As the current COVID-19 pandemic sweeps the globe and dramatically alters society, governments and corporations are turning to novel uses of biometric technologies to limit contagion and maintain economic opportunities. Technologies that may have once seemed like the province of science fiction—such as thermal facial recognition, remote fever detection, or smartphone-based immunity certificates—are now not only possible but also already in use. This raises important questions about the potential privacy implications of the widespread collection and use of such personal data. While multimodal biometric surveillance technologies such as these may prove useful in slowing the spread of SARS–CoV-2, we caution that the ability of governments and corporations to leverage these technologies will likely persist beyond the current public health emergency. Just as many of the privacy concessions made in the USA Patriot Act have become permanent since the emergency circumstances of September 11, 2001, the privacy-limiting technologies unleashed during this pandemic may well persist unless policies are enacted now to regulate their use and ensure responsible oversight. Recognizing that these emergent technologies may become entrenched long after this public health crisis subsides, we focus here on the case of fever checks and thermal facial recognition technology to illustrate the current state of the technology, existing policies related to its use, and suggestions for proactive policies to govern its deployment during and beyond the present pandemic. While SARS–CoV-2 (the virus that causes COVID-19) is particularly pernicious due to its high rate of asymptomatic transmission, identifying symptomatic individuals is nevertheless crucial to containing its spread.1 Among a growing list of COVID-19 symptoms, fever (defined as a body temperature above 100.4°F/38°C) is one of the tell–tale symptoms of infection.2 As the pandemic has gained momentum, government agencies and corporations are increasingly turning to fever checks as a mechanism for gauging the potential presence of SARS–CoV-2 among citizens, travelers, and employees. This includes using traditional thermometers as well as infrared cameras that assess internal temperature by measuring the energy emanating from the inner corner of the eye and running the data through a machine learning algorithm—technologies that have been used with limited success in previous pandemics.3 Such remote thermal detection would be particularly useful in situations where it is impractical to take individuals’ temperature (such as in a crowd), but existing studies cast doubt on the ability of these technologies to accurately and consistently measure core temperature.4 Fever check technologies are known to misidentify individuals under certain conditions that may elevate core temperature (such as through recent exercise) or lower it (such as having been in the cold for an extended time or having used medicine to mask a fever).5 Additionally, researchers considering the asymptomatic transmission of SARS–CoV-2 and its incubation period alongside data on the sensitivity of thermal scanning technology have estimated that 46 per cent of infected travelers may escape detection.6 Despite the potential inaccuracies and limitations of these technologies, they have been widely adopted for the purpose of detecting COVID-19 symptoms. While the Americans with Disabilities Act prohibits companies in the USA from requiring workers to submit to medical exams, the Equal Employment Opportunity Commission recently announced revised rules that permit employers to take workers’ temperatures regularly and withdraw employment offers if a newly hired worker received a COVID-19 diagnosis.7 Even before that announcement, Amazon had begun supplementing traditional thermometers with thermal cameras to monitor employees’ temperatures at several warehouse locations, as well as to check for fevers among employees and customers at their Whole Foods stores.8 Anyone flagged as febrile must undergo a second forehead thermometer check to verify temperature. At the time of this writing, other examples of mandatory fever checks have ranged from several cruise lines9 and grocery stores,10 to jails,11 co-working spaces,12 the White House,13 statewide employee testing,14 numerous cloud technology firms,15 hospitals,16 hotels,17 and some European borders.18 Liechtenstein has partnered with Swiss researchers to institute a voluntary campaign in which users’ wearable bracelet technology will collect temperature (as well as breathing and heart rate) data to monitor and curb coronavirus transmission.19 Emirates Airlines is even conducting blood tests (for SARS–CoV-2 antibodies), along with temperature and heart and respiratory rate monitoring, on prospective passengers prior to boarding.20 In China, which experienced the earliest wave of infections, state law enforcement agents have conducted temperature checks at highway checkpoints,21 and in some cases state officers have forcibly entered private residences to perform these checks.22 In South Korea, officials have begun conducting fever checks and limiting travel certificates to the USA only for those who registered a body temperature