Schneier on Security: Tagged medicine

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Me on COVID-19 Contact Tracing Apps

I was quoted in BuzzFeed:

“My problem with contact tracing apps is that they have absolutely no value,” Bruce Schneier, a privacy expert and fellow at the Berkman Klein Center for Internet & Society at Harvard University, told BuzzFeed News. “I’m not even talking about the privacy concerns, I mean the efficacy. Does anybody think this will do something useful? … This is just something governments want to do for the hell of it. To me, it’s just techies doing techie things because they don’t know what else to do.”

I haven’t blogged about this because I thought it was obvious. But from the tweets and emails I have received, it seems not.

This is a classic identification problem, and efficacy depends on two things: false positives and false negatives.

False positives: Any app will have a precise definition of a contact: let’s say it’s less than six feet for more than ten minutes. The false positive rate is the percentage of contacts that don’t result in transmissions. This will be because of several reasons. One, the app’s location and proximity systems—based on GPS and Bluetooth—just aren’t accurate enough to capture every contact. Two, the app won’t be aware of any extenuating circumstances, like walls or partitions. And three, not every contact results in transmission; the disease has some transmission rate that’s less than 100% (and I don’t know what that is).
False negatives: This is the rate the app fails to register a contact when an infection occurs. This also will be because of several reasons. One, errors in the app’s location and proximity systems. Two, transmissions that occur from people who don’t have the app (even Singapore didn’t get above a 20% adoption rate for the app). And three, not every transmission is a result of that precisely defined contact—the virus sometimes travels further.

Assume you take the app out grocery shopping with you and it subsequently alerts you of a contact. What should you do? It’s not accurate enough for you to quarantine yourself for two weeks. And without ubiquitous, cheap, fast, and accurate testing, you can’t confirm the app’s diagnosis. So the alert is useless.

Similarly, assume you take the app out grocery shopping and it doesn’t alert you of any contact. Are you in the clear? No, you’re not. You actually have no idea if you’ve been infected.

The end result is an app that doesn’t work. People will post their bad experiences on social media, and people will read those posts and realize that the app is not to be trusted. That loss of trust is even worse than having no app at all.

It has nothing to do with privacy concerns. The idea that contact tracing can be done with an app, and not human health professionals, is just plain dumb.

EDITED TO ADD: This Brookings essay makes much the same point.

EDITED TO ADD: This post has been translated into Spanish.

Posted on May 1, 2020 at 6:22 AM • View Comments

California Needlessly Reduces Privacy During COVID-19 Pandemic

This one isn’t even related to contact tracing:

On March 17, 2020, the federal government relaxed a number of telehealth-related regulatory requirements due to COVID-19. On April 3, 2020, California Governor Gavin Newsom issued Executive Order N-43-20 (the Order), which relaxes various telehealth reporting requirements, penalties, and enforcements otherwise imposed under state laws, including those associated with unauthorized access and disclosure of personal information through telehealth mediums.

Lots of details at the link.

Posted on April 16, 2020 at 10:34 AM • View Comments

Privacy vs. Surveillance in the Age of COVID-19

The trade-offs are changing:

As countries around the world race to contain the pandemic, many are deploying digital surveillance tools as a means to exert social control, even turning security agency technologies on their own civilians. Health and law enforcement authorities are understandably eager to employ every tool at their disposal to try to hinder the virus even as the surveillance efforts threaten to alter the precarious balance between public safety and personal privacy on a global scale.

Yet ratcheting up surveillance to combat the pandemic now could permanently open the doors to more invasive forms of snooping later.

I think the effects of COVID-19 will be more drastic than the effects of the terrorist attacks of 9/11: not only with respect to surveillance, but across many aspects of our society. And while many things that would never be acceptable during normal time are reasonable things to do right now, we need to makes sure we can ratchet them back once the current pandemic is over.

Cindy Cohn at EFF wrote:

We know that this virus requires us to take steps that would be unthinkable in normal times. Staying inside, limiting public gatherings, and cooperating with medically needed attempts to track the virus are, when approached properly, reasonable and responsible things to do. But we must be as vigilant as we are thoughtful. We must be sure that measures taken in the name of responding to COVID-19 are, in the language of international human rights law, “necessary and proportionate” to the needs of society in fighting the virus. Above all, we must make sure that these measures end and that the data collected for these purposes is not re-purposed for either governmental or commercial ends.

