That’s the premise behind new apps that developers worldwide are racing to write to aid in contact tracing — finding and alerting people who’ve been exposed to the coronavirus so they can break the chain of transmission, such as by getting tested and quarantining themselves.
Public health experts and California Gov. Gavin Newsom say widespread testing and contact tracing are key to easing current restrictions on social and commercial life. Bay Area counties and other locations are already doing traditional contact tracing, which involves calling newly diagnosed people and interviewing them about their past two weeks of activities, and then calling all those with whom they had extended contact.
Harnessing smartphones, which the Pew Research Center says are used by 81 percent of adult Americans, could supplement and speed up the painstaking process. It could help find people even when an infected person didn’t know their names or forgot spending time with them.
“We believe we can accelerate the detection of the virus,” said Micha Benoliel, CEO of Nodle.io, a San Francisco company that spun out a nonprofit, Coalition Network, to write a tracing app called Coalition. “This is a tool to protect you and give you information as soon as possible if you have been in contact with it.”
“If we want things to get back to normal, this is the fastest way to do it,” said Tina White, a Stanford doctoral candidate in mechanical engineering, who originated Covid Watch, an app being developed by dozens of volunteers. “It’s also altruistic, so your friends and family get informed earlier and can take the right actions. It’s a very pro-social thing to do.”
Efforts by developers got a huge boost this month when Apple and Google, in a rare instance of collaboration, said they will build technology into iPhones and Android phones to enable widespread tech-enabled contact tracing while maintaining user privacy. The two companies will release software tools for developers in May to harness Bluetooth signals for contact tracing. The short-range wireless technology is built into most modern smartphones.
Apple and Google’s involvement “is very, very helpful,” said Rhys Fenwick, a founding member of the Covid Watch team. “There have been a few problems with the nitty-gritty guts of how the app works and how to get devices to talk to one another over Bluetooth. Apple and Google can fix those issues; they have fundamental access to the phones in a way we don’t.”
To ensure that they uncover as many contacts as possible, smartphone apps need widespread adoption. App developers say they are talking to public health authorities in cities, counties and entire countries who would like to roll out the technology for their citizens. Most of the apps are free, the underlying software code released as open source. Some apps from different developers may be able to talk to one another to safely and privately exchange contact data.
Even though all the U.S. app developers pledge strict privacy controls, it’s a big hurdle to ask people to install apps that will monitor their movements and contacts. Some could be wary knowing that China, Israel and Singapore have used contact-tracing apps that were decried as invading privacy.
But some public-health experts think that citizens might become amenable to monitoring, considering the alternatives.
“This could be your ticket out of shelter in place,” said Josh Michaud, associate director for global health policy at the nonprofit Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.
“If we see large-scale transmission or rapidly increasing deaths again, it could be that psychology would change,” he said. “People would understand that for us to have a functional society and achieve some level of normalcy, that they’d need to make the small sacrifice of downloading an app and keeping it on their phone and monitoring.”
Ben Bartlett, a Berkeley city councilman, made similar points.
“If it comes to being locked in your house all the time, not making any money, not having human contact versus having an app on your phone that helps you integrate back into the community, I think the choices are pretty clear,” he said.
Bartlett held an online town hall Wednesday to introduce his constituents to Coalition. The city hasn’t yet officially vetted that app or others, Bartlett said, but he wants to give people hope for a homegrown solution, “a smarter way to engage this problem.”
Other Bay Area cities say they are open to contact-tracing apps.
“I think all avenues should be pursued,” said Dr. Susan Philip, director of disease prevention and control for the San Francisco Department of Public Health. “Nothing beats good old-fashioned being able to talk to health professionals who can answer questions and provide assistance, but there are definitely roles to be played by these tech applications. If they can complement the work our in-person team is doing, we’re happy to look at them.”
Besides privacy concerns, the digital divide could be an issue. Heavy reliance on apps could “worsen the current disparity in risks and adverse outcomes for COVID-19,” said Dr. Dan Diekema, director of the division of infectious diseases at the University of Iowa’s Carver College of Medicine. “The people more likely to be early adopters and users of apps would be higher socioeconomic strata.”
Benoliel said Coalition is working on an app for flip phones and other non-smartphone models — still used by roughly 1 in 7 Americans, according to Pew — to address this.
There are two ways the apps work:
Bluetooth Coalition and Covid Watch both rely on Bluetooth, which is the short-range wireless technology that Google and Apple are using for their software. An app uses Bluetooth to perform proximity sensing, recording everyone nearby who’s carrying the same app or a compatible one. It makes this anonymous by using random numbers to identify those contacts. If any of those people later test positive for the coronavirus, they notify the app and it in turn notifies you, without revealing the identity of the virus case.
Although exact parameters can be easily adjusted, spending 10 minutes or more within 6 feet of someone is an example of the time and distance for which an app might be set to track proximity. The records would go back two weeks, to capture the average virus incubation period — another factor that could be adjusted as scientific understanding of the virus evolves.
Benoliel said Coalition has a leg up on this technical challenge. His previous company wrote FireChat, a peer-to-peer chat app that lets smartphones communicate via Bluetooth without a cellular network or the internet. It has been used by protesters in Iraq, India, Ecuador and China; by people at the Burning Man festival and by disaster workers.
Covid Watch said it guards against false reports of infection by providing an app to doctors that will generate a unique number for people who test positive to enter when they self-report.
• GPS Another approach uses GPS, a satellite-based position detection technology, to track where you go, storing that data on your phone. The data can generate a heat map with time stamps showing how long you spent at each location.
If you test positive for the coronavirus, public health authorities would ask you to share that location information so they could anonymize it and then reach out to others who spent time at those places. Even if you didn’t have the app, as long as your phone had location services turned on, health officials could upload Google Maps’ record of your movements. Then, that information could be used to track down those who were near you.
A team with more than 900 volunteers centered at the Massachusetts Institute of Technology is working on the GPS approach, viewing it as an infrastructure that others can build upon. Covid Safe Paths is the user app, and web software for public health authorities is called Safe Places. Safe Paths also will use Bluetooth for proximity sensing.
“We call it the infectometer, like a dosimeter for radiation,” said Ramesh Raskar, an MIT Media Lab professor who has spearheaded the effort. He’s a veteran of Facebook, Apple and Google. “You need to know, did I get too much exposure? It’s an early warning system.”
Susan Garfield, principal in health sciences and wellness at consulting firm Ernst & Young, who is volunteering with Safe Paths, said using the apps will benefit society.
“It asks people to join the collective fight against coronavirus,” she said. “It isn’t something we’re going to beat with folks sitting down and doing nothing and acting like we all have before. These technologies are part of the request to have us all in this together and do our part to both learn about our exposure, and limit the risk we present to others.”
©2020 the San Francisco Chronicle. Distributed by Tribune Content Agency, LLC.
