The coronavirus pandemic has popularized terms that no one ever expected to be using. From “social distancing” to “Zoom happy hours” to “face mask“, the pandemic has created a whole list of buzz words. The newcomer to that list is “contact tracing”. But in fact, contact tracing is not just a buzzword, but an important strategy for preventing further spread of COVID-19.
Case investigation and contact tracing are core disease control measures that have been used by government health departments for decades. According to the Centers for Disease Control, “communities must scale up and train a large workforce and work collaboratively across public and private agencies to stop the transmission of COVID-19.”
What is contact tracing?
Contact tracing is a public health tool that has been used for a long time. The goal of contact tracing is to break the chain of transmission of infectious diseases.
The CDC has outlined six core principles of case investigation and contact tracing:
- Case investigation is part of the process of supporting patients with suspected or confirmed infection.
- In case investigation, public health staff work with a patient to help them recall everyone with whom they have had close contact during the timeframe while they may have been infectious.
- Public health staff then begin contact tracing by warning these exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible.
- To protect patient privacy, contacts are only informed that they may have been exposed to a patient with the infection. They are not told the identity of the patient who may have exposed them.
- Contacts are provided with education, information, and support to understand their risk, what they should do to separate themselves from others who are not exposed, monitor themselves for illness, and the possibility that they could spread the infection to others even if they themselves do not feel ill.
- Contacts are encouraged to stay home and maintain social distance from others (at least 6 feet) until 14 days after their last exposure, in case they also become ill. They should monitor themselves by checking their temperature twice daily and watching for cough or shortness of breath. To the extent possible, public health staff should check in with contacts to make sure they are self-monitoring and have not developed symptoms. Contacts who develop symptoms should promptly isolate themselves and notify public health staff. They should be promptly evaluated for infection and for the need for medical care.
What does Johns Hopkins have to do with contact tracing?
On May 11, Johns Hopkins University announced that it’s Bloomberg School of Public Health launched an online Coursera class that is designed to train an “army of contact tracers to slow the spread of COVID-19,” according to the press release.
The COVID-19 contact tracing class will be a requirement for those looking to get hired as a contact tracers by the state of New York, which is planning on hiring thousands of individuals to slow the spread of the virus.
The class teaches individuals how to interview people diagnosed with the virus, how to identify who they might have exposed to the virus, and provides them with guidance for the two-week self-quarantine.
“Even if you stop one or two new infections, you’re preventing many new cases down the line,” said Emily Gurley, Johns Hopkins infectious disease epidemiologist and lead instructor of the course, at a press briefing.
What do Google and Apple have to do with contact tracing?
The companies rolled out a coronavirus exposure notification system. Google and Apple did not create an app, but a unified application programming interface (API) that allows public health departments to create their own applications to conduct contact tracing.
“All of us at Apple and Google believe there has never been a more important moment to work together to solve one of the world’s most pressing problems,” a statement on Apple’s website read. “Through close cooperation and collaboration with developers, governments, and public health providers, we hope to harness the power of technology to help countries around the world slow the spread of COVID‑19 and accelerate the return of everyday life.”
Here’s how the technology works:
- A health authority uses Google and Apple’s API to create an application.
- Once you download the app, a unique token is formulated from the Bluetooth Low Energy (BLE) technology on your phone.
- If you are within a certain distance from someone for a certain period of time, and this person is also using the technology, your unique numbers would be exchanged.
- If you test positive for coronavirus, you would prove in the application that you had tested positive, which is a process that will likely be different for each state.
- The health authority would then be responsible to take your unique key and share it out to everybody using Google and Apple’s API.
- On the other hand, if you came into contact with somebody who tested positive, you would be notified that you had been in contact with someone who tested positive within the last 14 days. The health authority would also likely provide you with guidance for next steps and information on how to get yourself tested.
Digital contact tracing is designed to work hand-in-hand with the traditional form of contact tracing. The digital version of contact tracing has it’s pros:
- It is faster than traditional human-to-human tracing.
- It requires fewer resources than traditional tracing.
- It does not rely on human memory, making it easier to track exposure in crowded spaces or contact with strangers.
While digital tracing does have its pros, this version does have one major con: It requires people to download applications that will have access to their health data. One model by the University of Oxford, found that 60% of the population would have to use the technology for it to be effective in slowing the spread of the virus.
Does this technology pose security risks to users?
“Anytime we see a large amount of attention or development around a certain technology, in the security industry we see a shift in focus or research around that technology,” said Quentin Rhoads-Herrera, the Director of Professional Services at Critical Start, a cybersecurity company. “So as soon as Bluetooth started to be talked about for contact tracing, there was a lot of security research around those technologies.”
Back in February, there were Bluetooth bugs found, according to Naked Security by Sophos. The bugs weren’t “too serious” and also required “the attacker to be within Bluetooth Low Energy (BLE) range.”
Though manufacturers have patched vulnerabilities in bluetooth technology, it is still one that can be exploited and abused in some fashion.
The good news is that depending on whether or not your state decides to use this technology, it is a government agency collecting your health data, not a private company, meaning HIPAA regulations must be followed to protect individual’s privacy.
“Apple and Google don’t ever have access to your health data,” Rhoads-Herrera said. “They have access to your token that’s unique to you and that’s formulated from Bluetooth Low Energy.”
How can you protect yourself if you use this technology?
Technology risks shouldn’t discourage you from partaking in digital contact tracing if your state decides to use this method, however, there are steps you can take to protect yourself against any risk. One important step is making sure that you update your devices with the latest software improvements.
“When a vendor like Google pushes an update to your phone, make sure that you accept that update and keep your phone up to date as much as possible,” Rhoads-Herrera said. “Apple and Google are both fairly good at sending software updates and security updates on a decent schedule, especially when severe issues are found in certain technologies.”
That being said, it’s your responsibility to authorize those updates.
“It’s up to the end-user to update it, especially if you’re participating in something like contact tracing using Google and Apple’s method that’s using Bluetooth and they issue a Bluetooth update,” Rhoads-Herrera said.
Which states will be using human and digital contact tracing?
Across the country, a total of 100,000 contact tracers could be required in order to help limit the spread of COVID-19 and
The push for contact tracing is being backed by New York Gov. Andrew M. Cuomo and Michael R. Bloomberg, founder of Bloomberg Philanthropies and former three-term mayor of New York City.
New York State is partnering with both Bloomberg Philanthropies and Johns Hopkins Bloomberg School of Public Health and Vital Strategies to create the NYS Contact Tracing Program. The program, which will include a baseline of 30 contact tracers for every 100,000 residents in the state, is expected to have 6,400 to 17,000 tracers statewide depending on the projected number of cases.
“Contact tracing allows us to communicate with people infected with COVID-19, identify those who may have been exposed, and provide all of them with guidance to limit the spread of the disease,” Bloomberg said in a release. “This new training course, which we’re making available online for free, will teach contact tracers how to do this work effectively—and help cities and states across the nation undertake these critical efforts.”
Only four states have announced that they will be participating in using the digital technology. Alabama, North Dakota, South Carolina, and Washington were the first states to publicly announce that they would be using Apple and Google’s contact tracing technology in statewide apps in order to slow the spread of coronavirus.
Jennifer Fabiano is an SEO reporter at Ladders.