I worry that in our haste and fear, we will fail to do any of that.

TSA Admits Liquid Ban Is Security Theater

The TSA is allowing people to bring larger bottles of hand sanitizer with them on airplanes:

Passengers will now be allowed to travel with containers of liquid hand sanitizer up to 12 ounces. However, the agency cautioned that the shift could mean slightly longer waits at checkpoint because the containers may have to be screened separately when going through security.

Won’t airplanes blow up as a result? Of course not.

Would they have blown up last week were the restrictions lifted back then? Of course not.

It’s always been security theater.

Interesting context:

The TSA can declare this rule change because the limit was always arbitrary, just one of the countless rituals of security theater to which air passengers are subjected every day. Flights are no more dangerous today, with the hand sanitizer, than yesterday, and if the TSA allowed you to bring 12 ounces of shampoo on a flight tomorrow, flights would be no more dangerous then. The limit was bullshit. The ease with which the TSA can toss it aside makes that clear.

All over America, the coronavirus is revealing, or at least reminding us, just how much of contemporary American life is bullshit, with power structures built on punishment and fear as opposed to our best interest. Whenever the government or a corporation benevolently withdraws some punitive threat because of the coronavirus, it’s a signal that there was never any good reason for that threat to exist in the first place.

Posted on March 16, 2020 at 9:31 AM • View Comments

Security of Health Information

The world is racing to contain the new COVID-19 virus that is spreading around the globe with alarming speed. Right now, pandemic disease experts at the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), and other public-health agencies are gathering information to learn how and where the virus is spreading. To do so, they are using a variety of digital communications and surveillance systems. Like much of the medical infrastructure, these systems are highly vulnerable to hacking and interference.

That vulnerability should be deeply concerning. Governments and intelligence agencies have long had an interest in manipulating health information, both in their own countries and abroad. They might do so to prevent mass panic, avert damage to their economies, or avoid public discontent (if officials made grave mistakes in containing an outbreak, for example). Outside their borders, states might use disinformation to undermine their adversaries or disrupt an alliance between other nations. A sudden epidemic—when countries struggle to manage not just the outbreak but its social, economic, and political fallout—is especially tempting for interference.

In the case of COVID-19, such interference is already well underway. That fact should not come as a surprise. States hostile to the West have a long track record of manipulating information about health issues to sow distrust. In the 1980s, for example, the Soviet Union spread the false story that the US Department of Defense bioengineered HIV in order to kill African Americans. This propaganda was effective: some 20 years after the original Soviet disinformation campaign, a 2005 survey found that 48 percent of African Americans believed HIV was concocted in a laboratory, and 15 percent thought it was a tool of genocide aimed at their communities.

More recently, in 2018, Russia undertook an extensive disinformation campaign to amplify the anti-vaccination movement using social media platforms like Twitter and Facebook. Researchers have confirmed that Russian trolls and bots tweeted anti-vaccination messages at up to 22 times the rate of average users. Exposure to these messages, other researchers found, significantly decreased vaccine uptake, endangering individual lives and public health.

Last week, US officials accused Russia of spreading disinformation about COVID-19 in yet another coordinated campaign. Beginning around the middle of January, thousands of Twitter, Facebook, and Instagram accounts—many of which had previously been tied to Russia—had been seen posting nearly identical messages in English, German, French, and other languages, blaming the United States for the outbreak. Some of the messages claimed that the virus is part of a US effort to wage economic war on China, others that it is a biological weapon engineered by the CIA.

As much as this disinformation can sow discord and undermine public trust, the far greater vulnerability lies in the United States’ poorly protected emergency-response infrastructure, including the health surveillance systems used to monitor and track the epidemic. By hacking these systems and corrupting medical data, states with formidable cybercapabilities can change and manipulate data right at the source.

Here is how it would work, and why we should be so concerned. Numerous health surveillance systems are monitoring the spread of COVID-19 cases, including the CDC’s influenza surveillance network. Almost all testing is done at a local or regional level, with public-health agencies like the CDC only compiling and analyzing the data. Only rarely is an actual biological sample sent to a high-level government lab. Many of the clinics and labs providing results to the CDC no longer file reports as in the past, but have several layers of software to store and transmit the data.

