This article is part of Privacy in the Pandemic, a Future Tense series.
So far, attempts to use apps for contact tracing in the U.S. have largely fallen flat. Each state has had to decide whether to issue an app at all, and then what kind of system to use. States that have created apps have struggled to get people to download them at all. But Apple is hoping it might change things.
Last week, Apple released iOS 13.7 with built-in support for a new coronavirus contact tracing system. Unlike previous efforts to leverage smartphones for contact tracing, this built-in system doesn’t require you to use an app issued by your state. A notification will appear on iPhones that the tool is available, and users only have to tap the screen to enable it. (Google has released a complementary tool for Android, though it still requires users to download a separate app.) This could be a significant step in getting more people, which is crucial for the contract tracing to work, but there are still a number of outstanding issues with the technology.
Earlier in the pandemic, Apple and Google partnered on an exposure notification system that states and countries were supposed to use to build their own apps. Their system, like the new feature in iOS, takes advantage of Bluetooth signals that smartphones can emit and receive to track instances in which two users come within a close distance of each other. When a user reports a positive coronavirus test to the app, it sends a notification to everyone else that person has been in contact with. Studies indicate that about 60 percent of the population needs to be using such systems in order to considerably slow infections, though it could still be somewhat effective with adoption rates as low as 15 percent.
So far, it doesn’t look like any locale in the U.S. has reached that level of penetration, partly due to privacy concerns from the public. Indeed people have reportedly been wary about divulging info like home addresses and names of acquaintances. Less than 5 percent of the population in North Dakota downloaded the state’s app as of June, while only about 1.8 percent of Utahns had done so by July. A June survey further found that 71 percent of Americans were not planning on downloading these apps. Many states also haven’t made any plans to release contact tracing apps, and the ones that have are failing to sync their systems with others, which would make the technology much less useful. Apple and Google’s system, though, allows for interoperability between states.
Removing the extra step of iPhone users having to go download an app should make enrolling in the system a lot easier. “It can’t help but improve adoption,” said Jeffrey Kahn, director of the Johns Hopkins Berman Institute of Bioethics. “There are multiple layers of challenges for States and localities, but among them was how do they get an app made. That goes away with this new plan.” States previously had to build their own apps on top of Apple’s Exposure Notification API, which was costly—Virginia, which in early August became the first state to release such an app, spent almost $230,000 to develop it and $1.5 million to market it. Integrating contact tracing directly into the operation system could make the technology more enticing for both users and local governments. Nevada, Virginia, Maryland, and Washington, D.C., having already signed up to use Apple’s new tool.
But simply increasing adoption won’t be enough to make this contact tracing system effective. In fact, if a number of outstanding issues are not resolved, it could end up doing more harm than good, according to Ryan Calo, a law professor at the University of Washington who studies emerging technologies. “I don’t know that adoption is going to be good enough nor even that adoption is the biggest hurdle,” he said. “Absent a real sea change in the way that we address the disease, [native support] is not likely to overcome the problems.”
According to Calo, the app would be most effective in an environment where there is rapid and accurate testing, a low prevalence of the disease, and a high number of users. If it takes more than a week for people to get test results, this system is basically useless. And the technology can actively frustrate efforts to stem the spread of the disease if it is under- or over-inclusive. False positives are a common concern since there are scenarios in which people come into close proximity, but there’s little chance of infection: Perhaps two people are on opposite sides of a wall or briefly cross paths on the street. If people get too many alerts about contact, they could eventually lose faith in the system. False negatives, on the other hand, can give people an unwarranted sense of security. It’s also possible that bad actors could use the technology for spreading misinformation. Given what we’ve seen with the manipulation of social media, it’s not out of the question for trolls to unleash pandemonium by flooding the system with fake reports.
Kahn, though, believes that any damage that the app could potentially do wouldn’t likely be lasting or permanent. In cases where there’s an issue like a multitude of false positives, administrators can shut off the system and attempt to figure out a solution. Kahn expects that, as with any new technology, there’s bound to be continuous cycle of glitches and solutions, as evidenced by the fact that Apple has already moved away from an app approach—mere weeks after Virginia released its app—and instead pursued native support. It may be worth working out these kinks for posterity. “I don’t think anybody who lives in public health world thinks that this is the last pandemic we’re going to see in our lifetimes,” he said. “So we need to figure this out for the next time.”