When Apple and Google announced three weeks ago that they’d developed software to help fight the coronavirus pandemic, it was a big deal. The tech giants are fierce competitors. They rarely cooperate. And together, their software controls about 3 billion smartphones, equal to almost 40 percent of the world’s population.
It seemed clever, assuming the privacy implications could be worked out. The software would silently keep track of people who’d been near someone who tested positive for the virus, prompting those contacts to be tested and quarantined if necessary. The idea was to automate part of a laborious process called contact tracing, which public health officials use to stem the spread of an infectious disease. Thorough contact tracing, they say, is crucial to allowing the world’s economies to reopen without reigniting infection rates. But few organizations, if any, have ever done contact tracing at the scale that will be required to contain Covid-19.
Software developers flocked to tap the new Apple-Google capabilities. The state of Utah accelerated its work with Twenty, a small New York City-based social media app developer. Citizen, the developer of a public safety app with 4 million users nationwide, added a contact-tracing function to its app, though it is not yet activated. Tech executive Aniq Rahman created Zero, a group of about 200 developers and marketers including one of the developers of TraceTogether, Singapore’s contact-tracing app.
And why not? Cities and states were talking about hiring tens of thousands of contact tracers to manually reconstruct the movements of Covid-19 patients. But it wasn’t clear how these people could be hired and trained quickly enough to be useful. The Apple-Google software had the potential to do some of the same work effortlessly at a fraction of the cost.
It’s not working out that way. So far at least, the pandemic response has become a bitter lesson in everything technology can’t do and an example of Silicon Valley’s legendary myopia. States like New York, California, and Massachusetts, and cities like Baltimore and San Francisco, have looked carefully at cutting-edge contact-tracing solutions and largely said, “No thanks,” or “Not now.”
Instead, public health officials in hard-hit states are moving ahead to deploy armies of people, with limited assistance from technology. Massachusetts has budgeted $44 million to hire 1,000 contact tracers. New York State, with funding from Bloomberg Philanthropies, said last week it plans to hire as many as 17,000. California is soon expected to announce plans to hire as many as 20,000 contact tracers.
This analog approach will likely be the model nationwide, according to current and former health officials. Last week, two former federal health officials, Scott Gottlieb and Andy Slavitt, suggested the federal government create a massive, and manual, contact-tracing program. The plan, cosigned by 14 other doctors, scholars, and policymakers, would include $12 billion for up to 180,000 contact tracers; $4.5 billion to house infected and exposed people in vacant hotels; and $30 billion for 18 months of income support for those voluntarily self-isolating. “There is no silver bullet in the fight against coronavirus,” Slavitt, the former head of Medicare and Medicaid, told NPR. “But if we want to get back to a more normal existence, we need to give states the tools they need to contain the virus.”
It’s not super complicated to understand why technologists are having a hard time getting traction. Traditional contact tracing has been honed over decades of response to disease outbreaks. Officials ask patients where they’ve been and whom they’ve been near; they then suggest those people get tested for the disease and make sure they quarantine, if necessary. Quickly identifying and segregating people carrying the virus can slow the spread of a communicable disease. “It works by building a human bond between two people,” the patient and the contact tracer, says Tom Frieden, the former head of the US Centers for Disease Control and Prevention and the New York City Department of of Health and Mental Hygiene. “It means actually talking to someone and answering their questions, addressing their needs and concerns, and building, earning, and maintaining their trust and confidentiality.”