News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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In Australia, Pathology Profession Receives Recognition for Performing 12 Million COVID-19 Tests, Equal to About Half the Country’s Population

Royal College of Pathologists of Australia says the pandemic is ‘suppressed’ to ‘intermittent’ outbreaks, thanks to the dedication of thousands of pathologists, medical scientists, and laboratory professionals

COVID-19 efforts in Australia have achieved a milestone. Pathology laboratories there have performed more than 12 million SARS-CoV-2 tests since the pandemic began. That is an impressive feat and is equal to about half the country’s population of 25.4 million people.

In a column for ABC News, Dr. Debra Graves, MBBS, Chef Executive Officer, Royal College of Pathologists of Australia (RCPA) and Dr. Lawrie Bott, MBBS, Vice President of RCPA, and Chief Medical Officer of Sonic Pathology Australia, described the accomplishment. “Never before has pathology testing made such a clear contribution to the well-being of the community as during this pandemic,” they wrote.

“It is an incredible feat,” they continued. “Australia’s current position of having effectively suppressed the virus to intermittent outbreaks owes much to the year-long dedication and ingenuity of 35,000 pathologists, medical scientists, lab technicians, couriers, phlebotomists, and ancillary personnel.”

Australia Pathology Society Recognizes Accomplishments

Furthermore, Graves and Bott wrote, pathology in Australia deserves recognition for these pandemic-related accomplishments, among others, as well:

Quick Responses to COVID-19 in the Land Down Under

The Doherty Institute (a joint venture of the University of Melbourne and the Royal Melbourne Hospital) offers research, teaching, public health and reference lab services, diagnostics, and clinical care for infectious diseases and immunity.

After receiving the patient sample on Jan. 24, 2020, institute scientists were the first outside China to grow the coronavirus in cell culture, noted a University of Melbourne news release.

Dr. Mike Catton of Doherty Institute putting on a white laboratory coat and safety goggles
“We’ve planned for an incident like this for many, many years, and that’s really why we were able to get an answer so quickly,” Dr. Mike Catton (above), Co-Deputy Director, Doherty Institute and Director of the Victorian Infectious Diseases Reference Laboratory (VIDRL), said in the news release. (Photo copyright: ABC News.)

Doherty Institute researchers also were first to report on immune response to COVID-19, according to a second news release.

Their paper in Nature Medicine, titled, “Breadth of Concomitant Immune Responses Prior to Patient Recovery: A Case Report of Non-Severe COVID-19,” describes the immune response in a 47-year-old COVID-19 positive female who traveled from Wuhan, China, and presented in an emergency department in Melbourne.

Australian researchers were able to respond quickly by using the Sentinel Travelers and Research Preparedness Platform for Emerging Infectious Disease (SETREP-ID) at Royal Melbourne Hospital.

“When COVID-19 emerged, we already had ethics and protocols in place so we could rapidly start looking at the virus and immune system in great deal,” Dr. Irani Thevarajan, Infectious Disease Physician, Doherty Institute, Royal Melbourne Hospital, said in the second news release.

“Our study provides novel contributions to the understanding and kinetics of immune responses during a non-severe case of COVID-19. This patient did not experience complications of respiratory failure or acute respiratory distress syndrome, did not require supplemental oxygenation, and was discharged within a week of hospitalization, consistent with non-severe but symptomatic disease,” Thevarajan and co-authors wrote in Nature Medicine.

Drive-Through COVID-19 Testing Sites in Australia

Also impressive was Australia’s launch of drive-through COVID-19 testing on March 9, 2020, before the pandemic was declared by WHO on March 11.

The COVID-19 testing site in Adelaide, South Australia, was “believed to be a first for the country’s public health system,” ABC News reported.

Was it the first worldwide? Possibly. In “Sean Penn’s Foundation Partners with Healthcare Providers in Four States to Offer Drive-Thru COVID-19 Molecular and Serological Clinical Laboratory Specimen Collections,” Dark Daily reported on COVID-19 drive-through testing sites opening in May, 2020, in four states in the United States with the help of Community Organized Relief Effort (CORE), which was founded by Penn following the January 12, 2010, earthquake in Haiti. The non-profit foundation began planning for the drive-through specimen collection sites in April of 2020.

Public Recognition for Medical Laboratories has Global Reach

The COVID-19 response and scientific contributions by pathology laboratory scientists and researchers in Australia are noteworthy. It is also significant that Australia’s pathology professional society sought recognition for medical laboratory workers by detailing their accomplishments during the pandemic and sharing them in media with national and global reach.

—Donna Marie Pocius

Related Information:

Australia Has Recorded 12 Million COVID Tests, and We’re the Envy of the World

Melbourne Scientists First to Grow and Share Novel Coronavirus

Melbourne Researchers Show the Body’s Ability to Fight Novel Coronavirus

Breadth of Concomitant Immune Responses Prior to Patient Recovery: A Case Report of Non-Severe COVID-19

First Drive-Through Coronavirus Testing Station Opens in South Australia

Sean Penn’s Foundation Partners with Healthcare Providers in Four States to Offer Drive Thru COVID-19 Molecular and Serological Clinical Laboratory Specimen Collections

Researchers Easily Reidentify Deidentified Patient Records with 95% Accuracy; Privacy Protection of Patient Test Records a Concern for Clinical Laboratories

Protecting patient privacy is of critical importance, and yet researchers reidentified data using only a few additional data points, casting doubt on the effectiveness of existing federally required data security methods and sharing protocols

Clinical laboratories and anatomic pathologists know the data generated by their diagnostics and testing services constitute most of a patient’s personal health record (PHR). They also know federal law requires them to secure their patients’ protected health information (PHI) and any threat to the security of that data endangers medical laboratories and healthcare practices as well.