Potential vulnerabilities in these systems are legion: hackers exploiting bugs in the software, unauthorized access to a lab’s servers by some other route, or interference with the digital communications between the labs and the CDC. That the software involved in disease tracking sometimes has access to electronic medical records is particularly concerning, because those records are often integrated into a clinic or hospital’s network of digital devices. One such device connected to a single hospital’s network could, in theory, be used to hack into the CDC’s entire COVID-19 database.

In practice, hacking deep into a hospital’s systems can be shockingly easy. As part of a cybersecurity study, Israeli researchers at Ben-Gurion University were able to hack into a hospital’s network via the public Wi-Fi system. Once inside, they could move through most of the hospital’s databases and diagnostic systems. Gaining control of the hospital’s unencrypted image database, the researchers inserted malware that altered healthy patients’ CT scans to show nonexistent tumors. Radiologists reading these images could only distinguish real from altered CTs 60 percent of the time—and only after being alerted that some of the CTs had been manipulated.

Another study directly relevant to public-health emergencies showed that a critical US biosecurity initiative, the Department of Homeland Security’s BioWatch program, had been left vulnerable to cyberattackers for over a decade. This program monitors more than 30 US jurisdictions and allows health officials to rapidly detect a bioweapons attack. Hacking this program could cover up an attack, or fool authorities into believing one has occurred.

Fortunately, no case of healthcare sabotage by intelligence agencies or hackers has come to light (the closest has been a series of ransomware attacks extorting money from hospitals, causing significant data breaches and interruptions in medical services). But other critical infrastructure has often been a target. The Russians have repeatedly hacked Ukraine’s national power grid, and have been probing US power plants and grid infrastructure as well. The United States and Israel hacked the Iranian nuclear program, while Iran has targeted Saudi Arabia’s oil infrastructure. There is no reason to believe that public-health infrastructure is in any way off limits.

Despite these precedents and proven risks, a detailed assessment of the vulnerability of US health surveillance systems to infiltration and manipulation has yet to be made. With COVID-19 on the verge of becoming a pandemic, the United States is at risk of not having trustworthy data, which in turn could cripple our country’s ability to respond.

Under normal conditions, there is plenty of time for health officials to notice unusual patterns in the data and track down wrong information—if necessary, using the old-fashioned method of giving the lab a call. But during an epidemic, when there are tens of thousands of cases to track and analyze, it would be easy for exhausted disease experts and public-health officials to be misled by corrupted data. The resulting confusion could lead to misdirected resources, give false reassurance that case numbers are falling, or waste precious time as decision makers try to validate inconsistent data.

In the face of a possible global pandemic, US and international public-health leaders must lose no time assessing and strengthening the security of the country’s digital health systems. They also have an important role to play in the broader debate over cybersecurity. Making America’s health infrastructure safe requires a fundamental reorientation of cybersecurity away from offense and toward defense. The position of many governments, including the United States’, that Internet infrastructure must be kept vulnerable so they can better spy on others, is no longer tenable. A digital arms race, in which more countries acquire ever more sophisticated cyberattack capabilities, only increases US vulnerability in critical areas such as pandemic control. By highlighting the importance of protecting digital health infrastructure, public-health leaders can and should call for a well-defended and peaceful Internet as a foundation for a healthy and secure world.

This essay was co-authored with Margaret Bourdeaux; a slightly different version appeared in Foreign Policy.

EDITED TO ADD: On last week’s squid post, there was a big conversation regarding the COVID-19. Many of the comments straddled the line between what are and aren’t the the core topics. Yesterday I deleted a bunch for being off-topic. Then I reconsidered and republished some of what I deleted.

Going forward, comments about the COVID-19 will be restricted to the security and risk implications of the virus. This includes cybersecurity, security, risk management, surveillance, and containment measures. Comments that stray off those topics will be removed. By clarifying this, I hope to keep the conversation on-topic while also allowing discussion of the security implications of current events.

Thank you for your patience and forbearance on this.

