First and foremost, I would like to express my thanks and gratitude to all healthcare staff on the frontlines, be it the physicians and nurses caring for patients or technical staff maintaining equipment1 and information technology (IT) infrastructure. This has been a challenge very few of us have experienced in our lifetime. As I am writing this column in early April, I am very well aware that by the time it will get published, we will have been through much worse.But this being a cybersecurity column, I wanted to specifically look at how COVID-19 has affected and, in the future, will affect cybersecurity.For one, our crisis is the attackers' opportunity—be it from political or financial motivation. Some are specific attacks exploiting the current situation; others are general trends that get exasperated by it.In a sense, the situation we find ourselves in is a cumulation of many complex risk tradeoffs. We need to rapidly expand our care delivery capacity and shift to new models of care to reduce infection risk to providers and patients. Clearly, this is the single most important objective right now, and we need to accept the fact that as we do so, we are increasing our cyber risks. Right now, we really don't have a choice; it is as simple as that.We have the option to maximize our defenses or even go on the offensive,15 but considering the circumstances, our ability to focus on cybersecurity is limited. As the saying goes, you go to war with the cybersecurity you got—the war has begun, and it is exposing systemic weaknesses that we don't have time to address right now.Rapid development and deployment of sorely needed medical devices invites vulnerabilities, though many of these crisis-targeted devices are much simpler than their traditional brethren16 and may not even be network connected or software based.The general heightened level of activity and focus on the medical crisis will lead to lower defenses. For example, simply from being distracted, human error is more likely (e.g., falling for a phishing email, not properly putting up a network firewall). New and more complex information-sharing requirements will require an improvised approach and we may use means of electronic communication that we otherwise would prefer not to—and as a result, mistakes will happen.17 And if you feel you need to post a photo of your crazy busy hospital on social media, or if the local television station shows up, please remove those password stickers from your monitors.Furthermore, now more than ever, we are living amidst the convergence of physical security and cybersecurity. Devices are more exposed, devices get handled by many more people, networks get deployed hastily, telehealth and work-from-home infrastructures get deployed rapidly. In short, traditional boundaries and controls are no longer present, thereby creating opportunities for adversaries to take advantage.The need for information, both among health professionals and the general public, is an opportunity for disinformation, misinformation, and traps (e.g., fake websites). That is the human side of the attack surface, and we already are seeing it being exploited as well (e.g., by a malicious website mimicking John's Hopkins disease tracker18).We live in scary times, indeed. Healthcare workers have been carrying the brunt of this crisis. Yet, we need to admit that we have let them down and that our lack of preparedness, proper crisis management, and availability of emergency equipment (from personal protective equipment to ventilators) has made the situation worse than it needed to be. Let's make sure that history does not repeat itself and that we learn from this experience—certainly from an infectious disease and public health perspective, but also from a cybersecurity perspective.In my opinion, here the key changes we need to make once we are past this crisis (again, from a cybersecurity perspective—certainly, we will need to learn much more from this):COVID-19 has exposed the financial, care delivery, capacity, logistical, planning, and preparedness shortcomings of our healthcare and public health system. I believe we will emerge from this crisis bruised but with the opportunity to improve. We have the opportunity to learn from this, and this learning should, among many things, also lead to a better and proactive approach to cybersecurity.
Read full abstract