Does contact tracing work? This new tool aims to fight COVID in schools

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In Spring 2020, Graham Grieve was teaching English in Italy thanks to a Fulbright scholarship. The country was one of the first to face major outbreaks of COVID-19, and Grieve was one of the first in the world to attempt to teach through a screen. Struggling to connect with the students, he quickly began to think about how to get the students back into the classroom.

“I realized that schools were going to try to reopen if they could because online education was untenable for many,” he said. “But looking at the different public safety protocols that schools would use, it was clear that contact tracing was going to have a lot of holes.”

Contact tracing is a public health practice used to identify people who have been exposed to an infectious disease, in order to slow its spread. During the COVID-19 pandemic, contact tracers called people who tested positive for COVID-19 and asked them who they had spent at least 15 minutes with, less than six feet away, in the previous two weeks . The process is notoriously flawed as patients are often unable to remember the names of everyone they have come into contact with.

When Grieve returned to the United States in March, he immediately started building the Trace Innovations contact tracing app to help solve this problem. The company, headquartered in San Francisco, provides a centralized technology-based contact tracing tool for schools to reduce the burden of human contact tracers. Once the app is downloaded to student devices, it counts the number of students who spend fifteen minutes or more within six feet of each other. When a student tests positive, Trace Innovations provides school administrators with a list of potential close contacts.

It’s not the only company developing coronavirus-fighting technology based in the San Francisco Bay Area. Nodle has created a wearable device that makes employees vibrate when they are too close to each other to encourage social distancing, for example. The best-known contact tracing technology comes from Google and Apple, which have partnered with public health officials to create an exposure notification system. Their technology, called CA Notify in California, notifies users individually when they have been exposed to someone who identifies as positive for COVID.

Yet the promotion of these types of contact tracing technology solutions fizzled out around May of this year. San Francisco public health officials have focused their energy on measures like vaccines and masks, and cut resources for contact tracing overall. While the Department of Public Health once had 300 contact tracers, manually calling patients one by one, they now only have 80. For this reason, some people believe that contact tracing technology deserves another. luck.

“San Francisco probably had the best contact tracing program in the country, and yet we still weren’t able to reach all of the contacts as quickly as was necessary to prevent the spread of the disease,” said Michael Reid, the chief medical officer of UCSF’s Pandemic Equity and Action Initiative, who led the city’s contact tracing program until last June.

But there is a plethora of privacy concerns with technology-based contact tracing, mostly due to concerns about government control over location data and whether that data is being properly anonymized. (These apps don’t track a user’s location; they just know which users are within six feet of others.)

The fact remains that Trace Innovations has made a controversial choice with regard to privacy: the tool collects data and gives them to a singular and centralized body. In the case of the schools they work with, a school principal or nurse usually receives it.

Parents are notified when the school decides to start using the app, and students and parents sign the language of enrollment. In addition, Trace Innovations erases trace data from its personal servers every two weeks, which technology from Google and Apple does not. While some may fear CA Notify for its government affiliation, Trace Innovations requires users to trust a private company with their data, as well as a human contact tracer at school.

Grieve says it’s important for schools, where many unvaccinated students mingle. “A lot of people don’t actually take the recommended next steps after receiving a notification from Apple or Google,” like quarantining and getting tested for coronavirus, he said. “Without hierarchical authority, there is no monitoring to protect people. Private organizations need to be able to really understand who has been at risk to avoid a future outbreak. “

Reid, however, is cautious. “I think as long as this information is used judiciously, it is probably fine, but I am concerned about the way the information is disclosed,” he said. “Who guarantees the welfare of the Latinx kitchen worker who’s on display, and then the school says ‘hey, can’t you come to work?’ This is where I get worried about how these things are used in the private sector because it doesn’t always align with core values ​​of stocks.

Moreover, the technology itself is not always precise. Most contact tracing tools rely on Bluetooth technology, which the very inventors of Bluetooth claimed was a flawed approach in May 2020. Anyone who has ever struggled to connect their cell phone to a Bluetooth speaker within a few centimeters away knows their concerns: the technology just isn’t very consistent. It uses radio waves with which physical barriers and other electromagnetic signals easily interfere. It’s also possible for Bluetooth-dependent devices to declare someone as a close contact who was within six feet, but behind a sealed door.

Even at low adoption rates, however, technology is having an impact. An Oxford study conducted in Washington state showed that in areas where use of contact tracing apps is as low as 15%, infections and deaths have declined by 8% and 6%. Additionally, Reid argues that public health measures like vaccination and masking are more likely to negatively impact encouraging risky behavior than contact tracing technology – despite the three strategies creating more benefits. that damage.

As of August 16, 367 cases of coronavirus have been reported in SFUSD schools. However, due to heavy district bureaucracy, Grieve says Trace Innovations only works with private schools at this time. Six California private schools are using the technology, including Woodside Priory on the peninsula.

Google, Apple, and Trace Innovations all say their technology shouldn’t be viewed as stand-alone solutions. Grieve adds that the most successful implementation of contact tracing apps involves the people themselves.

“For contact tracing apps to be successful, they really need to be paired with a human contact tracer,” he said. “By combining manual methods with Bluetooth, we are able to fill in the gaps. “

virwin@sfexaminer.com

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