{"id":1674,"date":"2020-06-08T06:10:00","date_gmt":"2020-06-08T11:10:00","guid":{"rendered":"http:\/\/10xprinciples.com\/?p=1674"},"modified":"2020-06-08T08:01:38","modified_gmt":"2020-06-08T13:01:38","slug":"digital-apps-will-not-save-us","status":"publish","type":"post","link":"https:\/\/10xprinciples.com\/index.php\/2020\/06\/08\/digital-apps-will-not-save-us\/","title":{"rendered":"Digital Apps Will Not Save Us:
The Eminent Practicality of Basic Contact Tracing<\/i><\/br>"},"content":{"rendered":"\n

Contact tracing has been used for decades to fight Tuberculous, Smallpox, Ebola, and STDs. Despite the vast success of contact tracing in eliminating the world’s most dangerous diseases, it has always been a delicate dance between public health and personal privacy. New smartphone technology for contact tracing raises the big-brother hackles of people who distrust the data practices of the big corporations building these apps.<\/p>\n\n\n\n

As stay-at-home restrictions in the United States continue to be lifted and people increase their commingling, many scientists believe it will result in COVID-19 flare-ups. The CDC hopes vigilant testing and contact tracing will douse the flare-ups before they become full-fledged conflagrations. <\/p>\n\n\n\n

The potential of sophisticated contact tracing apps to help eradicate COVID-19 intrigues me. I’m a believer in using technological innovation to solve the world’s problems. With this in mind I decided to learn the basics about contact tracing by enrolling in Johns Hopkins epidemiologist Emily Gurley’s free Coursera COVID-19 Contact Tracing Course<\/a>. I began the class believing new technology will solve the problem but what I learned convinced me I was wrong.<\/p>\n\n\n\n

Common sense is the key ingredient in contact tracing. If someone is diagnosed with COVID-19, aka, a “case,” and is isolated<\/em> from others, the people who encountered the case during their infectious period, aka “contacts,” should be quarantined<\/em> from others. The Coursera course goes into detail about infectious periods, who is considered a contact, computing lengths of isolation and quarantine, and myriad other important details many of us may not know. This is the beauty of contact tracing – it’s a practical approach to corralling illness imbued with facts. Learning about contact tracing in this course takes less time than a couple of modern day movies – it’s closer to one movie if your choice is The Irishman<\/em>. <\/p>\n\n\n\n

As I was completing the course, in true 10xPrinciples<\/a> fashion, I wondered what makes a superb contact tracer? The course provides several entertaining Goofus and Gallant, (the Eddie Haskell and Wally Cleaver of Highlights Magazine<\/em>), comparisons showing the wrong way and the right way to conduct case and contact calls. A section of the course is devoted to building rapport on calls, how to productively ask questions, and how to show empathy. Dr. Gurley notes, “Contact tracers are equal parts detectives, investigators, social workers, and therapists.” This sounds very much like the job description for a Product Manager. It’s possible to teach a Goofus to say the right things but teaching empathy is nearly impossible.<\/p>\n\n\n\n

Contact tracers learn strict rules about confidentiality and privacy, and balancing them against the public good. For example, test results are confidential<\/em>, used only<\/em> for the public health investigation, and are not shared with anyone else. Furthermore, personal information about cases and contacts is kept private<\/em> – those who have been exposed will be informed, but will not learn the identity of the case. Contact tracers are trained to ignore any personal information revealed by a case or contact, e.g., “I’m afraid to seek social services because I’m undocumented,” unrelated to the public health.<\/p>\n\n\n\n

The United States is in a dark period with respect to immigration, racial relations, and income disparity. A municipality may implement a stellar testing and contact tracing program. Regardless, without buy-in from the community, the program’s foundation will have cracks. Some sick people are understandably wary of testing or being traced. Realistically, even if counties wage multifaceted public relations campaigns to dispel perceived fears, there’s no way to achieve widespread participation until societal changes rebuild trust. This means parts of a community may not receive time-sensitive and valuable contact tracing services.<\/p>\n\n\n\n

The chart below illustrates the very short time window before a person in proximity to a case may become infectious. On average, people exposed to COVID-19 display symptoms after five days and become infectious two days before exhibiting symptoms. This very narrow time window before infectiousness makes contact tracing urgent.<\/p>\n\n\n\n

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Image from COVID-19 Contact Tracing Course illustrating a short window of opportunity<\/figcaption><\/figure><\/div>\n\n\n\n

Given the time sensitivity of notification, a potentially large number of people to inform, and an overworked contact tracing team, technology may provide some badly needed assistance. Although flashy tracking apps in the works from Google and Apple are receiving the lion’s share of attention and trepidation, here are a few less intrusive technologies already used by contact tracers:<\/p>\n\n\n\n