Mayor of New York City, Bill de Blasio. The | Bryan Thomas / Getty Images
NEW YORK – Mayor Bill de Blasio, faced in May with the task of monitoring the spread of the coronavirus among a population of more than 8 million people, wanted community involvement to get his gigantic contact tracking program to work. city. He then created an advisory board and stacked it with community leaders and public health experts.
Two months later, members say the city has ignored the committee’s recommendations on a central theme for the program’s success: protecting privacy.
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The group pushed the city to ditch Salesforce, a third-party software program, and create an internal database to shore up. privacy concerns that have hampered the effort. That momentum along with other recommendations have fallen on deaf ears, according to 10 advisory board members who spoke to POLITICO.
“They are not particularly interested in our input,” said a board member who spoke on condition of anonymity to discuss the proceedings behind closed doors. “They want to have the community advisory board. They don’t really want the board to advise. “
The de Blasio administration created the board shortly after announcing the program in an effort to win over the government’s historically skeptical communities. The program aims to find everyone who tested positive for Covid-19 and find out where they have been and who they have been in contact with, and then communicate with those who may have been exposed. The goal is to stop the chain of transmission, a crucial step in reopening the city’s crater economy, and hopefully prevent hospitals from being overrun again.
The ignored recommendations are just the latest controversy for the program, which has been plagued by political disputes since the mayor decided to put New York’s public hospital system in charge of the effort, bypassing his own health department, which has traditionally been Responsible for tracking viral outbreaks. . Officials running the program have struggled to ensure a sufficiently high level of cooperation from the public, and many of those who have hired Covid-19 refuse to answer questions about others they have contacted. If the success rate doesn’t improve, the city could face another disastrous second wave this fall.
Members of the advisory board, most of whom spoke on condition of anonymity, said they had pushed to board lack of government transparency, data collection malpractice and privacy concerns, among other considerations, since they began meeting on May 13, but the city has refused to make most of the adjustments.
“We are totally a fig leaf, and there have been a number of cases where we have spoken vigorously about the issues and have been completely ignored,” said Housing Works CEO Charles King.
Members lobbied for stronger language in educational materials for the city’s testing and tracking program, to “really assure people that their information will not be shared with the federal government” or include questions about immigration status, said a board member. The board raised concerns when Health + Hospitals, the public hospital system, noted that people’s information will not be shared with the federal government, including ICE, unless required by law.
“If you can’t establish that trust, the system will collapse,” said the board member.
Jackie Bray, deputy executive director of the testing and tracing program, said the city takes confidentiality seriously, but that it cannot conflict with the law if it does.
“The city keeps all of this data completely confidential. Full stop, ”he said, citing legal protections and health codes in the books. “Anyone can spin any hypothesis they want, but we have a real history and we are using all the experience we bring to bear to combat this virus.
He dismissed the idea that the city’s health department, not Health + Hospital, is the agency with the record, pointing to the capacity of the municipal hospital system to protect patient data and its association with the health department.
“Making this deep distinction between the health department and H + H ignores how it is running and how it is running,” he said.
The city would fight a subpoena for specific case data, Bray said, but privacy experts and advocates cautioned that going to court is a risky proposition.
Data within a city-built database would be better isolated from citations under health information policy laws, said James Hodge, director of the Center for Public Health Law and Policy at Arizona State University.
“Data stored on social media or other sites like Salesforce may not enjoy the same legal protections against citations, despite the similar privacy interests of data subjects,” he said.
Salesforce declined to comment. The city did not say how much it is paying the company, and the contract is not registered with the city comptroller’s office.
The administration defended its use of Salesforce, saying that internal public health databases do not have the capacity to manage daily monitoring and support services “on this scale.”
Board members argue that now is the time to make that change, as Covid-19 cases are at levels in early March, or around fewer than 300 new cases per day, according to the latest data from the city health department.
