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    Can Blockchain Fix China’s Broken Public Health Emergency System?

    A blockchain specialist argues that the technology could help solve some of the problems exposed by the COVID-19 pandemic.

    This article is part of an ongoing series in which experts will analyze the role of science and technology in epidemic response and control in China and around the world.

    It took almost four months, but China’s frenzied initial battle against the coronavirus appears to be drawing to a close.

    The virus, which gradually spread through the central city of Wuhan from late last year before developing into a global pandemic, offered a harsh lesson in the flaws in the country’s current public health emergency response system. Now that we have a little breathing room, perhaps it’s time to look back and reexamine what worked and what didn’t: How can we improve or even rebuild our public health emergency management systems to prevent similar disasters from happening in the future?

    Nearly everyone — from doctors and scientists to journalists and ordinary citizens — has been reckoning with these issues since the first alarm bells began to sound late last December. After a deadly outbreak of another coronavirus-caused disease, severe acute respiratory syndrome (SARS), in the early 2000s, China spent heavily on an “automated” early warning system for infectious diseases. The system worked reasonably well for a string of regional outbreaks over the years, but the current pandemic has highlighted problems in its practical application, including lengthy review processes, susceptibility to outside interference, and a lack of transparency.

    Nor were the problems limited to the alert system. Government departments also struggled to coordinate and share information. For all of China’s investment in big data and tracking technology, the early days of the outbreak saw key officials trying to track potentially infected travelers by posting missing persons notices on social media. The combination of insufficient information, irregular management practices, poor transparency, inadequate accountability, and flimsy guarantees about the authenticity of donated materials together hampered the disbursal and use of vital protective gear and other materials, undermining the public’s confidence in epidemic control work.

    In short, COVID-19 has accentuated defects in data-sharing and collaboration at all levels of the public health emergency management system. To address these problems, it’s necessary to break through the barriers between departments and establish a new model for data governance, one which is open, transparent, and capable of protecting citizens’ privacy and security.

    That’s where blockchain technology comes in. Although most often associated with cryptocurrencies like bitcoin, blockchain is in essence a kind of public ledger: a collectively maintained online database. Data stored on the blockchain cannot be easily altered, and compared with traditional databases, decentralized blockchain networks offer increased anonymity, data encryption, and tamper protection, as well as the benefits of distributed storage and multiple fail-safes.

    In fact, blockchain — together with another field getting some buzz, big data — are already in use in the fight against the pandemic. A consortium of tech companies, including Micro Doctor, AliHealth, and DXY, have used the technologies to build a “virtual front line” capable of monitoring the pandemic in real time. 

    Meanwhile, my team at Wuhan University developed a national information exchange platform for personal protective equipment. We upload information about requests and material donations to the blockchain. After verification, we have a reliable database for users — donors, hospitals, and clinics, among others — to look up what’s needed and what’s available.

    These and other, similar projects show how blockchain technology can be used to build a new epidemic early warning mechanism, one protected from human interference, capable of providing timely and accurate information, and coordinated across departmental lines.

    Right now, key information is separated into departmental silos, but using blockchain to link the health authorities, hospitals, key charities, and public security apparatus could help increase the integration and sharing of epidemic data and enhance emergency management efficiency. Along with this, it could also allow for more transparent information that’s open to all.

    Of course, some sensitive information may not be suited for public release. Blockchain technology allows for safeguards to be put in place using keys and permissions, which can limit access to a certain class of users.

    Blockchain is not expensive — the core technology and software platforms are free — and my co-author and I believe it will become integral to the construction of public health emergency management systems in the future. In the short term, the primary challenge will be teaching people how to use it. Given its wide applicability — not just in health, but in finance and other fields — colleges and universities should start training specialists in order to meet the expected demand.

    This article was co-authored by Chen Leiyang.

    Translator: Matt Turner; editors: Wu Haiyun and Kilian O’Donnell; portrait artist: Zhang Zeqin.

    (Header image: Wang Zhenhao for Sixth Tone)