As the world scrambles to flatten the curve, contact-tracing apps have been positioned as a vital defense for suppressing the spread of coronavirus. Out of the more than 200 countries that have been hit, 30 have already rolled out a contact-tracing app, with more expected to launch soon.
Over the last few weeks, contact-tracing apps have emerged as a key part of various countries’ coronavirus efforts and campaigns. Two of the biggest tech companies that have a hand in pretty much every smartphone on the planet, Apple and Google, came together to build a universal and coherent standard for contact tracing. But despite how actively governments are investing in and promoting contact-tracing apps, they’re far from the modern, digital pandemic panacea they seem to be.
Experts argue that contact-tracing apps are vastly limited in their abilities and riddled with loopholes that make their diagnoses unreliable. More importantly, they’ve steered the spotlight away from health measures that are truly in dire need of more resources and attention from both public and government organizations.
How do contact-tracing apps work?
All contact-tracing apps fundamentally function the same way. They’re designed to notify you when you’ve recently been near someone who has tested positive for coronavirus so that you can self-quarantine and take the necessary precautionary measures.
The app does so by transmitting and exchanging unique tokens with every other phone in its Bluetooth range. So if a person registers themselves as coronavirus-positive on the app and their token is present on your phone, you will be alerted. A few contact-tracing apps, like the one available in India called Aarogya Setu (“a bridge to health” in Hindi), collect location data as well and can tell you that the supermarket you’re planning to head to is in a coronavirus hotspot.
It’s a fairly simple concept and in theory, can potentially prove effective. However, their success relies on far too many hypotheticals, and the way they work greatly overlooks the complexity of how coronavirus actually spreads in real life.
Why contact-tracing apps may not be reliable
The majority of digital contact-tracing solutions, including the one Apple and Google are jointly developing, factor in two attributes: Time and distance. When you’re within a specific range of another person who has the app on their phone, such as 6 feet for 10-15 minutes, the app is activated.
But there is a series of more channels through which you can possibly come in contact with the coronavirus — even when you’re not in an infected person’s proximity. You can pick it up from the air when someone sneezes without a mask, from a surface you touch at a crowded area, or even by being close to an asymptomatic carrier who’s not necessarily sick themselves.
At the same time, it is entirely possible you may not be at risk despite being in the presence of someone who has coronavirus. Bluetooth technology itself has been known to be unreliable, and its efficacy still hangs in the balance, especially when tasked to constantly send and receive signals in a public space with tens of other phones.
Clayton Hamilton, a Technical Officer in WHO’s Digitalization of Health Systems division in Europe, says there is no empirical evidence that backs up the effectiveness of contact-tracing apps or indicates whether they would “deliver the promised public health benefits that they claim.”
“What we do have are several advanced hypotheses that indicate that there is likely some utility in the use of these solutions in supporting existing well-established public health measures,” he added in a webinar hosted by the political group Renew Europe.
It’s also key to remember how dependent contact-tracing apps are on mass adoption. You see, they will be practically futile unless a large percentage of the population has them installed.
Since governments have not made them mandatory, this is another challenge that leaves a gaping hole in contact-tracing apps’ architecture. On top of that, millions who don’t own smartphones are left out, and the Bluetooth Low Energy standard needed for the Apple-Google API is available on only a quarter of smartphones worldwide.
An Oxford University epidemiological model found that for contact-tracing apps to make any noticeable difference in curbing the pandemic’s spread, about 60% of the population will need to use the app.
Plus, it’s worth noting coronavirus symptoms can take up to a week to show up, and even after that, it can take days for a person’s diagnosis results to return. Within this long window itself, there’s a good chance the person may end up infecting several others without triggering the contact-tracing app at all as they’re not yet confirmed to be a positive patient.
The aforementioned study adds that these delays can lead to a loss of epidemic control, and “initiating contact tracing based on symptoms makes sense epidemiologically because it’s fast enough to reach people before they transmit.”
Proximity apps, not contact-tracing apps
These apps also undermine the term “contact tracing,” which is a long, complicated manual process where a team of human tracers investigates an infected person’s history and who else he or she may have inadvertently exposed. The apps we’ve come to call contact-tracing solutions play a minor role, at best, as “proximity notifiers” and barely take into account the factors responsible for tracking down at-risk people.
“They [contact-tracing apps] don’t replace all the things that you can do with just people calling contacts and reaching out. Because there are so many things that go into a call like that and to help someone understand the nature of the contact and what they should do about it and what they should do if they become ill,” Dr. Roger Shapiro, Associate Professor of Immunology and Infectious Diseases at the Harvard T.H. Chan School of Public Health, told Digital Trends.
Dr. Shapiro believes for contact tracing, public health systems’ primary focus should be to “train an army of volunteer contact tracers that are willing to make those calls and put in the time to do it well.”
While states are ramping up contact-tracing teams, they’re still “relatively small” and nowhere near the 100,000 that a John Hopkins University report estimates are needed to truly combat the virus.
The development of contact-tracing apps has also been hamstrung by politics. Many countries have implemented custom solutions and refused to adopt the privacy-centric architecture offered by Apple and Google. France’s minister for digital technology, Cedric O, accused Apple of not offering help with the country’s homegrown contact-tracing app. “We will remember that when time comes,” he added.
This, most importantly, has resulted in inferior experiences on iOS apps that have not adopted Google-Apple’s contact-tracing system. Due to an Apple security measure, unless users keep the apps always open, the phone won’t transmit those necessary Bluetooth signals.
The unanswered privacy question
All of this raises the bigger question of citizen surveillance and privacy. The model proposed by Apple and Google draws a thick line when it comes to security and doesn’t let countries centralize health information, which could potentially lead to misuse and breaches. The data never leaves a person’s phone, and both companies have also announced they’ll be blocking location tracking.
Privacy advocates fear these custom versions of contact-tracing apps that have an all-access and unregulated key to sensitive data can have long-lasting security repercussions on people.
“From a societal perspective, we also have the increased potential for governments to use these apps as a veil for stealthily increasing their public surveillance measures to monitor. Due to the speed of coronavirus spread and subsequent introduction of contact tracing apps, legislation to protect citizen privacy hasn’t been able to keep up,” said the Executive Director of National Cyber Security Alliance (NCSA), Kelvin Coleman, over an email response.
In addition, Coleman anticipates a spike in Bluetooth-based attacks and recommends keeping phones up to date.
“Vigilance and rapid response towards collective vulnerabilities will be key to keeping people safe at scale if we expect contact tracing apps to become a prime tool in stopping the spread of this virus, rather than being abused for personal gain or as an excuse to tear down public privacy,” he said.
A group of U.S. senators has proposed a bill to protect health data, but it remains to be seen whether and how long it will take to pass and come into effect.
Contact-tracing apps have a mountain to climb before they’re able to lend an efficacious hand in nations’ battle against coronavirus. For now, they’re riddled with loopholes and may become a passing fad or, in some cases, an excuse for the absence of ample on-the-ground contact tracers.
“As such at this point of time, implementation should be viewed in the context of them being measures for social research rather than as key operational tools supporting national COVID-19 exit strategies to gradually loosening physical distancing measures. Several shortcomings have already been found in existing live implementations and they really need to be addressed prior to broad rollout,” said WHO’s Hamilton.