“I don’t think it makes sense to spend money on private institutions when we can bring it home,” said one member. “We cannot put [Covid-19 positive people] back in the same system that is inequitable. I would prefer a process to obtain it internally. ”
Another member of the advisory board said, as it stands now, that he would not encourage people in his community to share information with a contact tracker employed by the city.
“I would honestly tell them not to tell them anything,” he said. “Tell them places, but not people.”
Lack of privacy protection is why board members pressured Health + Hospitals to build their own internal network and establish a position on NY S 8450b / A10500a, a bill introduced by State Senator Gustavo Rivera and Assemblyman Richard Gottfried to ban Covid-19’s contact tracking data from being used for any other purpose.
The mayor’s office said it has been working with lawmakers on the bill and has told the advisory board that it supports the bill’s intent, despite “the specific wording problems we are working to resolve.”
Gottfried said the city communicated its concerns on Wednesday, two days after the health committee held its last meeting.
“We hope to address those concerns to the best of our ability given the extremely short deadline for further amendments at this time,” he told POLITICO.
Blasio’s administration asked to retain the data for a longer period of time than the law currently allows because of concerns that deleting the data prematurely could “inadvertently hamper our response,” Bray said.
“There are many questions about the epidemiology of this virus that make it important for us to examine the details of that bill,” he said.
The advisory board’s concerns are compounded by the internal dispute caused by De Blasio when he relinquished control of the health department over follow-up contacts to the city’s public hospital system, “clouding the public health law,” two said members.
Board members said there were several staff members who worked for the health department, but had been poached by Health + Hospitals, so lines of authority were unclear.
“It is a losing battle,” said a board member. “Taking control of [the health department] and having this entity called Test and Trace and having H + H in charge caused a real confusion about who is supposed to answer the questions. “
Board members also clashed with city leaders about how the data was collected and promoted. Some argued that the city was trying to make the show appear more successful than it was. The city has chosen to use a “waterfall chart” to show where people fall out of the process, such as not picking up the phone, ending the interview, or providing secondary contact information.
“It is better to be as transparent as possible when sharing the data, but in a fair analysis of the data,” Wafaa El-Sadr, a member of the advisory board and professor of epidemiology and medicine at Columbia University, said during a meeting. “Tracking contacts is not easy. Giving the impression that everything is perfect is not useful and leads to the loss of credibility for our city. “
Municipality has pushed back on criticism that the program was unsuccessful and questioned the idea that his mathematics is biased, saying that the program has reached more than 85 percent of the 12,384 cases it identified from June 1 to July 4.
Of those cases, the city reached 10,579 people, but only 6,752 completed the interview, resulting in a successful interview for just over half of the cases identified. The city’s numbers have improved markedly since the effort began. But a quarter of the people who completed the interview still did not provide a secondary contact, a crucial goal of any contact search program.
“All of our data is published and available on our website,” said Blasio spokesman Avery Cohen. “I would challenge you to find a location that regularly reports its tracking data with this degree of transparency.”
The city is also struggling to collect data, board members said.
The test and trace program has a Covid-19 control panel with data on the number of both New York and Health + Hospital patients tested for the new coronavirus, along with racial, geographic, and gender breakdowns of H + H patients. Races are grouped in white, black, Hispanic, and others – cubes that shut out large swaths of New Yorkers like Asian and Arab communities, among others, according to a screenshot from the Covid-19 control panel of the program reviewed by POLITICO.
The city council said it “does not control whether individual providers and doctors, hospitals collect race data and tests,” and noted April state data on granular racial data, but could not explain why Health + Hospitals could not provide a better racial breakdown for their Covid-19 patients.
“Without accurate data, we are in the dark,” said a board member.
That could deprive resources of the most affected areas.
“If you get granular and start exposing those problems, you need to put resources there,” he said, adding that this year’s budget may undermine Covid-19’s efforts. “It has been frustrating. It has been a frustrating experience for many. ”
