Early in the pandemic, countries like South Korea and Taiwan deployed contract tracing technologies to successfully contain the spread of COVID-19. This was not the case in the United States and Europe, where privacy concerns and the potential for misuse of personal information made people uncomfortable with mobile device-based technology that tracked their whereabouts, for example. Because of this resistance, the Centers for Disease Control and Prevention (CDC) relied on more traditional methods of notifying those who’d had direct contact with COVID-19 patients. When public health authorities don’t employ tracking technology, they must rely on patients to accurately self-report their recent whereabouts.

According to The New York Times, state and local health departments received $11 billion in funding from the CDC to carry out the task of identifying people exposed to COVID-19. Identifying the contacts of thousands of infected people in the U.S. every day is a massive undertaking that requires a lot of manpower. In June, National Public Radio counted 37,000 contact tracers nationwide, by surveying state health departments. About 31,000 more tracers are available, but the survey found that the nation needs upward of 100,000 more contact tracers. The tracing teams include hires from all walks of life,who are then trained according to each state’s mandates.

Harnessing the Power of Technology

When health departments are understaffed, mobile apps can fill a gap and simplify the process of notifying close contacts. There are two ways in which apps store data to make this possible, a centralized approach and a decentralized approach.

  • In the centralized approach, a central server stores all data related to the infected person and recent contacts, along with their locations and other personal information.
  • In the decentralized approach, only the infected person’s identification is sent to the main database. No contacts are named, and only those people who were tracked as being in near proximity to the infected person are notified.

Despite being competitors, Apple and Google collaborated to develop contact notification tools enabled by Bluetooth technology and linked to a central server. The contact tracing toolkit was launched in May, then improvements were made, based on feedback from health regulators. In June, the detection tool became available when users initiated a software update on Apple and Android phones.

In late July, Google announced that it is working with 20 states to deliver apps built using the Apple-Google server, as reported by CNET. The first state is Virginia, which bought the app developed by tech firm SpringML for $229,000. It will be used to notify people when they pass by anyone who has been diagnosed with COVID-19, Slate says. This Bluetooth service, called Exposure Notification System, has so far been used to make apps in Poland, Ireland, Denmark, Germany, Italy, Latvia, Austria, Switzerland and Gibraltar, Reuters reported

No Guarantee of Success

Initially, the centralized apps were used with little success. According to the MIT Technology Review’s Covid Tracing Tracker, 47 countries have started using apps for contact tracing. However, information is only available for 42, with 17 of the 42 taking the centralized route, according to How India Lives, an online database compiling information relevant to the public in India.

An example of a centralized app that did not work is the StopCovid app, which launched this June in France. It was hailed as a huge breakthrough when it was downloaded by 2 million people there. Three weeks later, a performance review revealed that only 14 people were alerted. Similarly, in Australia, the Covidsafe app was downloaded 6 million times, but failed to have an effect on contact tracing, according to MIT Technology Review.

On why these apps failed to work, Michael Veale, a digital policy professor at University College London, told MIT Technology Review, “They aren’t detecting many phones because the background Bluetooth does not function. That’s because they aren’t using a decentralized approach.” Decentralized apps include Germany’s Corona-Warn, Italy’s Immuni and Ireland’s COVID Tracker. However, these apps have also had little success, due to unexpected technical glitches that hold up notifications.

The Take-Away

In most of the world, technology has a long way to go before it becomes an effective tracing and notification tool. Contact tracing cannot be defined by the number of people subscribing to an app, but rather by the number of potential transmission routes disrupted, MIT Technology Review explains. More than anything, precaution is key. Self-quarantining, wearing a mask, maintaining personal hygiene and social distance is important on an individual level, with or without apps.

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Want More Information About Contact Tracing?

Contact tracing - This is defined as the systematic tracing of an infected person’s close contacts. The goal is to reduce the spread of COVID-19 by monitoring the health and activities of the infected person. Contact tracing has been used to break the chain of transmission during infectious outbreaks such as Ebola, tuberculosis and measles, according to the World Health Organization.

Close contacts – A close contact is defined as anyone who was within 2 meters or 6 feet of a person diagnosed with COVID-19 for 15 minutes or longer, two days before the diagnosis. This includes family, friends, co-workers and medical professionals who treated the patients. The health departments examine potential symptoms of close contacts and ask them to get tested if needed, Mayo Clinic explains.

Community engagement – Getting the buy-in of community leaders can help with contract tracing, particularly when it comes to overcoming language and literacy barriers that sometimes exist for refugees, minority groups, migrants and other vulnerable populations. A high level of engagement also ensures that those affected get access to food and medical care, and can reduce stigma of the disease.

Health department evaluation – People who are infected with COVID-19 are expected to provide health officials with a list of people they encountered during a certain period of time before they became ill. The labs, clinics or hospitals then notify close contacts that they were potentially exposed to the virus, ideally within 24 hours of the original diagnosis. Officials are expected to maintain confidentiality of the patients’ identity.

Symptomatic contacts - Contacts with mild symptoms that don’t require hospitalization are asked to cut off close contact with family members, roommates and pets, and are told to self-isolate from other people, using a separate room and bathroom, when possible. They are also advised about what symptoms to monitor. Anyone with trouble breathing or chest pain should seek medical help immediately.

Asymptomatic contacts – Asymptomatic people are those who test positive for the virus but do not show or feel any symptoms. These people are also told to self-quarantine at home and to maintain social distance from other people who live with them. They must watch for any COVID-19 symptoms to develop.

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