ad hoc.

They're solving a particular problem. And the real fear here in my view, and this is what I wanted to share is that, we will plummet into a fragmented set of ad hoc solutions. And the real victim is going to be human and civil rights. Things like privacy.

Things like my right to keep my diagnosis private and things like that. It's going to be very hard for society to plummet into this and then withdraw in any graceful way. Sanjay: So, one of the things I think both Dakota talked about it and Ramesh and I have been talking about it, is to think through these issues at a fundamental level now. Before it's too late and before the cat's out of the bag to mix my metaphors. Thank you. Ramesh: Wow, human values, Sanjay.

Thanks for reminding us. Nicholas from Stat News has written some really beautiful articles, very in depth articles on this pandemic. Nicholas, please. Nicholas: Thank you. Thank you so much for your time and thank you everyone for having me here. I'm a reporter at Stat News.

I covered the intersections of race and medicine and health. And I'm doing a lot of coverage right now on the vaccine rollout. A lot of my focus looks at health disparities. But also, looking at hesitations, especially in a communities of color and black communities, more specifically. Nicholas: Noel earlier had just talked about some of the examples of hesitation we see.

What people need to really understand is just how deep the mistrust in certain communities, especially black communities of medical research goes. Noel had brought up examples like Tuskegee. These are things that I'm hearing in a lot of my reporting. This is something that took place many, many years ago, but it's still fresh. It still scars that the psyche of so many black Americans. Nicholas: But I would also mention that, systemic racism in the medical system, it's not just a thing of the past.

It's also something that is still happening today. So, in terms of people's worries and such. The trust needs to be built, the trust needs to be worked on today. A perfect example.

I was just speaking with a source who was telling me about, right now, everyone is rushing to make sure that communities of color are towards the front of the line, when it comes to getting COVID vaccines and such. Yet, it's such a stark difference from the beginning of the outbreak. When communities of color, black communities had such trouble getting access to testing.

And still, do have the trouble with that. Nicholas: So, I would challenge everyone with whatever field or wherever they are working, whatever you're doing, make sure you're doing it equitably. Make sure you're keeping in mind that, this trust, this distrust, it's really on us in these professions to really work on and repair. Make sure you're in those communities just to begin with. So, when situations like this happen, you already have a basis there.

You're already there. You know who to talk to and you know how to proceed. Thank you for your time. Ramesh: Nicholas, I think that is one of the most important issues we have to deal with today. Peter Schwartz is finally back on video. And Peter, I know, you and I have been working on this since what? Early April? When your whole team at Salesforce was helping us launch open source protocols for the pandemic response.

And, you continue to do amazing work. So please share with us your thoughts. Peter Schwartz: Thanks, Ramesh, delighted to be with all of you this morning. I want to make two fundamental points.

They are based on my experience in working. First of all, at the state of California, and now currently with Hawaii. If you look out my window, you can see I'm actually on the big Island of Hawaii, where I fled to basically quarantine in paradise as it were.

And it was a personal decision. Peter Schwartz: I've worked with the state of California, the state of Hawaii and the government of Singapore. And so, what I want to comment on comes from those three experiences.

Where California is doing it mostly right. Singapore is doing it entirely right. And the state of Hawaii, not so much. Peter Schwartz: And so, let me share two fundamental points. One of the big issues that we've run into that I think is quite critical is policy confusion. And I think Adam Berry referred to some of this in his comments earlier.

That is that, where you have multiple, decision-makers all involved. You've got the federal government, that's one level playing some kinds of role. And now, with the new administration we're going to see probably a more active and coherent policy. At least some policy.

Then you have the state actors, you have county actors, you have private actors, you have community leaders, and so on. Peter Schwartz: California has had a very good hierarchy of pretty clear decision making with a very clear set of policy makers and good communication through county officers. State of Hawaii has nothing. There is a state health agency.

