One major reason for the divide, said Jeffrey Kahn, director of the Johns Hopkins Berman Institute of Bioethics, is that large consumer tech companies — which have been under fire for years over their methods of collecting and using personal data — have different motivations than health officials.
“Apple and Google’s incentive is to look like the good guys, related to the protection of privacy. That’s not a public health goal,” he said. He said the companies have done little to address states’ concerns that they won’t get the data they need. “At the moment, it feels kind of one-way.”
That skepticism isn’t limited to the United States. In Europe, Apple and Google are facing a backlash from some countries they persuaded to embrace their technology. Five countries, including France, Germany and Italy, published a letter in late May insisting the companies shouldn’t dictate conditions for contact tracing apps and arguing Europe must make itself less dependent on Silicon Valley. But those decisions are at least being made on a national level.
Singapore and Australia have seen some of the highest adoption rates of an app they both use called TraceTogether, in part due to intense government marketing. South Korea has integrated its app into a multipronged, nationwide response that includes extensive testing and detailed data collection.
China, meanwhile, has both a national app and a number of regional ones with disparate approaches to collecting data and keeping it private, according to the South China Morning Post.
In the U.S., Congress is trying to come up with a national strategy. Sen. John Thune of South Dakota, the chamber’s No. 2 Republican official, said lawmakers can’t just take tech companies at their word that their privacy rules are best, he said.
“I think that they’re saying the right things, but as is always the case, you want to make sure that they’re doing the right things,” he previously told POLITICO. “In the past, assurances have been made by some of the companies in that space that we found out later didn’t accurately reflect what was going on.”
Thune said he hopes lawmakers will find a middle ground on legislation to include online privacy provisions in a next potential coronavirus relief package. Democrats and Republicans have introduced dueling bills to establish privacy rules, but preexisting partisan divisions, such as differing views on whether to allow states to enact their own laws, appear to make that compromise unlikely.
The Centers for Disease Control and Prevention has issued only rough, voluntary guidelines saying digital contact tracing tools should be able to share information, limit data to health agencies and require user consent. So thus far, U.S. states have been left to make the decisions.
It mirrors the U.S. approach to the pandemic as a whole. Even as the Trump administration pushed guidelines for social distancing and other preventive measures, it allowed states to decide whether to keep schools and nonessential businesses open to the public. States and, in some cases, cities and counties have decided whether to require face masks and how to secure tests and medical supplies. And though Trump himself pressured some states to return to normal, the federal government has again deferred to governors to make the final call.
Now, as more people resume interstate travel, the danger of disparate apps will become increasingly and dangerously clear, said Paul Jarris, chief medical officer at MITRE, a not-for-profit that manages federal research centers, and former executive director for the Association of State and Territorial Health Officials.
“Two people sit next to each other on an airplane for six hours. … When they go off to their different states, [the disease] has just jumped states and we’ll have no way of knowing that,” said Jarris.
Not sold on the app solution
At least 13 states and the District of Columbia are looking at the range of decisions and considering whether to wade into digital contact tracing at all.
New Jersey, for example, is not sure it’s worth the investment of time and money.
Beth Simone Noveck, the state’s chief innovation officer, said in a statement that though “the tech could offer promise,” officials worry it will be difficult to deploy, that many people won’t use it and that it may not help them meet their public health goals. That, plus “significant privacy and security concerns,” make it a complicated decision.
A number of states are opting out for now. Colorado, Connecticut, Delaware, Georgia, Idaho, Indiana, Iowa, Louisiana, Maryland, Montana, New Hampshire, New Mexico, Tennessee, Texas, Vermont and Wyoming have all confirmed to POLITICO that they aren’t currently planning consumer contact tracing apps.
“We have not written off the idea, but are not convinced to use our time and resources to commit to that as a direction,” said Mark Raymond, Connecticut’s chief information officer. “We are tracking the field, but are not convinced we would see sufficient uptake or how much it will fill in any data gaps that we have.”
Many in the public health community say the digital push will always be less important than the traditional method: people interviewing the sick and following up with their contacts.
“Technology people feel like they can solve all the problems with technology,” said Shyam Gollakota, a University of Washington computer scientist developing the state’s app, which will not use the Apple-Google software. They plan to use the app to help users recall where they’ve been when interviewed by contact tracers.
“In this situation, in most public health situations, a human has to be involved,” said Gollakota.
Darius Tahir and Cristiano Lima contributed to this report.