1 Introduction

The COVID-19 pandemic has precipitated the first real opportunity to test the efficacy of the Responsible Research and Innovation framework (RRI) in a global health crisis. Although the European Commission has promoted RRI since 2011, little is known about the application of RRI approaches in a health crisis. This is especially important as high levels of both infection and death, along with the difficulty in finding a completely successful treatment for COVID-19, has paved the way for bold new approaches to health research and innovation. One such approach which has received a lot of attention during the COVID-19 health crisis is digital contact tracing applications (CTA). This chapter provides an extensive assessment of RRI related issues during the development of CTAs, discussing these issues from the experience of four countries – Germany, France, Spain, and the United Kingdom (UK) – and shows that although they did not explicitly use the RRI approach during the development of their CTAs, some of their activities during this period can be mapped to RRI. We ask: ‘What elements of RRI are identifiable in the development of contact tracing apps during the COVID-19 health crisis?

Although contact tracing is a well-established evidence-based public health measure for responding to outbreaks of infectious disease (Riley et al., 2003; World Health Organisation WHO, 2014; Kwok et al., 2019), digital CTAs were first developed in response to COVID-19. They have since raised serious ethical concerns. For example, in response to the planned release of a CTA in the UK, the Nuffield Council on Bioethics (2020) raised twenty questions about this application, including questions on privacy, security and ethics. Similarly, academics at Oxford University have provided 16 questions for the ethical assessment of CTAs (Morley et al., 2020), and tech experts in the United States (U.S) have suggested that this technology raises questions of reliability and inaccuracy of information (Sterman & Brauer, 2020). RRI, we contend, can help to enable a better understanding of the types of concerns highlighted here, and opportunities to mitigate them. Intending to mitigate societal concerns of emerging technologies, the European Commission began promoting RRI to enable a better understanding of unintended impacts of innovation whilst minimising associated ethical issues. RRI suggests that this can be achieved by bringing greater democracy to science and technology through research and innovation processes that emphasise public participation, deliberation, and reflexivity (Von Schomberg, 2011).

This chapter, therefore, highlights the issues around the development of COVID-19 CTAs and draws attention to salient issues regarding RRI in crises. The issues encountered during the development of contact tracing apps by four governments are described and an indication of the implications for the application of RRI in the development of ICTs during health crises is provided.

2 RRI for Crisis Response and Management

Emerging technologies are unpredictable. It is challenging to fully understand the ramifications of their adoption, trajectories, and societal acceptability. Unsurprisingly, a ‘policy vacuum’ (Moor, 1985; Moor, 2005) is commonly present in the governance of emerging technologies. Policies are often crafted in an institutional void without adopting generally accepted rules and norms (Hajer, 2003). To combat such issues in the European science and innovation arena, an approach of RRI was formally proposed by the European Commission (EC) in 2011 and subsequently adopted (European Commission, 2011).

RRI has been described as a ‘transparent, interactive process by which societal actors and innovators become mutually responsive to each other with a view on the ethical acceptability, sustainability, and societal desirability of the innovation process and its marketable products’ (Von Schomberg, 2011). To this end, the EC has promoted several fundamental elements as critical actions for RRI, including public engagement, gender equality, science education, open access, ethics, and governance (European Commission, 2015). Thus, RRI may be characterised by its focus on ethical aspects, meeting societal expectations, and inclusive participation.

As early as 2013, shortly after the formal ratification of the RRI framework, its usefulness as an approach for identifying the profound impacts of technology during crises was recognised. Stilgoe et al. (2013) argued that the 2008 financial crisis, (the most contemporaneous example of a crisis with wide-reaching implications) was an example of disruptive situations where RRI could have made a significant difference. They suggested this because existing governance processes, often premised on formal risk assessment, have done little to identify many of the profound impacts of innovation that have plagued society.

