Covid tracker apps show technology is not always the answer

At the start of the pandemic, Covid contact tracing apps were one of the most heavily hyped digital tools advanced for tech-ing our way out of an emerging global health crisis.

There were plenty of enthusiastic app cheerleaders, especially in the tech industry. Others debated what monitoring-based apps should do, how privacy-protective they were, and how they could be used or misused.

Ireland’s official Covid Tracker app, developed by NearForm, has been cited as a model and has become the foundation for other global apps. And it has many very good features.

Like many apps, Covid Tracker is based on the Apple/Google exposure notifications system embedded in iPhone and Android operating systems, utilising a phone's bluetooth communication capabilities. Phones can note the anonymised presence of another handset, and notify users if they've been in the presence of someone who has later tested positive.

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Their approach, the companies state, ensures user privacy and prevents the creation of centralised databases of sensitive location and health data by governments or private companies.

And yet.

The Markup, an organisation that writes about the ethics and impact of technology on society, recently disclosed that Google's Android system could allow third parties to access information on users from Covid tracing apps. Google is now being sued in California over this issue.

And we still don’t know whether any of these apps or exposure notifications have made any significant difference to contact tracing efforts or controlling the pandemic. The likelihood is that apps have not made much difference.

An Oxford study last autumn suggested that at least 56 per cent of a population would need to be actively using the app for it to be an effective tracing tool. As far as I can discover, no app has reached that population threshold.

Bluetooth has its limitations, too, highlighted last year in research from Trinity College.

Iceland has what was viewed as a model app and nearly 40 per cent of the population started using it. But the official leading their contact tracing efforts found early on that it “wasn’t a game-changer” and said manual contact tracing was more effective.

Last autumn, medical journal The Lancet published a detailed review of tracing apps which noted many inherent potential weaknesses, especially the need for very high uptake (up to 80 per cent), plus real-world follow-through like widespread testing and tracing, and adherence to self-quarantine.

Ireland's Covid Tracker app had a swift initial take-up, but it is used by only a third of the population. Active users levelled off at 1.3 million out of 2.52 million app downloads/registrations, according to the app, which also notes that 34 per cent of the over-16 population in Ireland use the app almost a year after its introduction.

What about Ireland?

Ireland has had more than 250,000 cases of Covid, but only 15,500 people have uploaded their positive test information to Covid Tracker, alerting over 24,000 people as contacts. Every possible Covid case prevented is to be applauded but still these are tiny numbers.

Comparing Covid Tracker to one US implementation of the Google/Apple system, I can see likely reasons why US app usage is low. I’m out in California, so I switched my phone over to the state’s Google/Apple CA Notify system. This logs exposures, and alerts contacts who cross an exposure risk threshold (based on proximity and time exposed).

There’s an Android app, while iPhone utilises the phone’s in-built “exposure notifications” setting. This lists your number of exposures over two weeks.

But figuring out what the numbers mean and if they indicate actual risk is exasperating. The information page (if you can find it) blabs on forever, in numbing detail. Going on the many worried questions (and incorrect replies) on internet forums, lots of Americans panic that all exposure indications are risk alerts (they’re not).

This straight-out-of-Silicon Valley implementation is off-putting and user unfriendly.

Using the California system has made me appreciate the thought that has gone into Covid Tracker, which presents data to Irish users in an accessible way, and adds features, like county case numbers and national vaccination numbers, that I find informative.

But again: given the cost of such apps, to what end? Compared to investing in human test and trace?

At this point, even the tech crowd is notably quiet. No one talks much about tracing apps anymore. Back in November 2020, The New York Times’ Wirecutter tech blog noted that limitations of tracing apps were becoming clear.

"We cannot 'tech' ourselves out of this pandemic," insisted Gennie Gebhart, acting activism director at the Electronic Frontier Foundation. Her cautions were spot on. I scoured search engines for new studies or updates on app effectiveness. Tumbleweed. App hype has turned to telling app silence, or maybe, disinterest.

It is telling how quickly tech solutions to complex issues are breathlessly celebrated, on scarce evidence, and without public buy-in. How swiftly they nonetheless get adopted by governments and pushed out, despite cautions and caveats.

Given endless proposals these days to tech our way out of all sorts of challenges, we’d be wise to heed such learnings from Covid apps, and beware tech solutions in search of a problem.