Digital Contact Tracing Technology: Overview and Considerations for Implementation

Digital Contact Tracing Technology: Overview and Considerations for Implementation

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May 29, 2020
Digital Contact Tracing Technology: Overview and
Considerations for Implementation
Background
Figure 1. Apple-Google Digital Exposure Notification
“Contact tracing” is a public health measure used to control
Using Bluetooth
disease spread. Trained public health workers assist patients
with an infectious disease recall their close contacts within
a given timeframe, notify them of potential exposure, and
provide advice to patients and contacts. Given the scale of
the COVID-19 pandemic, some public health authorities are
automating part of the tracing process with smartphone
applications (apps). Some apps take advantage of Bluetooth
signals to track individuals proximity to one another,
otherwise known as “digital exposure notification (DEN)”
Bluetooth allows short-range wireless communications
between electronic devices. Apps may also be used by
public health authorities to enable “digital contact tracing”
(DCT), which may also use location data.
Development of DCT and DEN Apps in
the United States
In response to the COVID-19 pandemic, several countries
have developed nationwide apps to support contact tracing
among their citizens. Singapore developed and adopted
both the BlueTrace protocol and TraceTogether app.
Although the app is used only in Singapore, its Government
Technology Agency has made the BlueTrace protocol
available to other countries; Australia has adopted the
protocol for its app. South Korea, Bulgaria, Iceland,
Germany, and France are among the countries that have
released or are developing nationwide apps.
The United States has taken a decentralized approach, with
states engaging the private sector to develop tracing tools.
North Dakota, South Dakota, and Utah have independently
deployed DCT apps using both location data and Bluetooth
signals. Companies such as PricewaterhouseCoopers and
Salesforce are developing apps to allow corporate clients to
track the proximity of their employees within an office or
on a campus. In both contexts, if a citizen or employee tests
positive for COVID-19, other individuals who may be at
risk can be identified and contacted. The possibility of
widespread, and perhaps mandatory, monitoring, whether
by the public or private sector, has drawn scrutiny from
privacy advocates.
Apple-Google Collaboration
On April 10, 2020, Apple and Google, which develop the
iOS and Android mobile phone operating systems,
respectively, announced a partnership to develop a protocol
to support the development of digital exposure notification
apps that use a smartphone’s Bluetooth signal. The protocol
will work on both operating systems, which account for