Surprisingly, however, since then, little has been said about using the RRI framework in crises, and only a handful of authors have highlighted its applicability in crisis management. One example is Buscher et al. (2018), who highlight the usefulness of RRI for crisis and disaster risk management, arguing that disaster risk management models are changing from publicly-funded command and control to ‘datafied’ and netcentric approaches with increased monitoring and surveillance, raising profiling and social sorting concerns. They suggest that the application of RRI to the development of information technologies (IT) for crisis and disaster management can help maximise the potential benefit of IT, address social concerns, and ensure social value alignment. To enable this process, they started an initiative that primarily has brought together ‘a critical mass of stakeholders’ for co-creation of principles, knowledge exchange, critical dialogue around controversies and standards for responsible IT research and innovation in disaster risk management.

It has also been suggested that the RRI framework has practical implications for the public health crisis triggered by the Syrian War. Khallouf (2018), who made the call for the urgent application of RRI in this context, suggests that the interdisciplinary collaborative approach which RRI promotes could help ensure that cloud computing systems developed for improving health care delivery are sustainable, ethically acceptable, and socially desirable. During the COVID-19 health crisis, the applicability of RRI has also been recognised. Braun et al. (2020) opened the dialogue on Responsible online Research and Innovation (RoRI) to deliberate on the challenges and socio-ethical opportunities that the use of online tools in place of face-to-face interactions has brought. They maintain that it is vital to consider an RRI perspective on the ‘onlineification of everything’ as it is easy for research to get hijacked by corporate interests leading to an obstruction of inclusive and democratising dynamics. To do this, they suggest that the procedural heuristic proposed by Stilgoe et al. (2013) based on the four dimensions of anticipation, inclusion, reflection, and responsiveness should be used alongside the RRI keys proposed by the EC.

One application of the Responsible Research and Innovation framework during the COVID-19 crisis can be seen in the Human Brain Project (HBP), where it has been foundational in promoting digital inclusiveness when people are required to work from home. Grasenick and Guerrero (2020), who introduced this concept, started ‘i-Include’, an initiative for inclusive digital engagement developed to ensure that no one is left behind when increasing the virtualisation of work, meetings, and association and that issues around diversity are also considered in digital collaborations. To this end, they introduced a set of recommendations for social and family life, stress and anxiety, roles and responsibilities in different career stages, as well as team cohesion and virtual collaboration.

In the context of this discourse, however, one of the most relevant applications of RRI in crises is highlighted by Monteiro et al. (2017), who considered the response to the Zika virus outbreak in Brazil. They maintain that in attempting to respond quickly to emergent health crises, irresponsibility could arise in implementing science and technology. Irresponsibility, they argue, comprises “forms of crisis governance implemented in times of emergency which do not fully engage with the public in ways which may be considered participatory or reflexive, a lack of care for the future, and a lack of reflexiveness about said solutions.” They argue for a balance between vigilance in times of crisis and responsible research and innovation in everyday situations. They highlighted how debates for the adoption of controversial technologies in the health crisis failed to consider pre-existing unequal social relationships and broader socio-political issues.

Nevertheless, their discussion highlighted the failure of crisis governance to engage with the public in participatory and reflexive ways during the development of solutions for the health crisis. This highlights that the ‘transparent, interactive process by which societal actors and innovators become mutually responsive to each other’ for which Von Schomberg (2011) alluded to in his definition of RRI was not applied, resulting in controversial solutions being promoted.

In summary, this analysis shows that RRI for crisis management appears to be characterised by calls or initiatives for wider and more inclusive participation in the management of crisis. The following examples highlight this:

  1. 1.

    Buscher et al. (2018) started an initiative involving a ‘critical mass of stakeholders’ for co-creation and critical dialogue to highlight the usefulness of RRI for crisis and disaster risk management.

  2. 2.

    Khallouf (2018) called for interdisciplinary collaboration to develop cloud computing systems in response to the health crisis triggered by the Syrian War.

  3. 3.