There is no County health officers and so on. So, what we find ourselves in this position is that for example, in Hawaii, there are five different decision makers of significance, trying to make every single decision, with no decision-making organization whatsoever. And so, we've had confusion on what the policy is on quarantining on the island. We've had the confusion of policies of masks, et cetera. We've had now, great confusion on what it takes to enter. The comment was made as well.

How will we know? What are the appropriate standards for someone who can enter say, the state of Hawaii? Well, every island now has a different standard. Peter Schwartz: So, one of the big challenges and lessons for going forward is the need for a coherent policy making structure, which we don't have. We have a high degree of confusion. So, that's number one. Related to that of course, is multiple apps that are being used for different purposes. We've got a safe Hawaii app.

There is no app for actually contact tracing. They're just launching a statewide contact tracing application, Ramesh, built on some of what you guys have done. But there is no coherent decision-making about that either. We've got five different applications, none of which talk to each other. So, we can't figure it out from the state of Hawaii, if someone has come in and actually complied with the quarantine and so on.

There's no enforcement mechanism. So, policy confusion is point number one. Peter Schwartz: Point number two. Ramesh: Yeah, let's come back to deeper conversations. But absolutely, I think policy cohesion and apps cohesion is definitely critical. Let me just make sure I give a chance to other speakers, in this opening two minute comments.

Ramesh: Let's bring in Susan. Susan Golfer from UI. Susan and I similarly have worked also since April on pandemic response. So Susan, your very short thoughts to get us started.

Susan: Yeah, absolutely. Good afternoon. Good morning, everyone. I think, the key for us as we start to address the rollout of the vaccinations is equity.

So we keep hearing we're all on the same boat together with COVID. It's a challenge everybody's been working on. But I think, the reality is that we're all on the same storm and there have been very, very different boats. And I think as we look forward, we need to look at these issues of health equity, disparities that Nick was talking about and figure out how to overcome them for the longterm, as we address the short-term needs of the COVID vaccine responses. Susan: At UI, we're really, really interested in addressing some of the public health transformation needs. Investing today for solutions that will help us moving forward and really thinking about how technology can be an accelerator to all of this.

And, in the comments around standards, comments around addressing those within the population most at need, I think are critical. And, one thing I just add as we continue into the dialogue together is, we're looking at that public private partnership opportunity, what role employers can play in helping with some of these vaccine hesitancy issues and how governments and the private sector can work together more effectively. Ramesh: Excellent. And, in addition to these introductory comments, we have many VIPs on this chart. I encourage everybody to turn on your video and let's spend the next 15 or 20 minutes or so, just thinking about why we are here, what we can do as a community together.

Of course, this 45 minutes is not enough to get all the points across. But, I hope a lot of us stay in touch. And in addition, anybody watching online go to, and you can post

your questions and join the conversation. Actually Surat, you just joined. I know you had a conflict. So, Surith if you want to just present your short two-minute comments. We're being very strict, two minutes.

Are you on Surith? Susan: Ramesh, I was very interested in what Peter was saying. I think, he has a very interesting model to report about the lack of interoperability among apps and other things. So I would like to hear him just finish his remarks if you might. Ramesh: Yeah. We'll definitely come back to feature on that, during the discussion. Ramesh: All right.

I'm glad everybody's on the screen together. I think, Surith, you're having challenges coming on board. But, glad to see you together. I heard two or three main discussion points. One is equity. It's a very critical one.

The point that Dakota and Sanjay and Peter and many others are making this point, about how do we make it interoperable? So, it's not yet another standard that we go towards. And maybe the third one, which is kind of at the center of our conversation here is, this trade-off between centralization and decentralization, right? Ramesh: So, let's start with maybe there's three broad areas and, and take them one at a time, maybe about five minutes each. Let's start with equity. I know Dakota, you wanted to have some comments as responding to Susan. Dakota: I actually wanted to follow up on a different piece of what Susan laid out there, which was, around this idea that we're at a very unique moment where there's a huge amount of investment being put into digital infrastructure. And I think, that brings with it a real obligation, not only to think about how that digital infrastructure is being built to address the immediate pandemic at hand.