below 99.5°F/37.5°C.23 Thailand also recently employed fever-detecting cameras into its biometric border screening system to measure travelers’ temperatures and notify border officers of febrile individuals.24 Clearly, fever check technology—particularly remote fever detection—is becoming ubiquitous throughout the post-COVID-19 world. In such exceptional times, one could argue that fever checks offer substantial population health benefits with limited long-term impacts on personal privacy. Yet, several private companies have integrated thermal imaging with facial recognition technology. Despite the aforementioned limitations of thermal detection technology and known shortfalls of facial recognition technology,25 firms around the world are marketing such multimodal biometric technologies as effective tools for combating the pandemic. Collectively these companies’ claims, which have yet to be systematically evaluated in the empirical literature, suggest clear benefits of combining thermal detection with facial recognition capabilities to detect and track potentially infected individuals. For example, police in China are currently using devices from Hanwang Technology that claim to identify an individual’s name within a second upon detecting a temperature over 99.5°F/37.5°C.26 The company claims that the technology is 95 per cent accurate, even in a group of 30 individuals or among people wearing masks.27 China-based firms SenseTime and Sunell are also selling similar technology.28 Sunell recently unveiled a body temperature detection network camera that they assert is able to identify individuals, collect real-time biometric data, and trigger a warning system upon detecting an unusual temperature.29 Additionally, Chinese startup Rokid has developed multimodal biotechnology that includes thermal-imaging wearable glasses, a technology they are currently marketing to US hospitals and local municipalities.30 These smart glasses, which Rokid suggests can be paired with facial recognition software, use an infrared sensor that Rokid claims can detect temperatures of up to 200 people as far away as 3 m, and they are already being used in China in national parks, schools, and by national authorities.31 In Singapore, Ramco Innovation Lab is promoting its integrated thermal imaging and facial recognition technology to launch an attendance tracking system that will ostensibly enable organizations to track employees and visitors with elevated temperatures.32 This multimodal technology includes contact tracing that sends notifications to event attendees if any person exhibits COVID-19 symptoms and uses facial recognition to capture both an employee’s presence and their temperature. A visitors feature also sends notifications to management when anyone with an elevated temperature enters the premises.33 The company touts that this contactless tracking system can be integrated with sliding doors, kiosks, and turnstiles to mitigate SARS–CoV-2 exposure by restricting access based on temperature range and recommending testing of flagged individuals, and they will share contract-tracing data with health agencies if mandated by the government.34 Beyond Asia, Australia recently reached a deal with drone manufacturer Draganfly to develop ‘pandemic drones’ equipped with thermal recognition technology that they say can monitor temperatures, heart rates, and respiratory patterns, as well as sneezing and coughing in coronavirus hotspots.35 In the UK, Silent Sentinel is marketing a line of what they describe as highly sensitive, high-resolution fever detection cameras that can be deployed as a standalone system or part of a network to conduct precise temperature detection and profiling.36 In Italy, the government recently purchased kits from Beijing-based biotechnology company Polysense with optional integrated thermal facial recognition technology to monitor populations at airports, train stations, schools, shopping centers, and on public transportation to aid COVID-19 containment efforts.37 The Polysense devices also purport to offer optional biometric features, including infrared technology, the ability to store up to 65,000 facial images, and integrated gate and door access protocols.38 While studies suggest that multimodal biometric systems increase overall identification accuracy compared with individual component technologies, their deployment has been limited historically by cost constraints.39 As the examples listed above indicate, however, the rapid progression of the current coronavirus pandemic has sufficiently alarmed governments, corporations, and other institutions to justify aggressive investment in such technologies. Within this emergency context, it may seem reasonable to integrate thermal scanning with facial recognition technology as an effective and efficient means to identify and track infected individuals.40 We argue, however, that the emergence of this type of multimodal biometric system blurs the lines between ‘over-the-skin’ and ‘under-the-skin’ surveillance in ways that demand closer scrutiny and potential regulation. 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Natta et al. (2020) studied this question.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: