Tracking Apps Prevent COVID Cases. Why Are So Few States Using Them?

For many countries, contact tracing apps are just another part of the new COVID normal. These apps run in the background of users’ phones, constantly pinging and listening to nearby phones. When a positive test result is logged on the app, exposure notifications are sent out to any phones that spent time near the positive patient’s, and users can take the appropriate testing and quarantining measures.

Despite being home to the tech companies powering many of these apps, the U.S. barely uses them ourselves.

A national adoption rate of 2.47% places the U.S. 56th globally.

What explains the U.S.’s failure compared to peer countries?

One possibility: states aren’t directing enough resources towards their tracking apps. It takes much effort to get an app into the hands of a significant part of the population. There are TV ads to run, criticisms to address, and bugs to fix. What’s more, many of the apps require a contact tracer to call the exposed user after exposure, adding to contact tracers’ already overloaded responsibilities.

Yet this hardly explains how the U.S, one of the richest countries in the world, lags behind 55 other countries in app adoption.

A better explanation looks at two uniquely American problems: the lack of public faith in technology privacy, and the country’s growing misinformation problem.

Privacy

Hesitancy around tracking apps presents a major hurdle for even the most technically private apps. Traditional American ideologies around privacy, combined with several major privacy scandals in the last decade, have heightened public suspicion in the U.S. around digital privacy

The U.S. ranked 36th out of 42 countries, for example, in a recent Harvard Business School study quantifying digital trust, as measured by willingness to complete actions on phones without giving up.

In fact, a robust link exists between this digital trust metric and adoption of COVID Tracking Apps, as measured by downloads from the Google Play store.

Among OECD countries whose data I could access (n = 23), 23.7% of the variation in tracking app adoption can be explained by differences in this digital trust metric. The 7 countries who scored below 2 on the HBS digital trust metric averaged 5.9% app adoption in the Google Play store. The 5 countries who scored above a 3 averaged more than triple this, at 18%. [1]

Misinformation

A second problem is that of misinformation. The broken information ecosystem in America that has haunted American politics this decade reared its ugly head again during COVID.

25% of Americans surveyed last July believed COVID was intentionally planned by powerful people. [2] Almost 40% of Americans surveyed in October felt that the COVID fatality rate was exaggerated. This placed the U.S. 11th out of 15 countries included in the survey, with almost double the percentage of affirmative responses as countries like Spain, Sweden and the U.K.

This does not a fertile ground for a tracking app make.

Privacy and misinformation issues overlapped, as misinformation stoked privacy fears about a government tracking app. In Virginia, one of the few states to reach widespread adoption, health officials described the fight against misinformation labeling a virtually impenetrable privacy protocol as government overreach.

“It’s unfortunate, but COVID has become politicized,” said Jeff Stover, a Virginia health department official. “We tried to get ahead of conservative media so that they didn’t jump in and say, here’s the government intruding, looking to track you.”

Social media, in particular, was a hotspot for misinformation about the app. Health officials doubled as content moderators to combat inaccurate information about the privacy of the app, responding to false statements on the app store with preloaded messages. In Virginia, officials went as far as hiring sentiment analysis consultants to monitor false privacy criticisms of the app and ramp up marketing efforts as needed.

All this to promote an app broadly approved of by privacy experts.

In Utah, health officials gave up completely on their $6 million tracking app project just months after launching, citing people’s privacy concerns as the primary reason for the app’s failure.

How important?

Researchers in the UK estimated that their app prevented between 300,000 and 600,000 infections since its launch last September. With 1 in 50 infections ending in death, this suggests the British app saved between 6,000 and 12,000 lives in just 5 months.

A similar app in the US, which has 5 times the population as the UK, could have saved between 30,000 and 60,000 lives. [3]

Trust as a public good

The U.S.’s inability to promote widespread adoption of COVID tracking apps underscores the cost of undermining the public’s trust. Worse, the U.S’s ongoing problem with privacy scandals and misinformation doesn’t seem to be stopping anytime soon. Just last month, 533 million users’ data (including this author’s) was leaked in a data breach at Facebook.

And April also ushered in the latest batch of viral false claims, among them that Joe Biden planned to force Americans to eat less meat, that racial equity measures in Virginia are eliminating advanced math, and that Kamala Harris is evangelizing migrants at the border with copies of her new book.

These problems won’t go away on their own. In a digitized world, secure and trusted privacy providers are paramount. The architecture of the internet must change, too, to prevent the viral spread of misinformation.

humanID as the Solution

Say there was a trusted, anonymous sign-on method to use a COVID app without ever revealing your identity. Say across the internet, this online identity was withheld from the bots and sock puppets that spread fake news on app stores and social media sites. Say everyone trusted COVID tracking apps as a result, and adopted them in numbers.

humanID strives to bring about this world. humanID is a single sign-on platform, replacing the commonly used “Sign in With Facebook” feature. By anonymizing your identity from the moment you sign, humanID prevents websites from connecting your online identity to your offline one. At the same time, it democratizes the world of online identities by restricting everyone to one online identity. One human gets one humanID. Democracy works when voices exist on a level playing field, and don’t when governments, partisan actors, and radical individuals can artificially amplify their voices through bot networks and multiple accounts.

A more private world is a safer world. A world where facts are believed is a safer one too. The COVID tracking app fiasco, and the tens of thousands of lives lost as a result, is a morbid reminder that our digital world needs fixing.

What’s humanID?

humanID is a new anonymous online identity that blocks bots and social media manipulation. If you care about privacy and protecting free speech, consider supporting humanID at www.human-id.org, and follow us on Twitter & LinkedIn.

All opinions and views expressed are those of the author and do not necessarily reflect the position of humanID.

[1] 23 OECD countries had data in both the HBS study on digital trust and on the Google Play Store. I fit their digital trust metric against their adoption % linearly, and found an R² of .238. Considering all the other factors that could influence this score (resources devoted to market the app, timing of pandemic, quality of app etc.), I consider this a pretty strong correlation. See data here.

[2] Similar percentages reported here

[3] I took two approaches to estimating the lost impact of COVID tracking apps in the U.S. First I looked at a research paper in the U.K. analyzing the impact of their app. The U.K. app uses the Apple/Google exposure notification protocol, as nearly every state does, making it an ideal comparison. The U.K. app was launched in September of 2020. It has since reached 50% of the eligible population (adults with phones). Over that time period, researchers estimated that the app prevented between 284,000 and 594,000 infections, corresponding to between 6,000 and 12,000 avoided deaths.

A second approach is to extrapolate from Virginia’s COVIDWISE app performance.

• Suppose every state achieved the same penetration as Virginia.
• Scale up Virginia’s 60,000 notifications (and counting) by population
• Estimate 6% of these exposures were actual transmissions ( this figure is drawn from data in the U.K.)
• Estimate that 80% of these notifications were not caught by other contact tracing methods (probably a conservative estimate as America still lags behind in contact tracing)
• Estimate that 50% of these exposures were not caught by people on their own
• Estimate that each successful notification prevents 1 additional COVID case. (R is 1.2–1.5 and most infections occur in the early stages of infection)
• Estimate that each prevented case would have averaged a 2% mortality rate

Multiplying everything estimates that a contact tracing app comparable to Virginia’s could have prevented 50,000 deaths if adopted across the U.S