The international consensus is growing: one of the keys to containing the COVID-19 pandemic and reviving a comatose world economy is a novel type of technology.
Daniel Leung says his mostly Canadian company, LivNao, has a ready-to-use version of the concept: a smartphone app designed to automatically identify those who have been in contact with infected people through Bluetooth and wireless methods and tells them to isolate themselves.
The idea was pioneered by Asian countries that have had success combatting the virus, and now it’s being implemented across Europe with high-profile support from the likes of German Chancellor Angela Merkel. A recent Oxford University study concluded that the crucial task of contact tracing may be impossible without such programs.
But governments in this country have shown limited interest, says Leung, even as other Canadian researchers and entrepreneurs have moved to develop other apps.
Most provinces that LivNao contacted failed to respond. Leung has heard that B.C. is worried about the privacy-related optics of the idea; Ontario actually had a virtual meeting with the Vancouver-based start-up, but did not seem in a great hurry to proceed, Leung says.
In desperation, LivNao added government links to its website, so that people can easily lobby governments to consider the idea.
“It’s a really annoying position to be in, knowing we have a solution that can work,” said Leung, who’s in talks with the U.S. federal health department, South Africa, Italy and Ecuador. “We just want people to use this kind of solution. It would be great if it was ours. But honestly it doesn’t matter; either way impact is going to be made.”
B.C., Ontario and federal health officials contacted by the National Post earlier this week were unable to comment by deadline.
I think that’s pretty minimal invasion
Another Canadian technology business, Toronto-based EQ Works, says it has spoken to provincial and federal officials about the concept and “it’s definitely a topic of conversation.”
But, said CEO Geoff Rotstein, “like any business trying to get something pushed, people always wish things would happen faster, things would happen sooner.”
Regardless, governments here should give the idea serious consideration, despite concerns raised by some privacy advocates, said Dr. Jeff Kwong, a public-health professor at the University of Toronto.
“I think that’s pretty minimal invasion and I think a lot of Canadians would find that acceptable as a trade-off for being locked down and losing their job,” he said.
Contact tracing has long been one of the cornerstones of epidemic response. Typically, public-health workers seek to find out where a person infected by a disease has been, and whom they’ve been near, during the time they could have been contagious. Then they notify possible contacts, so those people can be tested and/or quarantined themselves.
But as the COVID-19 pandemic began spreading rapidly, and its potential dire consequences were underscored by the experience of countries like Italy and Spain, Canada and other countries urged most people to stay at home, a largely unprecedented public-health response.
Some nations — notably South Korea, Taiwan and Singapore — managed to control their epidemics without such lockdowns, through aggressive quarantining, border controls and contact tracing. (Singapore did recently adopt a stay-at-home policy as new cases spiked.)
Now, weeks into the lockdown, contact tracing is again getting attention here.
The federal government recently put out a call for COVID-19 volunteers, partly to augment the tracing effort. Alberta Premier Jason Kenney said Tuesday that pursuing the practice more aggressively would be part of that province’s plan to eventually get life back to normal. Dr. David Williams, Ontario’s chief medical officer of health, urged public-health units last week to double-down on tracing, suggesting that doing so was like forest-fire fighters stamping out flare-ups before they become raging blazes.
Ideally, it would also be part of a strategy that surgically isolated those infected or at risk of having been infected, rather than keeping everyone inside.
It’s a really annoying position to be in, knowing we have a solution that can work
Kwong said he believes public-health agencies have simply been overwhelmed by the scope of the tracing task. He suggested to the Toronto health unit recently that it bring in medical students to help, as has already happened in Alberta. More than 20 are slated to start Thursday.
But he notes they will eventually have to return to their studies. And a paper last week in the journal Science came to a striking conclusion about such human efforts.
Given the speed with which the SARS-CoV-2 virus spreads, “traditional manual contact tracing procedures are not fast enough,” said the Oxford University health-data researchers. “Delays in these interventions make them ineffective at controlling the epidemic.”
Contact tracing through voluntary smartphone apps, however, could get the job done and “play a critical role in avoiding or leaving lockdown,” the article argued. That said, there is so far little real-world evidence that they do, in fact, work as epidemic busters.
The main pioneer app is one launched in Singapore on March 20, called Trace Together. Once downloaded, it uses Bluetooth communication to automatically detect interaction with another phone user who has tested positive for COVID-19, then issues instructions on what the contact should do.
Rotstein said he knows of three or four companies in Canada working on similar programs.
One is the Mila artificial-intelligence hub linked to the University of Montreal and McGill University. It should be ready to launch within a few weeks, but no government has committed to use it yet, said spokesman Vincent Martineau.
For COVID-19, LivNao modified an existing mental-health app it already sells to employers and insurance companies. It uses low-energy Bluetooth, a smartphone feature that’s usually turned on by default, and GPS to identify a close brush with someone who has tested positive. A notice is then automatically issued to the contact, urging them to self-isolate. They also have the option to identify themselves to local public-health officials, said Leung.
The app also allows the company to use anonymized data to make predictions of demand for medical services, he said, but the company’s server would not hold any identifiable information.
Still, such technology is fraught with the potential for privacy breaches and even discrimination against infected people, warns Brenda McPhail of the Canadian Civil Liberties Association.
Governments should ensure apps safeguard privacy and are actually useful before “jumping on this particular bandwagon,” she said, especially when the technology is being promoted by private-sector developers.
“Where some see economic collapse, others see economic opportunity,” said McPhail. “We need to guard very carefully in the area of public health and prevention against the potential for companies to try to profit from people’s fear.”