Anchorage, rather than germ-shaming businesses to assist with contact tracing, you could use technology for a better outcome.
Contact tracing was used — and proven — in the battle against infectious diseases throughout history. In April 2020, Johns Hopkins Bloomberg School of Public Health called it: “a mainstay of a robust health response.” More recently, Dr. Gregory Poland of the Mayo Clinic says the practice is “a time-tested public health strategy standard.”
Essentially, if all infected people and everyone they were in contact with and so on, were identified, self-isolation could stop the spread of COVID-19. But during a pandemic, the total case count grows faster than staff can manage, or, the process seems so daunting, contact tracing is not being done at all.
Now, even as commerce restrictions start to lift and we look ahead to education resuming on campuses in the fall, the United States continues to see thousands of positive COVID-19 cases daily. That’s why technology is imperative to enhance manual tracing efforts and reduce caseloads.
Historical Contact Tracing
In an early, well-known use of manual contact tracing, “sanitary engineer” Dr. George Soper discovered Mary, an asymptomatic carrier of Typhoid, as patient zero — but not until she passed the illness to an estimated 3,000 New Yorkers.
The World Health Organization (WHO) credits contact tracing for helping finally rid the world of smallpox in 1977. However, the manual efforts to get there were arduous. According to WHO, “Smallpox no longer occurs naturally since it was totally eradicated by a lengthy and painstaking process, which identified all cases and their contacts and ensured that they were all vaccinated. Until then, smallpox killed many millions of people.”
In this century, contact tracing was practiced during the SARS (2003) and Ebola (2014) outbreaks. Today, with short-term hindsight and a great deal of foresight, the importance of contact tracing to help prevent a second wave of COVID-19 is apparent.
The Center for Disease Control (CDC) says: “Identifying contacts and ensuring they do not interact with others is critical to protect communities from further spread. If communities are unable to effectively isolate patients and ensure contacts can separate themselves from others, rapid community spread of COVID-19 is likely to increase to the point that strict mitigation strategies will again be needed to contain the virus.”
However, health departments are overwhelmed and other and private sector businesses and institutions lack adequate resources. In fact, George Washington University estimates the country will need nearly 150,000 people in the public sector alone to create a contact tracing workforce. Amassing and training this many people will take time, but the CDC warns that time is of the essence.
Manual Tracing is Not Enough
The problem is that the contact tracing process in an outbreak as widespread and fast-moving as COVID-19 far exceeds human capabilities to be effective. It involves layers of identification, notification and ongoing checks.
Once a person tests positive, the people he or she has come in contact with during the previous two weeks need to be identified and notified — family, friends and strangers alike. Once the first line of contacts is known, then the second and even third lines must be found and alerted. The breadth is exponential, and, without technology, the process depends on the accurate memory of a stressed population.
It’s easy to see how technology would enhance manual efforts and expedite the process. The CDC agrees and outlined key concepts for implementing contact tracing, including: “Use digital tools. Adoption and evaluation of digital tools may expand reach and efficacy of contact tracers.”
The organization’s recommended “multipronged approach” states: “Case investigation, contact tracing, and contact follow-up and monitoring will need to be linked with timely testing, clinical services and agile data management systems to facilitate real-time electronic transmission of laboratory and case data for public health action.”
The Importance of a People-Centric Tool that Protects Privacy
The CDC encourages the use of technology partners to improve existing systems or develop new tools and affirms that automation is critical to efficient case investigation and the overall process. An easy-to-use, people-centered mobile app is one such tool and an ideal way to help assess, test and trace COVID-19.
The technology must be built to balance the need for user data to aid public health with the fullest possible respect and protection of every individual’s information.
Features and controls should include:
- The ability for users to opt in and out any time
- Freedom to keep location private
- Control over which data users share
- Limited use of data (for public health efforts only)
- Data encryption and security in transit and at rest
Depending on user permissions, this type of app would enable symptom assessment, test referral, notification and segmented informational and support messaging. If turned on, location history would allow for the creation of prioritized contact lists (those who potentially were most exposed), identification of second and third generation contacts and unknown contacts (strangers with passing contact on public transit or in a grocery store, as examples).
Healthy Together App
The Governor of Utah recently charged his staff to find a technology partner to create such a tool — one that could quickly create and scale a mobile app to augment that state’s 1,200 contract tracers. The staff reached out to Twenty, known for its app that helps friends get together in real life, for its communication and mapping capabilities.
Twenty quickly repurposed its existing iOS and Android mobile app technology with location data sharing, basic map visualization, user-to-user sharing and alerts to deliver a mobile app and official portal to help in the fight against the spread of COVID-19.
The company worked in collaboration with state officials to collectively come up with the best possible solution. They developed the “Healthy Together” program, a totally opt-in app in which users can choose to limit permissions such as GPS or Bluetooth on their phones depending on their preferences.
Users also have the choice to share their location data with the public health department if they test positive. The data is limited to the state of Utah’s use for public health and is deleted after 30 days.
Here’s how it works. Let’s say Mary downloaded the app and subsequently tests positive for COVID-19. Two chains of events would occur. Mary would receive validated results in the app and be alerted that someone from public health would be contacting her. Then, if her location tracking was enabled, she could decide to share any GPS and Bluetooth data the app detected over the last 14 days with the contact tracer. The app fills in any gaps in her memory and determines unknown contacts.
Many other states are rolling out contact tracing plans. The practice is also becoming part of COVID-19 mitigation strategies in business and higher education. Find out more about contact tracing technology…