    Monteiro et al. (2017) highlighted the failure of crisis governance to engage with the public in participatory and reflexive ways and called for more to be done in this area.

  4. 4.

    An initiative for inclusive digital engagement was started in a large interdisciplinary project to help address issues of participation for those working from home during the COVID-19 pandemic (Grasenick & Guerrero, 2020); and

  5. 5.

    Braun et al. (2020) highlighted how corporate interests could lead to an obstruction of inclusive and democratising dynamics.

Inclusive participation features prominently in the definition of RRI, dimensions of RRI, and the RRI keys proposed by the EC. This indicates the importance of highly inclusive processes for responsible innovation. This chapter expands on Monteiro et al.’s (2017) approach by assessing how anticipation, inclusive participation and reflexivity may have affected the development of CTAs.

3 Contact Tracing and the Move to CTAs

Contact tracing, alongside testing and vaccination, is a critical approach for infectious disease case management. It is used to identify, isolate and provide support to individuals who have been in contact with people with infectious diseases of concern such as smallpox, tuberculosis, Ebola (Crook et al., 2017) and STDs (Hogben et al., 2016). The logic behind contact tracing is that when a person tests positive for infectious disease, possible contacts are identified, notified and advised on any additional medical interventions. Conventionally, this was done via interviewing the index case followed by telephone calls or visits to the identified contacts. For several reasons, digital contact tracing has been heralded as pivotal in the fight against COVID-19. First, COVID-19 has a very high infection rate and has “tricky and complex mechanisms that have facilitated its rapid and catastrophic spread worldwide” (Pitlik, 2020). This makes it necessary to adopt faster means of breaking the chain of transmission. Second, the availability of technologies such as mobile and internet services, AI, Machine learning and other data-driven tools can help healthcare systems to achieve faster contact tracing to match the rate of infection (van der Schaar et al., 2021; Cave et al., 2021). The deployment of these tools at speed and scale for contact tracing has significantly accelerated since the global spread of COVID-19. The aim is to break the human-to-human transmission chain and allow for targeted public health measures considering pre-symptomatic and asymptomatic transmission possibilities (World Health Organization, 2020a).

Digital tools developed to assist contact tracing vary widely. They include proximity tracing tools, CCTV with facial recognition (FR) and geolocation-quick response code (GEO-QR) tagging systems. Proximity tracing is based on the use of GPS (Silveira, 2021), Bluetooth (Hatke et al., 2020) or ultrasound (Cranor, 2020) technologies that can record movements of individuals and who they have come in contact with. This means that when a person tests positive, people who may have been exposed may be traced, found and notified. The underlying logic is that the risk of exposure depends on the probability of coming into close or frequent contact with the infected person (World Health Organization, 2020b). Several countries (such as China, Russia and South Korea) have utilised facial recognition technology for COVID-19 contact tracing (Ramos, 2020). This level of surveillance requires that the identity of a positive patient is embedded into a biometric database and FR software run over live camera feeds or still images (Berman et al., 2020). This can be used to actively monitor confirmed cases or exposed persons who are self-isolating. QR code scanning technology underpins contact tracing efforts in countries such as Malaysia, Australia and New Zealand (Jahmunah et al., 2021). This requires placing a QR code at a venue and asking people to scan the code with a mobile phone to tag their visit (Nakamoto et al., 2020). Either centralized or decentralized communication protocols shape these digital approaches.

During the early development of CTA’s one of the protocols that became popular for systems using centralised servers is the Pan-European Privacy-Preserving Proximity Tracing (PEPP-PT). Although few countries have successfully developed CTAs based on this protocol, in April of 2020 at least eight countries including France, Spain and Germany backed the project developing this protocol. Whilst Germany and Spain pulled out of the PEPP-PT project, France went ahead in developing a CTA called StopCOVID in June 2020 using a variant of PEPP-PT referred to as ROBERT (Robust and Privacy Preserving Proximity Tracing) protocol (O’Brien, 2020). However, France discontinued it a few months later due to a host of problems, including poor download numbers and inefficiency of the app (Schechner, 2020). A revamped version of the app called TousAntiCOVID was launched in October 2020, and by June 2021, it had been downloaded by about 26% of France’s population of 67.39 million (World Bank, 2021).