But, I think we need to believe that there will be longevity to any of the technology that is being developed and deployed. And that necessitates us thinking through these precautions and these guard rails for things like privacy for user management, in a way that there's a higher burden of proof. Because, we need to ensure that what we lay now, is the technology indeed that we want to live with for decades.

Dakota: And so, I think there's a requirement for all of us. And I think this is particularly true for the technologists in the room. We have to slow down to speed up. We need to slow down and make sure that we are approaching this from a standards-based way. That we are thinking about interoperability.

We're thinking about privacy, decentralization. And laying a framework that ultimately allows for users to have control over their data, to be able to access it and replace it. Or not just around interoperability, but also around privacy and around user management. So, the pitch for standards and a pitch for public private partnership as a way to get there. Let me do so it's again...

Ramesh: That's fantastic. And, I'm seeing some comments already on the chat and the Slack channels. Thank you for covering that, Dakota. Let's spend a few minutes on this aspect of standards. And I know, Peter had a particular viewpoint on that. And also our friends from, from NTT and NTCS.

So Peter, go ahead. I know, you made that comment in the text. But, please go ahead. Peter Schwartz: Sure.

I want to build really on what Nicholas and Flora have said. We've had a lot of experience here, both in California and in Hawaii, dealing with how do you bring minority communities and diverse communities into it? California has done a reasonably good job. But here in Hawaii, we have multiple communities, South Pacific Islanders, native Hawaiians visitors, et cetera, all coming together in a complex mess.

And what we have done. And this has worked remarkably well. We've created ambassadors, local ambassadors, Hawaiian ambassadors, Marshalese ambassadors to go into those communities, communicate mask wearing, social distancing. And now, we're getting to prepare for vaccination. Peter Schwartz: Because, I thought the term bio mistrust was an excellent term. And unfortunately, we have a lot of it.

Virtually every minority community on the island has high degree of bio mistrust. Surveys suggest between 25% and 50% will not take the vaccine. That's a huge issue.

So, we have been able to use particularly, religious leaders of faith in these various communities as a vehicle for engagement. Because, we put it as a moral obligation to the community. And actually then, the religious leaders, the leaders of faith have been very powerful in communicating in those minority communities, and have been one of our best vehicles for dealing with the bio mistrust. Peter Schwartz: I'll stop there. Ramesh: Peter, you're saying that, although you're talking about empowerment of the citizens, the empowerment could happen not just at individual level.

But, also could happen through community leaders. Peter Schwartz: Exactly what I mean. Ramesh: And, I think that's a good point that the focal being at the node of an individual. Peter Schwartz: We had issues around testing that was where the first place we hit and a lack of trust and data, et cetera. And we have now broken through that, and have made great progress as a result of being able to mobilize those communities. Ramesh: Yeah.

Susan: I think what Peter is talking about is, one of the most important lessons we learned from public health is that, the need to mobilize local influencers to reach targeted communities. Shirley: Yeah Susan. It's something that's so true.

We see it over and over again. And, as we're designing these vaccine related solutions, moving forward. The most recent data tells us that we have to go local.

So, even as we look at surveys by state, the breakdown of hesitancy, the breakdown of issues is not consistent from Georgia to California, from Texas to Virginia. So we are in real danger of creating broad brush ideas of what's going on. We have a huge amount of diversity of thinking of issues of challenges. Shirley: So, as we think about our purchase, that local connectivity is critical. And then, pairing that with this amazing technological foundation that allows us to be incredibly targeted in how we engage with people. So, if we think back to that platform Ramesh with showing, what that is.

That's a personalized engagement tool in your hand, as well as a vaccine validator, as well as a health passport. As well as all those other things that Dakota was talking about. I think, putting those two things together, you're dead on.

