From the U.S. Government Accountability Office, www.gao.gov Transcript for: Contact Tracing Technology in the COVID-19 Era Description: Contact tracing may help reduce transmission rates for infectious diseases like COVID-19 by identifying and notifying people who may have been exposed. New technology, such as apps that can be downloaded to cellphones, could expedite contact tracing efforts. However, these apps also present challenges such as adoption rates and privacy concerns. We talk to GAO’s Karen Howard to learn more. Related GAO Work: GAO-20-666SP, Science & Tech Spotlight: Contact Tracing Apps Released: July 2020 [ Music ] [Karen Howard]: Contact-tracing apps are still very new, and more work is needed on challenges. [Holly Hobbs]: Hi, and welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. I'm Holly Hobbs. Contact tracing may help reduce transmission rates for infectious diseases like COVID-19 by identifying and notifying the people who may have been exposed. New technology, such as apps that can be downloaded to cell phones, could expedite contact-tracing efforts. However, these apps also present challenges such as adoption rates and privacy concerns. Today, we talk to Karen Howard, an expert on healthcare and technology assessment and a director in our Science, Technology Assessment, and Analytics team. Thank you for joining us, Karen. [Karen Howard]: Thank you, Holly. I'm glad to be here. [Holly Hobbs]: So Karen, how do contact-tracing apps work? [Karen Howard]: These are very, very new. We've never used them before. They really just came on the scene with the COVID-19 pandemic, but generally speaking, right now, there are two main approaches. One is based on GPS. Just as you might expect with GPS, the purpose of this app is to track where you go over a period of time so that if you should come down with COVID-19 or with another infectious disease, they can look at that GPS record and figure out where you've been. And then they use that as a starting point for the more traditional manual contact-tracing approach. The second approach is based on Bluetooth, and in this case, they're not tracking location. They're not gathering any identity information at all. Instead, the Bluetooth app just sends out a signal—it's called a chirp—from your phone to any other phone it encounters that's also running the app. And the phones store that chirp, and if neither person catches the disease, those chirps are irrelevant. If, however, one of those individuals comes down with the disease, then they can notify the app, and the app can then notify all the phones that it chirped with over a given period of time. [Holly Hobbs]: So it sounds like there could be multiple applications for contact tracing. How do these apps work together? [Karen Howard]: They're really developed and deployed independently by public health agencies, whether those be the public health entity for a given country or in the United States, perhaps on a statewide basis those are being considered and developed. So they're really not designed for interoperability. The public health agency that's developing and deploying the app isn't thinking about how it's going to work when you go somewhere else. They're thinking about protecting the people within their jurisdiction. However, it's likely that as authorities, policymakers turn their attention to these apps, they might want to find ways to make them interoperable. We live in a highly mobile society, right? So if people are moving around between jurisdictions, it would be helpful if those apps did interoperate with each other. [Holly Hobbs]: And given that the contact-tracing apps require people to proactively download them, do we know how broadly they're being used? [Karen Howard]: We really don't. There are not a lot of data on these apps yet. As with any new technology, adoption is usually slow at the beginning. As people get more familiar with the technology and become more comfortable with it, then the adoption rate usually begins to go up. Some countries have chosen to deal with this slow adoption rate by mandating the use of the apps, and of course that does increase the adoption rate. For countries that don't want to do that, adoption rates have been fairly low. The highest reported adoption rates that we've seen for countries that have a voluntary use policy are around 35 to 40% of the population, and in most cases, it's much, much lower than that—closer to the single digits. [Holly Hobbs]: So, are there privacy concerns with these apps? [Karen Howard]: There can be, particularly with the GPS-based apps, because, as we mentioned, those work by recording and storing a record of where you've been over a relevant period of time when you might've been contagious. So for COVID-19, that would be typically a 14-day period. Some people are not comfortable with that public health agency having information about everywhere they've been over that time period. The Bluetooth-based apps, though, do not do that. They don't track locations. They don't have any identity information. So the privacy concerns, again, at this early stage appear to be lower for that type of technology. [ Music ] [Holly Hobbs]: So it sounds like technology could help contact-tracing efforts by reaching more people and providing faster responses, but that the adoption of these apps by individual users is low. Karen, what is the future of these apps, and what role might policymakers or the federal government play in their use? [Karen Howard]: Well, it's hard to tell where the technology will go, but there are many potential advantages. Manual contact tracing is very time-consuming. They have to interview an infected individual, try to get them to remember everybody they've come into contact with, which of course remembering two weeks' worth of contacts is hard for the best of us under the best of circumstances, let alone when you're sick. This eliminates the need for that. The person who has come down with the disease does not need to remember who they came into contact with, and of course it also works when you don't know the people you've come in contact with, such as, you know, somebody who may have walked past on the street or somebody you stood in line behind at the grocery store. So, huge potential advantages. With that in mind, developers are likely to continue to work on these apps and refine them and incorporate more features that public health authorities would like to see, incorporate, perhaps, better privacy protections and other features that will make the public more comfortable using them. As for policymakers, one step they might take is to consider how they could develop protocols or maybe agreements between jurisdictions to make their apps interoperable or to use apps that are interoperable. They could also consider ways that they might encourage the public to adopt these apps -- things such as education efforts, clarifying the privacy concerns and communicating about those, and encouraging privacy protections to be strengthened wherever possible. [Holly Hobbs]: Karen, last question: What is the bottom line of your recent work, the spotlight on contact tracing? [Karen Howard]: The bottom line is that contact-tracing apps are still very new and more work is needed on challenges such as interoperability, privacy protections, and access for less tech-savvy demographic groups, such as some of the more vulnerable groups, where smartphone usage may not be very high. However, as these challenges are addressed, these proximity-based contact-tracing apps could potentially transform contact tracing by greatly improving the speed and effectiveness. [Holly Hobbs]: That was Karen Howard talking about GAO's recent review of contact-tracing applications. Thank you for your time, Karen. [Karen Howard]: Thank you, Holly. [Holly Hobbs]: And thank you for listening to the Watchdog Report. To hear more podcasts, subscribe to us on Apple podcasts, and make sure you leave a rating and review to let others know about the work we're doing. For more from the congressional watchdog, the U.S. Government Accountability Office, visit us at gao.gov.