Posted on March 5, 2020 at 6:10 AM • View Comments

Attacker Causes Epileptic Seizure over the Internet

This isn’t a first, but I think it will be the first conviction:

The GIF set off a highly unusual court battle that is expected to equip those in similar circumstances with a new tool for battling threatening trolls and cyberbullies. On Monday, the man who sent Eichenwald the moving image, John Rayne Rivello, was set to appear in a Dallas County district court. A last-minute rescheduling delayed the proceeding until Jan. 31, but Rivello is still expected to plead guilty to aggravated assault. And he may be the first of many.

The Epilepsy Foundation announced on Monday it lodged a sweeping slate of criminal complaints against a legion of copycats who targeted people with epilepsy and sent them an onslaught of strobe GIFs—a frightening phenomenon that unfolded in a short period of time during the organization’s marking of National Epilepsy Awareness Month in November.

[…]

Rivello’s supporters—among them, neo-Nazis and white nationalists, including Richard Spencer—have also argued that the issue is about freedom of speech. But in an amicus brief to the criminal case, the First Amendment Clinic at Duke University School of Law argued Rivello’s actions were not constitutionally protected.

“A brawler who tattoos a message onto his knuckles does not throw every punch with the weight of First Amendment protection behind him,” the brief stated. “Conduct like this does not constitute speech, nor should it. A deliberate attempt to cause physical injury to someone does not come close to the expression which the First Amendment is designed to protect.”

Another article.

EDITED TO ADD(12/19): More articles.

EDITED TO ADD (1/14): There was a similar case in Germany in 2012—that attacker was convicted.

Posted on December 18, 2019 at 5:34 AM • View Comments

Cardiac Biometric

MIT Technology Review is reporting about an infrared laser device that can identify people by their unique cardiac signature at a distance:

A new device, developed for the Pentagon after US Special Forces requested it, can identify people without seeing their face: instead it detects their unique cardiac signature with an infrared laser. While it works at 200 meters (219 yards), longer distances could be possible with a better laser. “I don’t want to say you could do it from space,” says Steward Remaly, of the Pentagon’s Combatting Terrorism Technical Support Office, “but longer ranges should be possible.”

Contact infrared sensors are often used to automatically record a patient’s pulse. They work by detecting the changes in reflection of infrared light caused by blood flow. By contrast, the new device, called Jetson, uses a technique known as laser vibrometry to detect the surface movement caused by the heartbeat. This works though typical clothing like a shirt and a jacket (though not thicker clothing such as a winter coat).

[…]

Remaly’s team then developed algorithms capable of extracting a cardiac signature from the laser signals. He claims that Jetson can achieve over 95% accuracy under good conditions, and this might be further improved. In practice, it’s likely that Jetson would be used alongside facial recognition or other identification methods.

Wenyao Xu of the State University of New York at Buffalo has also developed a remote cardiac sensor, although it works only up to 20 meters away and uses radar. He believes the cardiac approach is far more robust than facial recognition. “Compared with face, cardiac biometrics are more stable and can reach more than 98% accuracy,” he says.

I have my usual questions about false positives vs false negatives, how stable the biometric is over time, and whether it works better or worse against particular sub-populations. But interesting nonetheless.

Posted on July 8, 2019 at 12:38 PM • View Comments

Fake News and Pandemics

When the next pandemic strikes, we’ll be fighting it on two fronts. The first is the one you immediately think about: understanding the disease, researching a cure and inoculating the population. The second is new, and one you might not have thought much about: fighting the deluge of rumors, misinformation and flat-out lies that will appear on the internet.

The second battle will be like the Russian disinformation campaigns during the 2016 presidential election, only with the addition of a deadly health crisis and possibly without a malicious government actor. But while the two problems—misinformation affecting democracy and misinformation affecting public health—will have similar solutions, the latter is much less political. If we work to solve the pandemic disinformation problem, any solutions are likely to also be applicable to the democracy one.

Pandemics are part of our future. They might be like the 1968 Hong Kong flu, which killed a million people, or the 1918 Spanish flu, which killed over 40 million. Yes, modern medicine makes pandemics less likely and less deadly. But global travel and trade, increased population density, decreased wildlife habitats, and increased animal farming to satisfy a growing and more affluent population have made them more likely. Experts agree that it’s not a matter of if—it’s only a matter of when.