Around the same period (April 2020), the popular protocols for CTAs using decentralised servers were the Decentralised Privacy-Preserving Proximity Tracing (DP-3T) protocol and the Google Apple Exposure Notification System (GAEN). While DP-T3 was developed by an independent group of tech experts based mainly in Europe, GAEN was developed through a collaborative effort of the tech giants Apple and Google, yet it is widely considered a variant of DP-T3.

After Germany and Spain pulled out of the PEPP-PT project, they later opted to use the GAEN API (Application Programming Interface) for their apps. Germany launched its corona-warn app in June 2020 and a year later, it had been downloaded by about 35% of the German population. Conversley, Spain’s CTA RadarCOVID was released in August 2020. By June 2021, it had been downloaded by about 15% of the population (RadarCOVID, 2021). In the UK, attempts were made to create a CTA based on proprietary centralised protocols that were developed in-house. This NHSx app was discontinued and never launched for public use after trials (including one on the Isle of Wight in March and April 2020) showed that the app was highly inefficient and unpopular due to several issues, including privacy concerns (White, 2021). A separate version called NHS COVID-19 app was developed with the GAEN system and launched in England and Wales in September 2020 has been downloaded by 43.37% of the population (NHS, 2021). Table 4.1

Table 4.1 Comparison of population and download statistics
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below provides an overview of some of these developments.

4 Methodology

To enable a detailed understanding of the issues surrounding the development and use of CTAs, a Multivocal Literature Review (MLR) approach was applied. MLR is a systematic literature review that includes grey literature (GL) alongside peer-reviewed articles (Garousi et al., 2019). Ogawa and Malen (1991), who developed this methodology, describe multivocal literature as “all accessible writings on a common, often contemporary topic” which embody the voices or views of a diverse set of authors, including academics, practitioners, journalists, policy centres, independent research and development firms, state offices etc.

MLR has been utilised in a variety of fields, including software engineering (Garousi et al., 2019), education (Ogawa & Malen, 1991), management (Adams et al., 2017), finance, and health science (Saleh et al., 2014; Tarhan et al., 2020). Yet its application in Information Systems (IS) research is relatively new. The contemporary nature of many IS studies and the growing use of grey literature as a means for communication and dissemination means that other forms of systematic literature review underutilise this valuable source of information. By applying the MLR approach, this chapter also seeks to take advantage of the diversity of material produced outside the academic peer-reviewed process. Furthermore, the emerging nature of the COVID-19 health crisis means that adequate, relevant data may be unavailable for this study if traditional data sources are relied upon.

However, there are challenges in dealing with grey literature that must be acknowledged, including lacking an extensive peer-review process like scientific publications, limitations in scientific rigour, and limited methodological descriptions in grey literature that enable an evaluation of the quality of the research process (Adams et al., 2017). Given these challenges, Garousi et al. (2019) developed a Taxonomy for multivocal literature designed to minimise these issues by recognising four categories of literature based on the expertise involved, credibility, and publisher control (see Fig. 4.1).

Fig. 4.1
figure 1

Classes of multivocal literature (adapted from Garousi et al., 2019)

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Figure 4.1 shows a spectrum of four colours of increasing darkness plotted on two axes representing outlet control and source expertise. Outlet control is described as the extent of moderation or conformance with explicit and transparent knowledge creation criteria. Source expertise is the extent to which the authority of the content producer can be determined and is a measure of the author’s credibility (Adams et al., 2017). Based on these dimensions, peer-reviewed journals are represented in white, with increasing tiers representing ever lower outlet control and credibility.

