At present, as states across America are gradually easing coronavirus-related restrictions in public spaces, a central challenge is contending with our pressing desires to reclaim a familiar sense of normalcy, and yet to do so in a manner that’s safe for each of us. Over 75% of higher education institutions in America have announced a plan to resume in-person and hybrid operations this fall.
Such momentum suggests that other institutions will soon follow in welcoming back our communities of students, faculty, and staff. The reopening of our institutions with safeguard measures is an immense project, and it is one that represents a great responsibility. Safeguarding measures upon reopening include increased cleaning and sanitation measures, social distancing protocols, limiting the number of people on campus, ensuring facilities safety, increased COVID-19 testing, and performing lockdowns of areas in the event that coronavirus cases occur. Private universities and colleges are also adopting contact tracing as a key strategy for combating COVID-19.
Broadly, contact tracing is a safeguarding process that provides assurances that steps are in place to promote safety and good health. Leaders at our higher education institutions are now exploring how to implement contact tracing technology and protocols on their campuses while also ensuring that data remains protected and ethically utilized.
Understanding Contact Tracing
Contact tracing is a public health tool that works to identify, inform, and monitor those who may have been exposed to someone with an infectious disease, such as COVID-19. Traditionally, contact tracing has entailed a manual process by which trained staffers conduct extensive interviews with infected persons, and with the objective of determining the places and people they may have encountered within a set period of time.
The problem with any manual method is that it is time-consuming and labor-intensive. It takes about 90 minutes for each case—60 minutes to interview the person who tests positive and 30 minutes to call or send texts to those the sick person recalls being in contact with.
Thanks to advances in technology, however, contract tracing has recently undergone a major tech upgrade in the form of proposed apps or Internet of Things (IoT) devices. Apps can now track proximity to other users’ phones so that infected persons can self-identify their status in the app, a process that then anonymously sends notifications to all other users who may have been in contact with the infected persons.
Badges and other small devices that are not reliant on a smart phone are also being marketed with similar contact tracing capabilities. This is particularly helpful for those with lower incomes who are most at risk from COVID-19, but who may not own a smartphone.
Government-Led Contact Tracing Initiatives
In Canada, researchers are working on the CanShake, an app that involves people shaking their phones at each other upon meeting to transmit contact information. It is designed to harness common consumer technology to log people’s location or movements, and then to match it against the location of people known to be sick.
Dozens of similar apps exist all over the world, including in South Korea, Singapore, China, Italy, Australia, and Israel. The British government has plans to launch a contact tracing app via its National Health Service (NHS) as soon as the beginning of July. In America, Google and Apple have a partnership underway to develop software for smartphones that would enable them to continuously log information from other devices. Three states—Alabama, North Dakota, and South Dakota—have said they have deployed or are developing apps for tracking COVID-19.
At the end of April, a bipartisan group of health officials suggested that America would need 180,000 tracers in each state to detect and trail the virus’s movement from now until we find a vaccine. In early May, a National Public Radio survey found that there were only about 11,000 total tracers in states already using contact tracing. The technology of contact tracing can be instrumental, but we need more users to help combat the virus.
Geolocation, QR Codes, & Bluetooth: Three Contact Tracing Technologies
In terms of technology’s role in contact tracing, there are at least three possibilities for sharing, storing, and communicating information. Geolocation is one such possibility. This software typically runs in the background on phones to help with location services like Google Maps. It can track people within 30 or so feet of their location, and can be turned on and off voluntarily. QR codes are another option. When coronavirus cases surged in South Korea this past winter, local hospitals asked patients seeking tests or treatment to answer questions on their phones before arriving, including whether they had a fever or cough. After completing the responses, each person received a QR code by phone.
When the individual reached the hospital, a scanner captured the code, plugged in the responses, and then determined if the patient should get a coronavirus test. Initially, this was seen as a way to process patients without paperwork, but South Korea is considering expanding the use of QR codes for contact tracing. The proposed idea is to scan visits by people who attend larger gatherings at restaurants, churches, sporting events, night clubs, and so forth.