Therefore, recent coverage in The Guardian which reported on how easily so-called “deidentified data” can be reidentified with just a few additional data points should be of particular interest to clinical laboratory and health network managers and stakeholders.

Risky Balance Between Data Sharing and Privacy

In December 2017, University of Melbourne (UM) researchers, Chris Culnane, PhD, Benjamin Rubinstein, and Vanessa Teague, PhD, published a report with the Cornell University Library detailing how they reidentified data listed in an open dataset of Australian medical billing records.

“We found that patients can be re-identified, without decryption, through a process of linking the unencrypted parts of the record with known information about the individual such as medical procedures and year of birth,” Culnane stated in a UM news release. “This shows the surprising ease with which de-identification can fail, highlighting the risky balance between data sharing and privacy.”

In a similar study published in Scientific Reports, Yves-Alexandre de Montjoye, PhD, a computation private researcher, used location data on 1.5 million people from a mobile phone dataset collected over 15 months to identify 95% of the people in an anonymized dataset using four unique data points. With just two unique data points, he could identify 50% of the people in the dataset.

“Location data is a fingerprint. It’s a piece of information that’s likely to exist across a broad range of data sets and could potentially be used as a global identifier,” Montjoye told The Guardian.

The problem is exacerbated by the fact that everything we do online these days generates data—much of it open to the public. “If you want to be a functioning member of society, you have no ability to restrict the amount of data that’s being vacuumed out of you to a meaningful level,” Chris Vickery, a security researcher and Director of Cyber Risk Research at UpGuard, told The Guardian.

This privacy vulnerability isn’t restricted to just users of the Internet and social media. In 2013, Latanya Sweeney, PhD, Professor and Director at Harvard’s Data Privacy Lab, performed similar analysis on approximately 579 participants in the Personal Genome Project who provided their zip code, date of birth, and gender to be included in the dataset. Of those analyzed, she named 42% of the individuals. Personal Genome Project later confirmed 97% of her submitted names according to Forbes.

In testimony before the Privacy and Integrity Advisory Committee of the Department of Homeland Security (DHS), Latanya Sweeney, PhD (above), Professor and Director at Harvard’s Data Privacy Lab stated, “One problem is that people don’t understand what makes data unique or identifiable. For example, in 1997 I was able to show how medical information that had all explicit identifiers, such as name, address and Social Security number removed could be reidentified using publicly available population registers (e.g., a voter list). In this particular example, I was able to show how the medical record of William Weld, the Governor of Massachusetts of the time, could be reidentified using only his date of birth, gender, and ZIP. In fact, 87% of the population of the United States is uniquely identified by date of birth (e.g., month, day, and year), gender, and their 5-digit ZIP codes. The point is that data that may look anonymous is not necessarily anonymous. Scientific assessment is needed.” (Photo copyright: US Department of Health and Human Services.)

These studies reveal that—regardless of attempts to create security standards—such as the Privacy Rule in the Health Insurance Portability and Accountability Act of 1996 (HIPAA)—the sheer amount of available data on the Internet makes it relatively easy to reidentify data that has been deidentified.

The Future of Privacy in Big Data

“Open publication of deidentified records like health, census, tax or Centrelink data is bound to fail, as it is trying to achieve two inconsistent aims: the protection of individual privacy and publication of detailed individual records,” Dr. Teague noted in the UM news release. “We need a much more controlled release in a secure research environment, as well as the ability to provide patients greater control and visibility over their data.”

While studies are mounting to show how vulnerable deidentified information might be, there’s little in the way of movement to fix the issue. Nevertheless, clinical laboratories should consider carefully any decision to sell anonymized (AKA, blinded) patient data for data mining purposes. The data may still contain enough identifying information to be used inappropriately. (See Dark Daily, “Coverage of Alexion Investigation Highlights the Risk to Clinical Laboratories That Sell Blinded Medical Data,” June 21, 2017.)

Should regulators and governments address the issue, clinical laboratories and healthcare providers could find more stringent regulations on the sharing of data—both identified and deidentified—and increased liability and responsibility regarding its governance and safekeeping.

Until then, any healthcare professional or researcher should consider the implications of deidentification—both to patients and businesses—should people use the data shared in unexpected and potentially malicious ways.

—Jon Stone

Related Information:

‘Data Is a Fingerprint’: Why You Aren’t as Anonymous as You Think Online

Research Reveals De-Identified Patient Data Can Be Re-Identified

Health Data in an Open World

The Simple Process of Re-Identifying Patients in Public Health Records

Harvard Professor Re-Identifies Anonymous Volunteers in DNA Study

How Someone Can Re-Identify Your Medical Records

Trading in Medical Data: Is this a Headache or An Opportunity for Pathologists and Clinical Laboratories

Coverage of Alexion Investigation Highlights the Risk to Clinical Laboratories That Sell Blinded Medical Data