These findings are primarily based on ‘white literature’ and include tier 1 and tier 2 grey literature. The procedure followed is primarily based on the guidelines for MLR developed by Garousi et al. (2019), itself adapted from the guidelines for systematic literature reviews provided by Kitchenham and Charters (2007). It includes specifying the research question(s), developing and evaluating the review protocol, search process and source selection, study quality assessment, data extraction, and data synthesis. One of the ways that MLR was utilised for this chapter was to understand the gaps in the literature on doing RRI in a health crisis. The research question identified in this case was ‘what is known from the existing literature about doing RRI in a health crisis?’

This was an important question because the nature of health crises means that rapid solutions are sought and often involve the development and deployment of new digital technologies. Stahl (2020) argues that although these technologies are usually well-intentioned, they are generally potentially problematic, and RRI may provide a valuable approach for addressing such problems. Thus, a literature search was carried out on the Scopus abstract and citation database and Google. These databases were selected because of their size, scope, user-friendliness, search simplicity, and institutional support for Scopus. The search strategy used to determine what the existing literature says about RRI in a health crisis used the keywords “Responsible Research and Innovation OR RRI and crisis” covering the period 2011 to 2021. The literature search goes back to 2011 (before COVID-19 developed in 2019) to consider relevant RRI years and other crises during this period, e.g. ZIKA Virus (Díaz-Menéndez & Crespillo-Andújar, 2017), MERS (WHO, 2015) and EBOLA (Quaglio et al., 2016). Articles without reference to the relevant themes in their titles or abstracts were eliminated, and the remaining were read in full to capture the full scope.

Of the 50 articles that resulted from this strategy, 6 articles in Scopus were found to have some relationship to the question of existing literature on RRI in crisis. After eliminating duplicates, 1 additional article was found via Google. However, three of these articles (Carrier & Irzik, 2019; Stilgoe et al., 2013; Buscher et al., 2018) focused on subjects unrelated to health crises. As outlined earlier, the strategy for this chapter also includes determining how four European countries have responded to the development of CTAs to capture the interaction of factors and events. The four countries are Germany, Spain, the UK, and France.

The countries were selected because they are the biggest funders of the Horizon 2020 Framework Work Programme, which is the EU primary mechanism for funding RRI related activities in Europe. RRI is a cross-cutting issue in Horizon 2020. Therefore, the most prominent funders (who are also amongst the wealthiest countries in Europe) are likely to have the highest capacity for RRI related activities. According to the European Commission (2020), these countries rank the top four based on contribution rates and participation in Horizon 2020. A similar search strategy was used in both Google and Scopus. The terms used were ‘country name OR adjective’ AND COVID-19 AND “Contact Tracing app”. For example, for Spain, the search term was Spain OR Spanish AND COVID-19 AND “Contact Tracing app”. A total of 80 relevant articles were found; grey literature constituted 26, the others were journal articles. The findings provide an understanding of the activities of four countries during the development and deployment of CTAs that can be classified using the dimensions of RRI.

5 Elements of RRI in the Development of Contact Tracing Apps

To understand the activities that can be mapped to RRI during the COVID-19 pandemic, three dimensions of RRI (anticipation, reflexivity, and inclusive public participation) were considered. Anticipation is a key dimension of RRI that Stilgoe et al. (2013) argue involves systematically thinking of opportunities to develop socially robust research. This requires researchers and organisations to consider what is known, likely, and plausible. Furthermore, they maintain that ‘reflexivity at the level of institutional practice means holding a mirror up to one’s activities, commitments and assumptions, being aware of limits of knowledge and being mindful that a particular framing of an issue may not be universally held’. Finally, they argue that researchers and organisations must move beyond engagement with stakeholders to include the broader public for inclusive participation, which they also link to the provision of clear communication of the nature and purpose of the project and mechanisms for understanding public and stakeholder views.

