Contact tracing apps were supposed to help the world minimize the spread of COVID-19, and although the idea had a lot of promise, in reality, it fell short of expectations. In this episode, we dive deep into the role of technology and COVID-19, why contact tracing apps haven’t lived up to the hype, and what it would take to introduce something that… you know… works?
Contact Tracing 101
- The premise is simple: Your phone notifies you when someone near you has had contact with someone who had COVID-19, or notifies you if you’ve been around someone who had COVID-19.
- Experts are referring to the apps/technology as exposure notification apps to make a point that it is benefiting the users, not the trackers.
The problem: widespread adoption
- Google and Apple formed a rare, collaborative partnership to create “Exposure Notifications” API based on Low Energy Bluetooth, keeping all data exchanged anonymous and limited to only what’s necessary.
- Early versions of apps in states like Rhode Island, Utah, North Dakota, and South Dakota actually DID use GPS tracking, which sparked immediate privacy concerns, and the apps were pulled back.
- An Oxford study concluded that 60% of a country’s population would need to use contact tracing technology in order for it to be effective. But many experts disagree and believe that any adoption could help mitigate risk.
- It comes down to the user experience, and right now, “it just works” isn’t it. Getting someone to download it is the first step. Getting someone to use it is the second step. And anyone that’s deployed an application knows just how hard it is to do both of those things.
Getting more adoption:
- What other options or experiences can we use to get more people to engage with contact tracing applications?
- We have to prove that it works in order for adoption to happen. Right now, there is no social proof that contact tracing is working and minimizing the spread of COVID-19.
- What if we paid Americans $1,000 to download a contact tracing app?
(01:15) Introducing Contact Tracing Apps
After a person tests positive for COVID-19, contact tracing is the process by which health officials try to track down who that person has had close contact with in order to warn those people and hopefully contain further spread.
(02:05) How do the apps work?
Most of them generally work like this: You have a friend over in your backyard for a socially-distanced drink after work, your phones recognize they’re close to one another and exchange some encrypted information via Bluetooth, which is added to an anonymous log, simply noting that the phones were close.
(03:04) Language Matters.
Exposure Notification vs. “Contact Tracing”. Experts suggested we should refer to the technology as “Exposure Notifications” instead of contact tracing. Contact tracing often sends the wrong message—it sounds like the technology is, well, tracing you, tracking your movements. It suggests the benefit is geared toward those doing the tracking and tracing—the public health officials. Exposure Notifications, however, is about notifying YOU if you’ve been around someone who had COVID.
“There’s no way to track somebody back to who they are based on the Bluetooth data that’s being shared.”
Jenny Wanger – Head of Implementor’s Forum at the Linux Foundation Public Health (LFPH)
(05:23) In collaboration with Google & Apple
In a rare collaborative effort, the two tech giants created their “Exposure Notifications” API, using only Low Energy Bluetooth, keeping all data exchanged anonymous and limited to only what’s necessary. “It turns out that what they chose for their protocol was very, very similar to what organizations like TCN Coalition were trying to do with their protocols,” explained Jenny Wanger, Head of Implementor’s Forum at the Linux Foundation Public Health (LFPH).
(08:46) The Oxford Study controversy
While talking with Jenny, we brought up a stat from an Oxford University study we’d seen cited over and over in doing research for this piece. According to sources all over the internet, this Oxford study concluded that 60% of a country’s population would need to use contact tracing technology in order for it to be effective. “This is an often misquoted statistic,” she said and explained that 60% adoption would be needed if Exposure Notification technology was going to be the only technology used in order to prevent COVID from spreading. (find out more in her blog article)
(11:06) Trust & Privacy at heart
Since the beginning, the issue of privacy and trust has been at the heart of the conversation. According to Jenny and the LFPH–confusion in the media and the public is largely drawn back to very early “contact tracing apps” that actually were using GPS tracking. But, she clarified: “There’s no way to track somebody back to who they are based on the Bluetooth data that’s being shared.”
For those who maintain privacy concerns, the importance of open source development is at the top of the priority list. This is what Google and Apple have done—the source code for the exposure notifications app is available on GitHub.
So if privacy isn’t really the problem, what is?
“I think that we need to put a lot of intentional effort into publicizing the wins”
Ellie Daw – Senior Researcher & Working Group Lead at TCN Coalition
(15:43) Changing human behavior
One major issue is friction. In the U.S., identifying the right app, downloading it, understanding how it works, and enabling your phone’s ability to allow it to work… it’s too much. “This is another thing that has to be prioritized and is competing with the other priorities of the average main street individual during this pandemic,” suggested Paul Heckel, VP of Experience at Kin + Carta
(18:05) Prove it works
One simple area that researchers and designers like Jenny and Ellie are longing for—simple stories showing that the tech actually works. “I think that one of the biggest elements of getting over that hurdle is going to be let’s make sure that the people hear about the ways that it is working, and let’s just really celebrate those wins.”
(19:10) Focus on Small Community Adoption
Some are suggesting that public health officials and developers should look to how companies like Facebook, Uber, and WhatsApp gained traction before they were the behemoths they are today: Targeting local, highly-focused communities where they’d be of immediate use, and then scaling up. Paul actually brought up a study that PR firm Edelman puts out called the Trust Barometer. In 2019, “My employer” was the one that outscored everybody else on the trust index.
“Pay Every American $1,000 to Download a Contact Tracing Application”—that’s the headline from a Slate.com article written in August by Zachary Kellenborn, a national security consultant. While the logic has an appeal, critics have been quick to raise the difference between downloading an app and actually using it properly.
As we talked further, Paul from the Kin + Carta team suggested a different way to think about exactly that problem—incentivizing the behavior itself, and actually forgoing the download altogether, by integrating it into the “health” apps already on our phones. “I think that’s probably a better pathway to getting these things done, rather than certainly municipal or state engineered and delivered contact tracing apps, but I don’t think that’s ever going to work.
“It’s not just about developing a viral loop and making sure that you’ve got app store optimization and throwing up some Google ads and then working on advertising on podcasts. We’re really looking at it as a public health intervention.”
Jenny Wanger – Head of Implementor’s Forum at the Linux Foundation Public Health (LFPH)
(22:57) A public health issue
Jenny Wanger explained it’s critical to follow models focused on public health, not just digital user experience: “It’s not just about developing a viral loop and making sure that you’ve got app store optimization and throwing up some Google ads and then working on advertising on podcasts. We’re really looking at it as a public health intervention.”
(23:42) Narrow the options
This brings up an entirely different perspective, and we acknowledge the delicate dance we’re doing around the politics of this topic, but in matters of public health intervention, the argument would be, in Paul’s words: “Don’t give them a choice.”
As Paul explained, in the U.S., there’s a pretty good example of the non-elective type approach already installed on every smartphone, one we happened to experience not too long ago when the “Derecho” storm brought a rare tornado warning. “The wireless emergency alert service,” he said ”There’s no friction. There’s no opt-in. It’s just mandatory.”
Certainly a big leap for anyone already concerned about privacy and access, but an interesting way to look at how certain trade-offs between public health and privacy really aren’t that controversial at all. What if they all rolled out an Exposure Notifications feature? We have the greatest marketing machine known to man. Put it into service for the greater good. We got GM to make masks, let’s get Silicon Valley out there to save lives.