Medicine & Health

GAO: National strategy could improve infection exposure apps

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Setting a national strategy and researching best practices could lay the groundwork for broader adoption of exposure notification apps during future infectious disease outbreaks, the Government Accountability Office wrote in a report delivered to Congress Thursday.

Exposure notification apps—mobile applications that alert people who may have been in close proximity to someone later diagnosed with COVID-19—gained prominence last spring when Apple and Google teamed up to create the technology that powers the apps. Since then, nearly half of U.S. states and territories have deployed apps that build on the Apple-Google system, according to the GAO.

In those 26 states and territories, public health departments released their own exposure notification apps, which used application programming interfaces from the two technology giants.

Ideally, such apps should designed to support manual contact tracing by notifying those who otherwise might not know they could be infected with a communicable disease.

“Manual contact tracing can be effective, but it has limitations,” the GAO’s letter to Congress says. Traditional contracting tracing is most useful during the early stages of outbreaks and when infectious diseases have affected few people, the GAO report says. The COVID-19 pandemic spurred the creation of digital tracing technology—and demonstrated its unmet potential.

The app deployments have been plagued by consumer privacy concerns and, since states launched them one by one without a national strategy, the apps rolled out over the course of 10 months. It’s been an expensive endeavor: States reported app development costs of up to $700,000, plus marketing costs that ranged from $380,000 to $3.2 million.

There’s also not much evidence to support how effective the apps have been at notifying people about possible exposure to the novel coronavirus, according to the GAO.

Policymakers could promote research and development efforts to better understand the limitations of exposure notification apps and how to improve them, to promote privacy and security standards, to establish ways to measure the effectiveness of exposure notification apps, and other best practices, the GAO advises.

The GAO reviewed public health agency documents and met with officials from federal agencies, public health organizations, federally funded research and development institutions, academic researchers, and app developers to compile its report.

A national strategy would also support the adoption of exposure notification apps in the future by enabling coordinated efforts across the public and private sectors, the GAO wrote. To accelerate that process, policymakers could recommend a national app that public health authorities would decide whether to use, according to the GAO. An app with a coordinated national marketing campaign could also lead to wider adoption, although some users might be less likely to trust a national app over a local one, the GAO report says.

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