By Jerri-Lynn Scofield, who has worked as a securities lawyer and a derivatives trader. She is currently writing a book about textile artisans.
Ars Technica ran a piece yesterday that clutched its pearls at poll results showing the number of US respondents who intend to use a contact tracing app is declining, More than 7 in 10 Americans won’t use contact-tracing apps, data shows:
Because of the lag between infection and the onset of symptoms, people can contract the SARS-CoV-2 virus and then pass it on, potentially to many others, before they know they’re infected and have to isolate. So being able to identify and warn individuals who have been exposed to an infected person—known as contact tracing—is widely acknowledged to be a vital part of any effective strategy to beat COVID-19. Which is why it is extremely dismaying to see survey data that says fewer than 3 in 10 Americans intend to use contact-tracing apps to allow that to happen.
That’s down from 1 in 2 in April who would use such an app.
Interestingly, those most at risk appear to be most skeptical:
Most of the resistance to downloading a contact-tracing app came from people over the age of 55. US Centers for Disease Control and Prevention data show that people aged 55 and over account for almost 80 percent of US COVID-19 deaths to date.
Okay then, why?
Survey respondents who replied “no” to the first question were then asked to explain that decision with a multiple-choice poll. The most common reason cited was a concern about privacy; in all, 44 percent of those who said “no” to a contact-tracing app said they would not trust the technology to protect their digital privacy. But nearly as many (39 percent) also said they thought the apps created a false sense of security, and 37 percent said they believed the apps would not work to slow the spread of the pandemic. Thirty-five percent also indicated a lack of trust in the app providers.
You know what? These skeptics have a point. For Hong Kong, as I’ve written previously, has so far had remarkable results in checking COVID-19 spead, without relying on the use of any app (see Contact Tracing Via Old Shoe-Leather Epidemiology While Spurning the Techno-Fix Fairy: How Hong Kong Quells COVID-19 Without Killing Civil Liberties.)
One month after I wrote that last piece, this city of 7.5 million people – roughly the size of New York City – has so far logged 1113 cases and 4 deaths, despite being one of the most densely populated cities in the world, where many people would regard even tiny NYC studios as spacious paradises, and being located to close to mainland China, where the COVID-19 pandemic commenced.
Compare these figures to New Yorks: 17,193 deaths, out of 210,000 reported cases ,in a population 8.5 milllion.
Now, remarkably, Hong Kong never went to full lockdown. Look at my earlier piece if you haven’t already for it outlines some of the common factors Hong Kong shares with the US, such as incompetent leaders, e.g. Carrie Lam, Donald Trump, not to mention Andrew Cuomo, who were slow off the mark in embracing the use of masks.
For more on the mask issue, I refer you to this post from yesterday, Nassim Nicholas Taleb: The Masks Masquerade.
The debate over masks is in some places highly political, Yet in Hong Kong, anti-government sentiment cuts in the opposite direction to how it cuts in the US. The Hong Kong citizenry is by no means conformist and has indeed been in a state of revolt for more than a year. In October 2019. the Hong Kong government invoked a colonial-era antimask restriction, in response to the extensive use of masks by protestors to foil facial recognition software.
So, when COVID-19 appeared at their doorstep, people in Hong Kong were more than happy to embrace wearing masks, Other factors that contributed to Hong Kong’s success: experienced, competent public health officials, and a recent history of infectious disease outbreaks, with people well aware of their conseuences and more than willing to embrace measures to reduce their risks. Plus I shouldn’t forget to mention that the city offers top-notch, affordable health care, and its citizens aren’t afraid to ask for it.
Also key to stopping COVID-19 from taking hold in Hong Kong is a mind-bogglingly thorough test and trace policy (sometimes called track and trace; for more discussion of what such a policy looks like, see my shoe leather piece referenced above, plus U.S. COVID-19 Contact Tracing Programs Designed for Failure, Despite Bloomberg Money; Why Can’t the U.S. Copy the Lessons of Hong Kong’s Success?)
These posts describes what rigorous testing and tracing looks like, and what the US is doing instead. Test and trace is not, alas, a mere slogan. It must be properly undertaken. And once a sick person has tested positive, s/he must accept the consequences of that testiing. In a nutshell: the citizen must agree to be quarantined or self-isolated, but the state also has reciprocal responsibilities: it must monitor the patient, in self-isolation or quarantine facilities, plus provide health care and other support until a patient recovers (such as care for any caretaker for a child or elderly person who is isolated or taken into quarantine). I elaborate on these poiints in the Bloomberg money piece referenced above.
Now, it may be too late, given how far and fast COVID-19 has spread in the US (and elsewhere, for that matter), and the deficiency of its and trace measures, to eschew the use of an app entirely. But don’t kid yourself that apps are a panacea, nor by any means the approach that’s yielded the best results so far.
South Korea has similarly stopped COVID-19 spread in Seoul, another densely-packed city, again by using masks and test and trace, but also with use of an app. An app thefore might be a useful tool, but as Hong Kong shows, is by no means a necessary condition.
I don’t know much about other places, so I ask readers to weigh in in comments, but I know in Asia alone, Taiwan, Thailand, and Vietnam have shown great success in managing the pandemic, despite the density of Taipei, Bangkok, and Hanoi and Ho Chi Minh City, respectively – without I believe relying unduly on apps,
One other point. These apps are untested. Do they yield useful information, or is it just case of garbage in, garbage out? They also raise very real issues of who controls the data we surrender.
Whereas other mechanisms also work. And still work well. They’ve been part of the infectious control playbook for quite some time, and are tried and tested.
A vaccine may rescue us. As may discovery of therapies or prophylactics. And maybe contact tracing apps will be part of what one will have to accept in the future, as is now the case in India for boarding a flight. (See In new flight rules, airfare fixed by govt, only one check-in bag allowed.) As of this date, India has yet to restart incoming and outgoing international commercial flights, but when they are available, it’s overwhelmingly likely that downloading the app will be necessary to purchase an international fare.
As the WSJ makes clear in a lucid discussion of indoor air pollution and controlling the spread of COVID-19, What It Will Take to Make the Indoors Feel Safe Again – which strays IMHO a bit much into technofix fantasy – but then rights itself in its last paragraph:
Experts emphasize that the best approach to reducing illness in shared spaces is to employ many different interventions, not just one magical air filter or light fixture. In other words, you’ll still have to wear a mask, keep your distance and wash your hands.
People are not necessarily deluded, as the Ars Technica piece implies, for saying they won’t download a contact tracing app. As at present, such a tool is neither necessary, nor even the only or even the best way of stymieing the spread of COVID-19.