Although there was no explicit evidence found that shows the RRI was addressed during the development of the CTAs in France, the UK, Spain, and Germany, the literature review has identified some interesting linkages to this framework. The following highlights the findings of the literature review for the four countries:

France

In France there appears to have been some reflexivity at the governmental level during the development of the StopCOVID app. An instance of this is seen in the Government’s request for a debate on the development and deployment of the app in parliament and to seek the legal advice of the National Commission on Informatics and Liberty - CNIL (CNIL, 2020; Rowe et al., 2020). CNIL is an independent data protection body set up to ensure that data privacy laws are maintained in collecting and using personal data.

The French government also asked the National Pilot Committee for Digital Ethics to reflect on the CTA and issues around digital ethics during the health crisis (National Pilot Committee for Digital Ethics, 2020; Institut Français des Droits et Libertés, 2020). While the government was responsive to most of the advice from these bodies, CNIL (2020) highlights that one issue that the government didn’t anticipate was the generation of false positives due to failure to take the context of contacts being made into account, e.g. the type of protective equipment an individual might have. Rowe et al. (2020) have pointed out other government failings in this regard, maintaining that interventions like the CTA were developed based on incomplete knowledge, there was a lack of readiness for the crisis, and they defaulted to a strategy that relied on executive summaries from the UK’s NHS rather than anticipatory research.

At the development stage of the app, some effort was put towards being inclusive and participatory. The StopCOVID development team comprised several private companies and public institutions (Institut Français des Droits et Libertés, 2020). Nevertheless, Information Systems research findings were not considered in the app’s planning, design, and deployment, and crucial information regarding data collection, privacy, security, and data processing, storage, and reuse was not explained clearly to the public (Rowe et al., 2020). It appears that as many citizens had to rely on other sources of information, their trust in the system waned and acceptance levels for the app dropped from 80% to 44% between March and April 2020 (Guillon & Kergall, 2020). Also, Montagni et al. (2020) who explored reasons for the low uptake of contact tracing apps among university students in the health disciplines, found a limited awareness and a considerable amount of misinformation about the app among this group. These issues raise questions about inclusivity and the participation of the public during the development and deployment of the CTA.

The United Kingdom

In the UK, a similar situation can be seen for the RRI dimensions of anticipation, inclusive participation, and reflexivity. In terms of anticipation, the government anticipated some of the privacy issues that could result from the use of location data from mobile network operators to reveal trends in social mobility, even if such data were aggregated and anonymised. This is because the UK is among the few countries in Europe that decided against collecting and submitting such data to the EC’s Joint Research Centre (European Commission, 2011). Like Denmark, concerns focused on the reversibility of ‘anonymised’ data and potential third-party access. Nevertheless, whilst some level of anticipation of the effect of CTAs on different demographics was considered, Guinchard (2021) argues that the timing of development in the middle of the pandemic raises important questions as to why no consideration was made to develop such apps years earlier.

Ryder et al. (2020) maintain that the UK government engaged with several groups and organisations during the development of CTAs in terms of inclusive participation. These organisations include (i) the National Health Service (NHS); (ii) the Information Commissioner’s Office (ICO); (iii) the National Data Guardian’s Panel; and (iv) patient advocacy groups like ‘Understanding Patient Data’. However, it appears that little dialogue happened early enough, and insufficient effort was put into public communication as the information provided was ‘scattered and vague’ and did not help allay concerns of the problematic impact of the app (Guinchard, 2021; Williams et al., 2021).

Arguing for clear public communication, point out the need for any messaging around the app to be done in such a way as to alleviate fears about surveillance, hacking and to reduce anxiety around the epidemic. Also, McGregor et al. (2020) point out that insufficient information was provided about the operation of the app and its data flows, the legal basis, oversight, accountability, possible future uses of data and impact on human rights, as well as remedies. These issues indicate a disconnect between the development of the app and public engagement, and consequences included lack of information, increasing mistrust of the app, and growing unwillingness to download and use it (Ada Lovelace Institute, 2020b).