Susan: I think where we are arriving is, building the public health infrastructure of the 21st century. It is taking those proven public health practices and marrying them with new technological innovation. Thank you for that comment. Peter Schwartz: I just march here, trust and ease of use, are key to the success of any of this technology working. There's even debate out there right now, whether or not we can capture people's cell phone number to remind them about the second dose and things like that. So, if people don't trust the technology and it's not easy to use, they're not going to adopt it.

And we're not going to have a successful program. It's going to have to take place at the local level, to educate people. Ramesh: On that note actually, the point that Susan also made earlier about the local communities, I want to invite a Quenton, who's not only a [inaudible 03:46:40] Cambridge, but also an MIT grad, and he thinks a lot of technology and people all the time. Quenton, what's your take on this? Quenton: Thanks Ramesh and glad to be here with you all.

You're all covering exactly the right topics. It's been very challenging for us on the ground. Even here in Cambridge, the innovation capital of the world, we have a very diverse population in a very small city. And, we're definitely struggling with the racial inequity, getting access to testing to our community members. We're struggling with keeping the schools open. The schools just closed for in-person learning, because of our case rates going up.

And yet, overall we've been able to maintain relatively low COVID-19 cases in Cambridge itself. So definitely a lot of challenges, but it sounds like you all are focusing on the right topic areas. And I'm optimistic that we'll be able to apply the technology and the solutions. And I completely agree with you that we have to go hyper-local and I'm ready to help in any way I can. Ramesh: Yeah Quenton, it's amazing. You and I have been talking about distance being another pandemic.

Given your MIT background, I know your wife is a Harvard professor. So, you're wearing a Harvard vest there. Despite all the innovation in Cambridge, it's very, very difficult to move these things along because, as the points we heard earlier, that the trust with the community continues to be a challenge. Let's spend a few minutes going back to this tension between centralization and decentralization of data. Clearly when you centralize, it's much easier to deploy the systems. And Susan and I have been talking about this for quite some time.

She has a lot of experience, years of experience working in the government. On the other hand, we have organizations and new non-profits that are pushing for this de-centralization. Just want to open that up, if anybody wants to share their thoughts.

Nicholas: If I could just jump in real quick. And I apologize, cause I, I had a point for what was previously talked about kind of the hyper localization. And I'm so happy that was brought up because more and more from what I'm hearing in my reporting is that, the role that faith leaders and community organizers are really playing in combating vaccine hesitancy. It's funny.

I'm not sure if there are other journalists on the line. But, I'm working on a story, looking at the role of celebrities and as COVID 19 vaccine ambassadors. Last week, I believe it was Barack Obama had said that he was going to take the vaccine on camera and such. And speaking to some experts about, would this nudge people in a certain direction, what kind of effect it might have. Nicholas: And, one source I spoke with brought up an interesting point that I think, sets a background for when we think about these things.

Which was, for some people, it doesn't really matter, who's getting that vaccine, if it's some celebrity. The issue that they see is that, this celebrity, this person has really good healthcare, right? So, if something does go wrong, like say, they have some kind of reaction, there'll be fine. They'll be able to see their doctor. They'll be able to take care of it. But, that's not the same case for everyone else in this particular instance.

They have really bad reactions to something like that, which is what they're thinking, when it comes to whether or not to take the vaccine. Will I have to miss work? Who's going to watch my kids? Who's going to do this? Who's going to do that? Nicholas: So thinking about, on the hyper-local level, what are the problems that, the same people who are the faith leaders are going through are the same people who they're talking to, who they're trying to convince those are those same problems. So, I just wanted to say, to echo that I think that's a very important area to be focusing on. And now, we can go back to the question at hand.

Ramesh: Yeah, hyper-local is related to the centralization and decentralization of this aspect. Because, there's a tension between a bird's eye view that allows you to deal with every outlier, as opposed to aggregation, privacy preserving aggregation. But you could lose out on all these outliers, individuals of color, or if there's one single person who is low income in a high income neighborhood.

