Emerging SARS Contact Tracing Technologies May Significantly Increase Need for COVID-19 Testing

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Though privacy and data protection concerns will persist about digital smartphone tracking for COVID-19, clinical laboratories and pathology groups should expect increased COVID-19 testing volumes resulting from new contact tracing technology.

Google and Apple have announced a joint venture to provide a COVID-19 contact tracing tool that enables better and more effective virus contact tracing. This tool takes the form of software that the companies released that enables development of apps that use Bluetooth technology in smart phones to alert users to possible COVID-19 exposures. The technology will have long-term COVID-19 testing implications for clinical laboratories and pathology groups.

Downloadable by Apple and Android users, Google-Apple enabled COVID-19 contact tracing apps will monitor for the presence of unique IDs associated with the app on nearby phones. The app uses Bluetooth to only exchange information with phones that have been in proximity to the user. If a user later is diagnosed with COVID-19, that user can upload the information into the app. Those who have the app and have been in close proximity to the affected user over the infectious period will then receive a notification about exposure to someone who has recently been diagnosed with COVID-19.

Forbes reported May 20, 2020, that Alabama, North Dakota, and South Carolina are among the first states to sign on to the new Google-Apple based contact tracing software.

While contact tracing technology has multiple public health benefits and enhances contact tracing abilities, potential risks have been raised. One revolves around privacy. The other concerns possible reports of false positives (by people erroneously or deliberately identifying themselves as COVID-19 positive when they are not). Google and Apple appear to be addressing these concerns that properly managed and mitigated may foster broad public appeal and wide utilization of contact tracing apps.

For the JAMA Network, I. Glenn Cohen, JD, of Harvard Law School, and others presented cautions and viewpoints on smartphone tracking and civil liberties in a May 27, 2020 article, stating: “Once an application is in the public sphere, it could remain a long-term feature in the smartphone environment. To avoid long-term uses, so-called function creep, especially for nonpublic health purposes, federal or state authorization for digital applications could be tied to the duration of COVID-19 emergency declarations with an automatic sunset in place.” 

I. Glenn Cohen of Harvard Law warns of function creep with COVID-19 contact tracing apps

I. Glenn Cohen, JD (pictured), of Harvard Law School and others warn of “function creep” with smartphone tracking apps such as those being developed for COVID-19 contact tracing. (Photo copyright: Harvard Law School)

It is unknown what regulations and standards will emerge that seek to protect personal privacy, protect the use of the data, and ensure the quality of the algorithms that develop.

US States Adjusting Resources for COVID-19 Contact Tracing Programs

Contact tracing is considered the next step in slowing the spread of COVID-19. It is a process that has been used by public health for decades to slow the spread of infectious disease. 

In addition to the work of the Google-Apple contact tracing app and similar technologies of other private companies, various states around the US are beginning to launch or have already launched their contact tracing programs to varying degrees, using unique and common resources.

The Connecticut state Department of Public Health launched that state’s COVID-19 contact tracing program May 20, but acknowledged that more work is needed to get it running at full strength, according to a May 26 article in the Hartford Courant.

“The bigger picture here is you can’t expect systems to just automatically click a switch and be prepared to deal with situations of the magnitude of which we are dealing with when you have disinvested in your public health system for eons,” stated Farmington Valley Health District Director Jennifer Kertanis in the Courant’s coverage. For Connecticut’s contact tracing initiative, officials are using Microsoft’s At Risk Investigation and Alerting System, a platform which has the capability to make automated text and voice calls to mobile telephones. 

In Delaware, contact tracing involves mobilizing 100 members of the Delaware National Guard, embedding them with the Division of Public Health to begin wide-scale, statewide contact tracing, the state announced May 12. Delaware Gov. John Carney announced that the State of Delaware entered into an agreement with the nonpartisan research institution NORC at the University of Chicago to build Delaware’s statewide contact tracing program to contain COVID-19, limit Delawareans’ exposure to the disease, and restart Delaware’s economy.

California is planning to launch 10,000 contact tracers statewide as part of its plan to reopen that state. More than 500 individuals have been trained under the new contact tracing program, and more than 300 are being trained this week, according to a May 22 release from Gov. Gavin Newsom. To streamline and coordinate these efforts, Accenture, a leading global professional services company, is launching a data management platform developed by Salesforce and contact capabilities (phone calls, texts and emails) in collaboration with Amazon Web Service’s Amazon Connect. These organizations have already successfully implemented a large-scale contact tracing effort in Massachusetts, according to the release.

Impact of Contact Tracing Programs on State and Local COVID-19 Test Demand

As more contact tracing systems and technologies are used, clinical laboratory directors and pathologists will want to monitor COVID-19 lab test demand patterns in their respective regions and locales. According to Wired, a publication focusing on the effects of emerging technologies, “Any effective contact tracing will require testing for Covid-19 to ramp up far past current levels.”

Implementing broad or statewide contact tracing initiatives may lead public health officials to encourage more COVID-19 testing at levels beyond current testing levels. The public at large may also demand more testing as increasing awareness of COVID-19 exposure may lead some to pursue testing on their own if pushed through privately developed smartphone apps.

Though questions may remain about COVID-19 contact tracing programs and the reach and risks of the digital technologies used for them, clinical laboratory directors and pathologists can expect that demand for SARS-CoV-2 testing will increase in the coming months.

Caleb Williams

—By Caleb Williams, Editor, COVID-19 STAT

Related Resources:

Implications of COVID-19 Contract Tracing Technology

Digital Smartphone Tracking for COVID-19 Public Health and Civil Liberties in Tension

Alabama, North Dakota And South Carolina To Debut Apple And Google’s Covid-19 Contact Tracing

Alabama balances privacy against accuracy in contact tracing app

Governor Carney Announces Statewide Contact Tracing Plan for COVID-19

Connecticut coronavirus contact tracing plan hobbled by inadequate staffing and training

Governor Newsom Launches California Connected

Contract Tracing: Latest from the CDC

Apple and Google Partnership for New Technology Statement

Health Officials Say No Thanks to Contact Tracing Tech

Google and Apple COVID-19 Contact Tracing App Overview

COVID-19 TESTING DATA

Helping Your Lab Stay Afloat During Challenging Times

Dear Colleague,

Robert L. MichelIn these challenging times for our colleagues in clinical laboratories, pathology practices and hospital administration, The Dark Intelligence Group (TDIG) — through generous grants from our partners — is bringing you the COVID-19 STAT Intelligence Briefings.

We’ve added analysts, writers and skilled editors to the COVID-19 STAT team to uncover, analyze, and immediately report to you what’s happening with the SARS-CoV-2 pandemic, packaged with the insights you need to deliver quality testing for patient care and keep your lab’s financial ship afloat. As part of our mission, we are also bringing you real-time data from our partners around testing that you will not find anywhere else.

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Sincerely,

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