Covid-19: Extending the value of contact tracing apps

Contract tracing apps are rapidly becoming the central plank of strategies around the world which aim to allow people to return to a more normal life while preventing a renewed spread of coronavirus.

According to the Massachusetts Institute of Technology (MIT)’s global tracker, 29 countries including China, Australia, France and the UK currently have apps deployed or under development.  The apps work by notifying people if someone they have been in close contact with subsequently tests positive for coronavirus.

The ability to identify those potentially infected so they can take themselves out of circulation allows lock-down for many to be replaced by isolation for the few.
However, one of the main challenges of contact tracing apps is getting enough people to download and use them.  Studies estimate that 60 per cent of a population needs to download an app for it to effective, a level yet to be met in any country publishing statistics.

• Iceland, according to MIT’s tracker, has the best download rate in the world with 38 per cent of the population – but that is still far off the levels needed.
• In Norway, 1.5 million people downloaded the local app, but just under 900,000 were using it in test zones, representing just over 20 per cent of over 16s 
• India, too, has seen modest uptake, with 50 million downloads on Android phones, which dominate the market, a small fraction of its 1.3bn population.

This means global governments urgently need to augment the user base and widen the scope of the alert, to fulfil their duty of warning absolutely everyone potentially infected. Public warning systems using mobile phones are the most effective tool for this. 

Covid-19 and beyond

Population alerting  solutions keep people safe and have been proven to prevent loss of life when major incidents occur.   Governments have a moral obligation to protect people within their borders and by investing now on public warning solutions to manage COVID-19, they will have a long term solution which will strengthen their resilience to all types of life threatening incidents in future. 

In Europe, all member states have less than 2 years to implement the requirements of Article 110 of the EECC Directive on public warning (see more).  This month BEREC will issue their long awaited  guidelines on how to assess the effectiveness of public warning systems transmitted by different means which will give countries a framework from which to plan their public warning solutions.  

Between an app and a hard place

Contact tracing apps are not flawed – the underlying principles and technology are sound – but scale is a significant, and not easily solvable, problem.
A lack of access to smartphones, as well as privacy concerns especially for apps which hold collected data centrally, are the key factors leading to low uptakes.  American research has reported “widespread reluctance” to embrace smartphone-based contact tracing.  This all matters because contact tracing apps only work for those who have it installed, and if people don’t know they’re infected, they will carry on unwittingly spreading the virus. This inherent lack of data means that apps simply cannot be effective enough in isolation. And this is not just a lay view, the product lead for Singapore’s TrackTrace app was clear they cannot be a universal panacea, writing:

“You cannot ‘big data’ your way out of a ‘no data situation’.”

Australia’s experience is also a warning here – a month after its app went live, just one person had been reported to have been identified using data from it.
The UK’s test, track and trace system – now live although the accompanying app is still being tested – is relying on an army of 25,000 human tracers for the third step, when automating through a warning system would be much more efficient.
In the wake of all of these issues, governments need to be prioritise augmenting the user base for maximum effectiveness.  Primarily, this is to contain the virus, but it would have a secondary use too.  As moves begin around the world to restart stalled economies in the face of a looming recession, a major global study found that effective track and trace systems can reduce working hours lost to sickness by as much as 50 per cent.

Accelerate the return to normal with bigger thinking

Authorities have an opportunity to think much bigger when exploring and deploying new technology in the fight against Covid-19. For a complete solution they could consider adding a communication step beyond test, track and trace. With a public warning system that uses location data to send alerts to mobile devices or apps, it is possible to extend the value of track and trace apps thereby reaching everyone who could be exposed to the virus.

Consider a few scenarios:

• Countries will need to manage a changing landscape of new ‘hotspots’ or ‘clusters’ of COVID-19. Communication to the public will therefore change over time and will vary from place to place. The ability to send different alerts to different areas will be key to a successful ‘return to normal’ strategy. This includes sending updated ‘follow up’ messages when the risk is over.
• The biggest challenge is how to reach people that have come into contact with an infected person. Using location-based public warning systems such as Everbridge’s, it is possible to ‘turn back the clock’ and send SMS messages to anyone who was an area at the same time as someone who has since been diagnosed with coronavirus.
• In addition, as travel opens up within countries and across borders, it will be vital to alert anyone entering a COVID-19 hotspot or arriving into a country, providing them with instructions on lock down restrictions or quarantine procedures.

Eradicating the threat from Covid-19 

The overriding priority for all of us is to eradicate the threat of Covid-19. Minimising the virus’s impact on our lives, now and in the future, means reaching everyone exposed to efficiently limit the spread. Using contact tracing apps in tandem with a public warning system could be the solution.

References:

• Norway: Bare én av fem deler data fra Smittestopp-appen
• Al Jazeera “Contact-tracing apps enjoy limited success amid privacy fears”
• USA: “Americans’ perceptions of privacy and surveillance in the COVID-19 Pandemic”
• Singapore “Automated contact tracing is not a coronavirus panacea”
• The Guardian: How did the Covidsafe app go from being vital to almost irrelevant?
• New York Times: “How Do You Save a Million People From a Cyclone? Ask a Poor State in India”
• Background to EECC Article 110
• BEREC – Body of European Regulators for Electronic communications