When the next pandemic strikes, accurate information will be just as important as effective treatments. We saw this in 2014, when the Nigerian government managed to contain a subcontinentwide Ebola epidemic to just 20 infections and eight fatalities. Part of that success was because of the ways officials communicated health information to all Nigerians, using government-sponsored videos, social media campaigns and international experts. Without that, the death toll in Lagos, a city of 21 million people, would have probably been greater than the 11,000 the rest of the continent experienced.

There’s every reason to expect misinformation to be rampant during a pandemic. In the early hours and days, information will be scant and rumors will abound. Most of us are not health professionals or scientists. We won’t be able to tell fact from fiction. Even worse, we’ll be scared. Our brains work differently when we are scared, and they latch on to whatever makes us feel safer—even if it’s not true.

Rumors and misinformation could easily overwhelm legitimate news channels, as people share tweets, images and videos. Much of it will be well-intentioned but wrong—like the misinformation spread by the anti-vaccination community today —but some of it may be malicious. In the 1980s, the KGB ran a sophisticated disinformation campaign —Operation Infektion —to spread the rumor that HIV/AIDS was a result of an American biological weapon gone awry. It’s reasonable to assume some group or country would deliberately spread intentional lies in an attempt to increase death and chaos.

It’s not just misinformation about which treatments work (and are safe), and which treatments don’t work (and are unsafe). Misinformation can affect society’s ability to deal with a pandemic at many different levels. Right now, Ebola relief efforts in the Democratic Republic of Congo are being stymied by mistrust of health workers and government officials.

It doesn’t take much to imagine how this can lead to disaster. Jay Walker, curator of the TEDMED conferences, laid out some of the possibilities in a 2016 essay: people overwhelming and even looting pharmacies trying to get some drug that is irrelevant or nonexistent, people needlessly fleeing cities and leaving them paralyzed, health workers not showing up for work, truck drivers and other essential people being afraid to enter infected areas, official sites like CDC.gov being hacked and discredited. This kind of thing can magnify the health effects of a pandemic many times over, and in extreme cases could lead to a total societal collapse.

This is going to be something that government health organizations, medical professionals, social media companies and the traditional media are going to have to work out together. There isn’t any single solution; it will require many different interventions that will all need to work together. The interventions will look a lot like what we’re already talking about with regard to government-run and other information influence campaigns that target our democratic processes: methods of visibly identifying false stories, the identification and deletion of fake posts and accounts, ways to promote official and accurate news, and so on. At the scale these are needed, they will have to be done automatically and in real time.

Since the 2016 presidential election, we have been talking about propaganda campaigns, and about how social media amplifies fake news and allows damaging messages to spread easily. It’s a hard discussion to have in today’s hyperpolarized political climate. After any election, the winning side has every incentive to downplay the role of fake news.

But pandemics are different; there’s no political constituency in favor of people dying because of misinformation. Google doesn’t want the results of peoples’ well-intentioned searches to lead to fatalities. Facebook and Twitter don’t want people on their platforms sharing misinformation that will result in either individual or mass deaths. Focusing on pandemics gives us an apolitical way to collectively approach the general problem of misinformation and fake news. And any solutions for pandemics are likely to also be applicable to the more general —and more political —problems.

Pandemics are inevitable. Bioterror is already possible, and will only get easier as the requisite technologies become cheaper and more common. We’re experiencing the largest measles outbreak in 25 years thanks to the anti-vaccination movement, which has hijacked social media to amplify its messages; we seem unable to beat back the disinformation and pseudoscience surrounding the vaccine. Those same forces will dramatically increase death and social upheaval in the event of a pandemic.

Let the Russian propaganda attacks on the 2016 election serve as a wake-up call for this and other threats. We need to solve the problem of misinformation during pandemics together— governments and industries in collaboration with medical officials, all across the world —before there’s a crisis. And the solutions will also help us shore up our democracy in the process.

This essay previously appeared in the New York Times.

Posted on June 21, 2019 at 5:10 AM • View Comments

Maliciously Tampering with Medical Imagery

In what I am sure is only a first in many similar demonstrations, researchers are able to add or remove cancer signs from CT scans. The results easily fool radiologists.

I don’t think the medical device industry has thought at all about data integrity and authentication issues. In a world where sensor data of all kinds is undetectably manipulatable, they’re going to have to start.

Research paper. Slashdot thread.

Posted on April 12, 2019 at 11:13 AM • View Comments