After much public backlash, the government showed some reflexivity by agreeing to open up the code used to develop its CTA to the public and published a Data Protection Impact Assessment (DPIA)(Ryder et al., 2020; Guinchard, 2021). However, further issues, including poor data security and privacy controls (Culnane & Teague, 2020), meant that the UK government discontinued the development of a centralised CTA (the NHSx app) and opted instead for the GAEN system (Wise, 2020; Ada Lovelace Institute, 2020a; French et al., 2020). Once again, reflexivity in these cases appears to have been an afterthought predicated on extensive criticism, as many remedial actions could have been taken sooner.

Spain

The publications reviewed convey an impression that Spain has a more limited experience of the activities that can be mapped to RRI than the other countries examined. Although some interesting points are highlighted here, it was challenging to find relevant publications based on the search criteria used and map them to the government’s actions on the RRI dimensions. For anticipation, like the UK, the timing of the app’s development in Spain has been criticised by Zeng et al. (2020), who compare it to countries like Singapore which quickly saw the potential of CTAs and developed them early in the pandemic. One of the press conferences given by Spain’s Interior Minister Grande-Marlaska, who argued for the use of geolocation of citizens’ mobile phones not just for contact tracing but also for policing (Binnie, 2020), shows another poor example of anticipation. This would have been a problematic departure point from previous use of geolocation data in Spain when anonymised, and aggregated mobile phone location data was used to track people’s movement to determine compliance to lockdown rules (Rodriguez-Ferrand, 2020). The government likely wanted to further capitalise on an earlier poll that showed 47% of citizens were willing to share personal information to contain the pandemic (Miláns del Bosch, 2020), but this plan quickly changed public perception.

That the Spanish government decided against using geolocation for policing is an example of reflexivity as they likely realised that their framing of the issues was not universally accepted. Nevertheless, Hernández-Quevedo et al. (2020) point out that as countries like Spain continue to struggle with the difficult balance between effective contact tracing and privacy preservation, there is a need for greater transparency in the collection and use of data to ensure that privacy is prioritised. Furthermore, transparency is closely linked to openness, and this, in turn, may be linked to inclusive public participation. In this regard, Weiß et al. (2021) point out that the Spanish CTA has an open-source repository for its code that acts as a dedicated information hub. Similarly, Raman et al. (2021) suggest that in terms of factors that determine the effectiveness of CTAs, Spain appears to have done quite well in the areas of accessibility and raising awareness.

Germany

Germany appears to have fared little better than France and the UK regarding the activities identified using the outlined RRI components. One example is the push to utilise the PEPP-PT protocol to facilitate digital contact tracing (Walther et al., 2020; Moreno, 2020). This led to intense public backlash (Leith & Farrell, 2020), which may be interpreted as poor anticipation by the government as it failed to consider the societal desirability of such a centralised system especially considering historical issues around surveillance in Germany (Eley, 2016; Schaer, 2019). The government also appears not to have anticipated issues with the use of the app in public transport systems; Leith and Farrell (2020) demonstrate that the apps are ineffective in trams, likely due to the reflection of radio signals from the metal structure. Grill et al. (2021) assessed sociodemographic characteristics of users of CTAs in Germany and found that on the one hand, users of the app were less likely to be female, younger, and to have a lower family income, but on the other, they were more likely to live in one of the Western federal states. This suggests that the government has inadequately anticipated how factors like education, income and region affect usage despite previous studies identifying such problems (McAuley, 2014; Carroll et al., 2017; Latulippe et al., 2017).