nearly the entire share of the U.S. mobile phone market. It
Source: https://blog.google/documents/57/Overview_of_COVID-
was released to developers on May 20, 2020. Figure 1
19_Contact_Tracing_Using_BLE.pdf.
illustrates how apps built using the Apple-Google protocol
In the United States, users must download and opt in to an
are planned to work.
appropriate state or regional tracing app as well as opt in to
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Digital Contact Tracing Technology: Overview and Considerations for Implementation
the Apple-Google tracking feature in the operating system.
state apps already in use, and any new apps that use
Once enabled, a person’s smartphone will exchange
location data, will not be interoperable with those using the
anonymous identifier beacon keys with nearby smartphones
Apple-Google protocol. The inability to exchange data
using the Bluetooth signal. According to both companies,
among some proximate app users will impact the
personally identifiable information will not be collected.
effectiveness of digital contact tracing efforts.
The anonymous identifier beacon keys remain on a person’s
Coverage: Public Attitudes and Tech Availability
phone unless that person reports a positive COVID-19
Many epidemiologists have stated that apps will be
diagnosis through the app. At that point, the phone uploads
effective in halting the spread of COVID-19 nationwide if
the last 14 days of proximate contact data to a server, which
between 60% and 80% of the population downloads and
sends automated alerts to the individuals whose beacon
uses them. However, it may not be possible to reach even
keys are in the dataset. The alert provides recipients with
the low end of this estimate. A recent Washington Post-
public health information and what actions to take without
University of Maryland poll found that nearly 60% of
revealing the identity of the infected person.
Americans would be either unable or unwilling to use a
Considerations for Implementation
digital contact tracing smartphone app. Differences in state
digital contact tracing requirements and uneven adoption
Discussion of U.S. digital contact tracing has identified a
across states may further complicate efforts to reach the
number of challenges related to its use, including Bluetooth
required number of users nationwide.
limitations, app effectiveness versus personal privacy,
interoperability, and coverage. Each poses a different
U.S. smartphone ownership rates will affect the ability to
challenge to effective use of digital tracing capabilities.
reach the estimated number threshold needed for effective
Bluetooth Limitations
digital contact tracing. The Pew Research Center found that
in 2019, 81% of Americans had a smartphone, but that
The Bluetooth signal strength and attenuation are variable
figure is lower for the elderly and those making less than
and affected by numerous factors. Distance between
$50,000. Those without smartphones will not benefit from
smartphones, smartphone type, and object interference
public health interventions enabled by digital tracing apps.
affect signal strength, which will be stronger when a
smartphone is carried by hand and weaker from the bottom
Related Legislative Proposals
of a purse. Signal variation will make distance sensitivity
As of May 22, 2020, three bills have been introduced that
calibration difficult, affecting the accuracy of the app.
address privacy issues related to digital contact tracing
Observers have noted that if the calibration is too sensitive,
apps, one proposal from the Senate and a second proposal
there would be a risk of false positives, but if it is not
that has been introduced in both the House and the Senate:
sensitive enough, some interactions would go undetected.
 The Public Health Emergency Privacy Act (H.R. 6866,
App Effectiveness Versus Personal Privacy
S. 3749) was introduced in the House by Representative
Bluetooth data cannot provide the location of possible
Anna Eshoo on May 14, 2020, and referred to the
contacts, only that two users have been proximate. Global
Committee on Energy and Commerce the same day. The
Positioning System (GPS) data, and to a lesser extent cell
bill was introduced in the Senate by Senator Richard
tower signal and Wi-Fi data, can provide location
Blumenthal the same day and referred to the Committee
information. Apps collecting both Bluetooth and location
on Health, Education, Labor, and Pensions.
data provide greater detail to health officials than apps
using only Bluetooth tracking, which may better support
 The COVID-19 Consumer Data Protection Act of 2020
manual contact tracing efforts by identifying where
(S. 3663) was introduced in the Senate by Senator Roger
exposure may have occurred. Apple and Google, though,
Wicker on May 7, 2020, and referred to the Committee
have explicitly banned the collection of location data by
on Commerce, Science, and Transportation the same
apps built using their protocol to protect individual privacy.
day. A House version has not been introduced.
State public health officials will need to decide to either use
The three bills aimed at securing the data collected by
a Bluetooth-only app that will only identify encounters or
digital contact tracing apps differ significantly in their
use another app that will identify encounters and collect
approaches, such as:
more detailed location data. They will also need to
determine whether to make the use of digital contact tracing
 how and to what extent the legislation would ensure
apps mandatory. Privacy advocates have raised concerns
government transparency and consumer privacy;
surrounding apps using location data, fearing the data may
 the scope of entities covered (private, or public and
be used for punitive purposes, such as individual quarantine
private);
enforcement, or used for purposes unrelated to fighting the
pandemic, such as law enforcement.
 whether to preempt state laws that might require more
Interoperability
robust consumer protections; and
As of May 20, 2020, Apple and Google have reported that
 whether to provide a private right of action to
22 countries across 5 continents and many U.S. states have
individuals against companies if their data is used in an
decided to base their apps on its protocol. As noted earlier,
unauthorized manner.
though, some countries and U.S. states developed their
digital contact tracing apps before Apple and Google made
Patricia Moloney Figliola, Specialist in Internet and
their announcement. Since Apple and Google disallow the
Telecommunications Policy
collection of location data in apps using their protocol, the
IF11559
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Digital Contact Tracing Technology: Overview and Considerations for Implementation

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