Bluetooth is already proving to be the most popular option, and it is about ten times more precise than geolocation technology. Bluetooth, of course, is the technology that your phone uses to communicate with other devices, and it is also what CanShake uses. Apps utilizing Bluetooth are currently being developed that run in the background of an individual’s phone—with that person’s permission—creating and storing a history of movements. If an individual tests positive for COVID-19, his or her history would be downloaded to a database. Afterwards, others who use the same service can check to see if their movements have intersected with a positive test case.
Applying Contact Tracing Principles at Vanderbilt University
A new virtual self-screening tool developed by Vanderbilt University professors helps individuals assess their risk of infection with COVID-19. The app gives public health officials real-time, anonymous data to identify, map, and target potential virus hot spots. The app is a product of transdisciplinary collaboration between T.S. Harvey, Associate Professor of Anthropology and expert in risk reduction and global public health, and Thomas Scherr, Professor of Chemistry and expert in mobile health.
The public can access the web app on a computer or mobile device, and it guides users through a screening quiz that asks about symptoms as well as demographic and social risk factors. The tool analyzes these answers to develop a user’s risk score; it then guides the user towards appropriate next steps in accordance with the CDC and state public health guidelines. When a local healthcare system partners with the app, the app can generate a QR code for the user that expedites pre-screening at the test site. The healthcare provider makes the final determination regarding whether testing is necessary.
Moreover, when a public healthcare agency partners with the app, it uses anonymized screening results to map hot spots and to identify areas of emerging risk. This could be a particular neighborhood or among a certain demographic, for instance. The app does not aim to replace a conversation with a health care professional; rather, it is designed to assess a person’s risk of exposure.
Contact Tracing Innovations at MIT
A team led by MIT researchers is developing a system that augments manual contact tracing by public health officials, while still preserving the privacy of all individuals. The system relies on short-range Bluetooth signals emitted from users’ smartphones. The signals represent random strings of numbers, likened to “chirps” that other nearby smartphones can remember hearing. If a person tests positive, they can upload the list of chirps their phone has put out to a database. Others can then scan the database to see if any of those chirps match the ones picked up by their phones. If a match is found, a notification will inform that person of possible exposure, and will include information from public health authorities on the next steps to take.
This entire process is managed while maintaining the privacy of those who are COVID-19 positive and those wishing to check if they have been in contact with an infected person. The researchers at MIT have worked closely with a medical advisory team, one led by Louise Ivers, an infectious disease expert, Associate Professor at Harvard Medical School, and executive director of the Massachusetts General Hospital Center for Global Health. As quoted by MIT News, Ivers contends that “in order for the U.S. to really contain this epidemic, we need to have a much more proactive approach that allows us to trace more widely contacts for confirmed cases. This automated and privacy-protecting approach could really transform our ability to get the epidemic under control here and could be adapted to have use in other global settings.”
Ivers continues, “What’s also great is that the technology can be flexible to how public health officials want to manage contacts with exposed cases in their specific region, which may change over time.” The ability to utilize contact tracing quickly and at a large scale can work to flatten the curve of the outbreak. This can also enable people to safely reintegrate into public life as a community on the downward side of the curve.
Additional Benefits of Contact Tracing in Higher Education
Contact tracing technologies are beneficial in so many ways, not least of all because they keep users informed about possible incidents of exposure. From the perspective of those employed by higher education institutions, contact tracing enables them to survey their symptoms. This not only makes exposure less likely, but it keeps users mindful of the safety habits necessary amidst the COVID-19 outbreak.
In this regard, contact tracing has the capacity to empower all areas of the higher education workforce, whether it is the professor inside a classroom, a bookseller at a register, or a food service worker during lunchtime rush. Contact tracing technologies also make it remarkably easy to add users. With more users, the more effective contact tracing can be on our campuses. Additionally, the larger the network of users, the easier it becomes to trace the degree of separation between contacts, thereby increasing the likelihood of identifying and eliminating any possible contagion.
The COVID-19 outbreak has compelled us all to address safeguarding measures as we gradually return to our public lives. With contact tracing, we have a technology available that can keep us all safer, healthier, and as participants in a society that works together to slow down this contagion. To do so is our collective responsibility.