All those challenges do run into, when you start aggregating the data and start using for the sake of privacy. Shirley: I think, as you're saying, it's a really important question. Because, having worked on many public education campaigns, like the first one for depression in 1980s. Or, trying to get people to get mammographies in the '90s, that we reached out to local faith leaders, to hairdressers, to barbers and to others who had impact in the communities. But then, that knowledge is sometimes lost.

And I think, the challenges from a centralization point of view, how do we keep a roadmap of all of these community leaders, so that when another problem arises, we can easily mobilize them. And how do we map trends in terms of side-effects or adherence, in terms of something that's needed now, to really reflect on what's happened. But, to protect privacy, which needs that very individualized, private centric response. So I think, going forward, we really need a discussion about this. And that's part of a national plan for innovation in public health, moving forward. Ramesh: Susan, and anybody else on this call, do you see that as a tension.

Because, you see that the ability for public health and CDC, and of course, worldwide. It's not just for the US and the world we live in, the Snowden world, the Cambridge Analytica world we live in. Do you see that conversation happening.

Or, you think it's the pandemic, some of these things can wait. Shirley: No, I don't think it can wait. I think it's urgent to have it.

Because, as was pointed out, there are billions of dollars being put into these, building digital solutions and creating as the UN is a kind of a repository of information. But, let's make sure that it's kept modernized so that we're prepared for the future. And, I think it really provides a wake-up call that these areas have been neglected, that these issues have been neglected. Equity has not been at the forefront of our discussions, but needs to be. And, that we have to put the hyperlocalized together with the national and find a way forward.

Time is of the essence. And nothing could be more simple. Ramesh: I'm glad to hear that. I know Adam Berry is here, who's a big proponent of the decentralized systems. If he wants to add in any thoughts. Speaker 6: Maybe, answer to your question on centralized versus decentralized.

Just talking about the experience from India, right? I think, it all comes to interoperability of these systems, right? Each state spends their own time and schedule. Then, you will never interrupt, right? And it takes years together to create systems. I think, what India has done is, created software at the central level, made it available to states. It is the same software, right? That is customized.

The data is owned by the states. But, whenever they need to, like in case of public security police, they are able to aggregate the data at a central level, if they need to. So my sense is, probably there is a smart way of doing things which is building one system, make it available for everybody. Ramesh: That's right. Shirley: It would be customized.

I want Peter to talk more about this because, saying that we're four or five different apps for different things. After a while, you don't even go to it anymore because it's so confusing. So Peter, do you have any thoughts about how to make this a more seamless system? Peter Schwartz: Well, I think there's the technical dimensions, which are frankly the easy part of it. It is actually the institutional questions, getting collaboration among the different players and agree either for interoperability and ease of communication or, let me call it, single master application. As you know, the world economic forum and the Swiss actually came up with a good travel application, which actually, if you were to use it for all of these purposes, is probably the best that we've seen so far of that sort. I think frankly, it's unlikely that we're going to get a single tool.

So, finding ways to get data sharing becomes, I think the only way to actually make it work. Some kind of protocols for actually being able to share the data. Ramesh: Very well said, Peter. I know we're coming up on the hour, so I definitely want to appreciate everybody joining us. And just in the last one minute, if folks have thoughts on what we can do next, write an open letter. Folks wanted to participate in creating a protocol that can have a trade-off between centralization, decentralization.

The issues of equity and equitable distribution are extremely important and mistrust. Any thoughts on what this group can do? And if you want to invite anybody else, who's watching. Susan, Shirley, Jagjit. Susan: I'm happy to jump in here with at least sort of one specific call to action, which is, as it relates to vaccine credentialing and credentialing for any test results. What we've seen is that there is this fragmentation happening at the moment. And I think, Peter was just referencing one of multiple different solutions that we've seen, brought to bear around test credentials that relates to travel.

