How surveillance technology powered South Korea’s COVID-19 response

SEOUL, SOUTH KOREA - In the photos taken on February 20, 2020, medical workers sterilize all public places in downtown Seoul on February 20, 2020. After South Korea reported the first death of a patient with COVID -19 on Thursday (20) and confirmed 53 new cases of coronavirus, raising the total of infected to 104 in the country, the authorities take more preventive measures against coronavirus.

South Korea has been widely praised for its use of technology in containing the coronavirus, and that praise has, at times, generated a sense of mystique, suggesting that Korea has developed sophisticated new tools for tracing and stopping the outbreak. But the truth is far simpler. The tools deployed by Korean authorities are readily available in other technologically advanced countries. What sets Korea apart is the political willingness to use these tools to their full potential in supporting a public health response.

Take, for example, Korea’s COVID-19 patient #10422. Before being diagnosed, patient #10422 visited the Hanaro supermarket in Yangjae township on March 23 from 11:32 p.m. to 12:30 a.m. The patient was accompanied by their spouse, both wearing masks and using their own car for transportation. On March 27, the pair visited the Yangjae flower market from 4:52 p.m. to 5:18 p.m., again wearing masks. They then had dinner at the Brooklyn The Burger Joint at Shinsegae Centum Mall from 6:42 p.m. to 7:10 p.m. This detailed record can be found, publicly available, on many government websites, and is a testament to the extensive contact tracing carried out by Korean authorities.

But how exactly is this information compiled? There are essentially three sources: electronic transaction data, mobile phone location logs, and surveillance camera footage.

Even before the COVID-19 outbreak, the Korean government collected massive amounts of transaction data for investigating tax fraud. Literally every credit card and bank transaction in Korea is recorded on government databases. During the outbreak, this information was repurposed to retroactively track where people went: not just coffee shops and restaurants, but also buses and subways (the latter two mostly paid for by cashless tools). For patient #10422, such transactions would have revealed visits to the supermarket and burger joint, allowing authorities to quickly quarantine and sterilize both locations.

Since the new millennium, South Korea has consistently ranked as one of the most connected countries in the world, with over 96 percent having daily internet access. Much of this access has been through smartphones, with a staggering 95 percent of adults owning one. This connectivity has, over the years, precipitated policies allowing law enforcement officers to collect mobile phone locations in pursuit of criminals. Amid the outbreak, this information has been repurposed to retroactively track both COVID-19 patients and suspected patients.

Even without GPS or other locational services enabled, cell phone providers are able to track phones with an accuracy of a kilometer or less as they connect to cell phone towers. In Korea, it is mandatory for companies to log the connections between towers and phones, making this information available to authorities. These logs would have confirmed patient #14022 and their spouse had visited the supermarket and burger joint together, providing an addition layer of corroboration.

Mobile locations are also used when providing outbreak updates. I, for example, live in the city of Busan. When a new patient is diagnosed here, I receive text messages about the places that person visited during the last few days. This allows me to determine if I might have been in proximity of that person, helping me make informed decisions about whether I should be tested. If I were to visit the neighboring city of Ulsan, I would start receiving messages about patients and locations there, keeping me informed about my immediate environment in real time.

Surveillance footage has undergone a similar repurposing amid the outbreak. Much like mobile phone locations, law enforcement has long exercised procedures for obtaining quick access for investigative purposes. These procedures likely enabled health authorities to determine the minute-specificity of patient #10422’s visits to the supermarket and flower market. Other details, such as the patient and their partner’s use of masks and the car they traveled in, were most likely obtained through this footage.

Korea’s ability to quickly repurpose and integrate different forms of digital information is a testament, not only to existing infrastructure and procedures, but also to the previous government’s efforts to learn from prior public health crises. Following Korea’s experience with Middle Eastern Respiratory Syndrome in 2015, the government recognized the need for real-time tracing and amended the Infectious Disease Control and Prevention Act to include provisions about surveillance amid outbreaks. These provisions have allowed health authorities to collect the same information as law enforcement, significantly enhancing their ability to focus testing and quarantine on those individuals more likely to be infected.

IDCPA amendments also added language about the public’s right to be informed. This language is what requires the government to send me text messages about new patients in my area and publish online reports about patient #10422. This transparency not only helps the public make better decisions but also helps them feel a greater sense of control over their environment, increasing confidence in government activities, as evinced through recent parliamentary elections.

Throughout the outbreak, the Korean public’s opinions about surveillance have been overwhelmingly positive. COVID-19 fatalities in Korea are a third of the global average, and Korea is one of very few countries to have flattened the curve and so far avoided a re-emergence of virus. Despite these successes, there have been voices expressing concern about the level of detail released by health authorities. In one case, netizens appear have to identified a couple engaged in an extramarital affair by matching their trace records. Such incidents are rare, but they have nonetheless motivated updates to surveillance guidelines, including the implementation of a petition process for rewording or withholding information deemed sensitive.

The technologies used by Korean authorities are basically ubiquitous among technologically advanced countries. Credit card companies and banks across the globe already keep logs of electronic transactions. Mobile providers have the capacity to record locational information for every phone they serve. The real question is not about technology but about the political and public desire to use it constructively in outbreak management.

Justin Fendos is a professor of cell biology at Dongseo University in Busan, South Korea.