Contact tracing apps for coronavirus are the new trend. Heres why. – India Gone Viral

Next up on the how to get life back to normal checklist: contact tracing. But its not going to be easy.

Experts already say states need to wait until coronavirus cases actually start to decline over several weeks before they begin reopening businesses and sending people back to school and work. The US also needs to dramatically ramp up its capacity to conduct tests for Covid-19. It would help, too, if there were accurate antibody tests that would show if somebody has already been infected and is now immune.

But once people start resuming their normal routines, contact tracing will be essential to containing emerging clusters of coronavirus infections. Without those efforts, new infections could silently spread before we realize whats happening, leaving more lockdowns as the only option to guard against an out-of-control outbreak and more deaths.

If lockdowns are a sledgehammer to clamp down on new clusters, contact tracing would be the more preferable scalpel.

Traditionally, contact tracing is the work of public health staff. When somebody tests positive for an infection, field workers interview them, find out people the infected person has been in close physical contact with, and then notify those people about their exposure. Ideally, the potentially exposed people would either get tested themselves or, at the minimum, self-quarantine until symptoms show up or the incubation period has passed.

In the United States and across the world, smartphone applications are seen as a promising option to automate some of the work that health workers have traditionally been asked to do. Namely, they could silently track which people weve been in contact with, and if one of those people tests positive for Covid-19, our phone would send us a notification letting us know about our potential exposure. Apple and Google have modified their operating systems to allow our phones Bluetooth functions to do this work.

This diagram from Google helpfully explains how this would work in practice:

Google

Google

But you can probably imagine all the practical challenges and privacy concerns such a program could raise. Thats why the Center for American Progress, one of the leading left-leaning think tanks in Washington, DC, is releasing a list of recommendations for states to utilize digital contact tracing, which it shared exclusively with Vox.

Their approach seeks to maximize privacy protection while encouraging the most effective application of these tech tools. To summarize CAPs advice for states:

Digital contact tracing apps may allow all of us to better fight this virus and return to more open ways of life, CAP tech policy experts Erin Simpson and Adam Conner wrote. We come to the recommendation of distributed digital contact tracing reluctantly and only in the context of exploring the range of other recommendations. However, we find hope in the idea that new approaches make it possible to build this in a maximally privacy-protective way.

But even the best-intentioned plans are going to raise questions and be at risk of privacy violations. As Shirin Ghaffary wrote for Recode over the weekend:

The contact tracing system Google and Apple are working on is notably more privacy-centric than the methods were seeing in China or South Korea, but it still poses concerns. The two companies have now committed to shutting down the tool once the pandemic is over which was a key issue for many privacy experts but other concerns abound. There are still ways that even the randomly generated Bluetooth keys meant to anonymize users could be linked back to real identities.

Apple and Google are also leaving it up to public health authorities to develop and manage the apps that will use their contact tracing tool. Its conceivable that those authorities could introduce their own ways to circumvent privacy protections if their governments so desire.

You can see how the CAP recommendations aim to assuage these concerns (by, for example, prohibiting law enforcement access), but state governments will have to actually commit to those principles for them to be effective.

And people will have to be willing to give the government even limited access to their phones for these plans to work, and, as Shirin notes in her story, that is no small challenge in a post-Edward Snowden world. Reuters reported on Tuesday that only one in five people in Singapore, which has rolled out an app similar to what experts are envisioning in the US, have signed up for the digital tracing app. That is nowhere near the 60 percent adoption rate experts think is necessary for digital tracing to have a measurable impact on containing the coronavirus.

And all of this is why, according to the CAP experts and Shirins reporting and really anybody you could ask, digital contact tracing can only be part of a bigger solution. The ideal plan includes the traditional kind of tracing that we discussed at the top.

The problem is the US is woefully understaffed for the kind of contact tracing that is necessary for a highly infectious pathogen like the coronavirus. Public workforces have seen their federal funding cut by 28 percent over the past 15 years, and about 50,000 jobs in this now-essential field have been lost.

According to the Johns Hopkins Center for Health Security, the US needs at least 100,000 more public health staffers to conduct contact tracing, many of whom will need to be trained. Politico reported that before the coronavirus pandemic, states had fewer than 2,000 workers capable of performing these duties.

So a lot more investment may be needed. The Johns Hopkins researchers, led by Crystal Watson, put the price tag for hiring and training the necessary contact tracing workforce at $3.6 billion. The new coronavirus stimulus bill passed by Congress this week included $11 billion for states and cities to ramp up their testing capabilities, laboratory capacity, and contact tracing. Well see if that is enough.

Between the CAP recommendations, the work of other experts, and the examples of other countries that have already pursued these initiatives, we know what good contact tracing of both the digital and traditional variety might look like. But it will take the resources and commitment to certain ideals to make it happen.

This story appears in VoxCare, a newsletter from Vox on the latest twists and turns in Americas health care debate. Sign up to get VoxCare in your inbox along with more health care stats and news.

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Contact tracing apps for coronavirus are the new trend. Heres why. - India Gone Viral