But, in order to forestall that type of fragmentation, and instead to have a standards based, there's an urgent need to bring together a critical mass of organizations who say, "We're going to develop those protocols and those standards, so that all of these pieces can inter-operate with one another." Susan: And so, we've been working with World Economic Forum, working with WHO, on the testing side of things, on the vaccination side of things, respectively. And, in either of those would welcome partners. On the testing side, there will be an open letter around the needs for standards based approach that we're working on by the end of the year.

And, then a sprint into February to develop the standards. Please do contact me if you know, your organizations are interested in being part of either of those efforts. Ramesh: Yeah, fantastic.

So, we can do that on Slack. I would like to invite all my co-organizers to just provide their closing thoughts. I know we're at the top of the hour. And Susan... Surith: I just wanted to mention one thing Ramesh before we close, because I missed the earlier half. Did anybody comment on the immediate, urgent, pragmatic aspect of how to minimize wastage, given that initially there is huge scarcity.

That's an aspect that me and my company, we are deeply interested in. But I wanted to just make sure I hear from the experts in here, if they have any thoughts related to that? Ramesh: I think Surith, it's such an important topic. I wish we could continue, but we have to close off the session, because we... Surith: No, sure. Just the name of anybody in here who's interested in that. And then I'm...

Ramesh: Yeah, let me, let me give it to my co-organizers to wrap it off. Susan, Shirley, Sanjay, and then Jagjit to take us to the next panel. Susan: Thank you. Well, I just want to thank all of the experts and our audience today for participating Ramesh, Shirley, Jagjit, Sharma, everyone who's been part of this conference in organizing it. This is the public health threat of our generation. It has challenged the health, wellbeing, and the economies of every nation.

And, it's going to take the innovation and the expertise of each one of you here today, working together at the community, the state, the federal level. Because, the spread of infectious disease, like COVID knows no state or national borders, and we can only beat it by working together. Ramesh: Thank you Susan. Shirley.

Shirley: You said that beautifully and I will echo every single thing you just said. And also, just say that, there really is this kind of call to arms for everybody to be involved. There's no time to sit back.

You may not think you have a, you know, an expertise or a skill that is needed and you'd be wrong. Because, I think we're not going to solve this in silos. We're going to solve this multidisciplinary collaboration. And so, we need, designers and artists and economists and policymakers and doctors and lawyers and technologists.

You need a real robust representation of the world. And that's not going to happen if we play in our own little sandboxes. So, I encourage everybody to be bold and brave and to stand up for being a part of the future. Ramesh: Thank you, Shirley. I believe Sanjay just had to drop out. So I'll hand it over to Jagjit to take us home.

Jagjit: No, thanks from Asia. I mean, I really enjoyed it. I think as a county representative, as well as part of our MIT collaboration efforts, I really like the perspective of the centralization and decentralization aspect. Fully agree, it's not going to be a one solution.

But the point which Peter talked about, data sharing is a big problem on the ground. And how we can enable these kinds of platforms, where we can share and where we are not working in silo. Integration of the different systems and data aggregation and tracking of it. So, it all goes back to the collaborative efforts, which all of our agencies and jurisdictions have to play and work out together. And it is not just the public sector effort.

It is about the holistic stakeholders. We have private sector academia, corporations, and everyone has to come together for this common cause. So, I'm really glad that every different perspective came into it. Jagjit: Really like Surith's point about waste management. That's one of the key focus area for us too.

So definitely we might be able to continue that conversation on Slack. Ramesh: Thank you everyone. Jagjit: So with that permission, Ramesh, we can wrap up here. We can go to the next topic to wrap up. Ramesh: Yeah. Thank you everyone.

Thanks for joining. Susan: Thank you. Shirley: Thank you.

Nicholas: Thank you. Peter Schwartz: Thank you so much.

2020-12-29 00:21

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