This is also significant for inclusive public participation as it raises important questions about the German government’s prioritisation of public engagement during the development of the app (Zimmermann et al., 2021). It must, however, be noted that although the population download rates of the CTA in Germany remains relatively low (Amann et al., 2021; Zimmermann et al., 2021; Blom et al., 2021), Munzert et al. (2021) suggest that considerable awareness of the app was generated and the provision of monetary incentives for downloading the app might be more effective than further awareness-raising. Also, the government has been hailed for its open-source approach, which enables public scrutiny of the apps source code and increased transparency (Sonnekalb et al., 2020; Amann et al., 2021; Weiß et al., 2021). However, Grill et al. (2021) argue there has been a ‘missed communication opportunity’ because many non-users are not aware of the usefulness and effectiveness of the app, and, the government has been criticised for the lack of transparency and clear communication about its purpose and function (Amann et al., 2021). Public outreach by political representatives has been particularly problematic and has created some confusion (Ranisch et al., 2020); in March 2020, Health Minister Jens Spahn commented that the government was trying to extend the German Epidemic Law to enable tracking and surveillance, sparking intense criticism.

One of the best indications of reflexivity on the part of the German Government during the development of its CTA can be seen in its decision to adopt the GAEN Framework despite being one of the biggest state supporters of the PEPP-PT protocol (Walther et al., 2020; Moreno, 2020). Interestingly, this change was precipitated by privacy concerns (Reintjes, 2020), massive criticism (Ranisch et al., 2020), considerable indignation (Grill et al., 2021) and enormous outcry from academics and organisations (Bagchi et al., 2020). Despite this being an example of some reflexivity, it is noteworthy that the decision to change course has been widely criticised, with some questioning the trustworthiness of big tech companies, and others perceiving this as another example of big tech dominance (Amann et al., 2021).

All these paint an interesting picture of activities that have some resemblance to RRI during the development of CTAs. Although few and far between, instances of such activities have been described here, along with the highlighting of situations where there appears to have been failings. The issues identified are illustrated in Table 4.2

Table 4.2 Summary of identified issues classified using RRI dimensions
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.

6 Implications for RRI in Health Crisis Situations

Despite there being no explicit mention of RRI during the development of CTAs in the cases considered here, the analysis has shown that some of the activities during this period can be mapped to RRI. Using RRI as an analytic tool, the chapter has also identified and classified key issues in the process of development of CTAs. For example, none of the governments had anticipated the need for CTAs and was unprepared to rapidly develop and deploy them. In many cases, they did not anticipate societal concerns like those related to privacy and trust. There were also issues with inclusive participation as many felt information about CTAs was poorly communicated and inadequate, and there were problems with public outreach and transparency. Likewise, reflexivity on the governments’ part appears to be mainly due to intense public criticism and backlash and little to do with ‘holding a mirror up to their own activities, commitments and assumptions (Stilgoe et al., 2013)’.

Thus, this chapter has identified issues that could be addressed with the application of RRI during the COVID-19 health crisis. This chapter has also indicated that although little appears to have been said about the opportunities for RRI, an important theme in the discourse on RRI for crisis management is inclusive engagement. This chapter has demonstrated how all previous literature on RRI in crises either called for greater participation or started initiatives to advance participation. Issues around inclusive participation have also featured in the development of CTAs and, along with the other issues identified, may have resulted in low public acceptance of COVID-19 CTAs.

Considering that crises management requires speed (Nickson et al., 2020; Am et al., 2020), the possibility for effectively engaging in inclusive public participation must be questioned, as indeed for other RRI dimensions like anticipation and reflexivity. Anticipatory techniques like foresight, horizon scanning and technology assessment used for looking ahead at the societal impact of technology often involve prolonged periods of assessments and deliberations that are unsuitable in a crisis. This is equally true for institutional reflexivity mechanisms such as codes of conduct, moratoriums, and standards adoption. Despite these challenges, RRI has its uses in a crisis. It has been shown here how it can be used effectively as an analytical tool to identify opportunities for improving techno-social responses to crises and for reflection on the development of emerging technologies in a situation like those created by the COVID-19 pandemic.