Smartphone apps promised to help combat the pandemic. How well did they work?

“A new review paper, published Monday in Nature Biotechnology, explores the wide range of apps rolled out to combat the pandemic [..].

Here are four questions that still need to be answered about how apps can combat Covid.

[1] How do you get broad swaths of the public to adopt an app?

“Contact tracing had a lot of problems,” said [physician and Director of Digital Medicine at Scripps Research Translational Institute and a co-author of the new paper Jay] Pandit. [..] The initial goal for the U.K. National Health Service’s Covid-19 app was to reach a 60% adoption rate. [..] Taking into account uninstalls and inactive users, Pandit said the app — “considered the most successful” — has an adoption rate in the high 20% range. [..]

[2] How do you make the best use of the data?

When it comes to contact tracing, apps can either function on a decentralized system, such as via Bluetooth, or through communicating with a central server, which is how apps tracking the spread of the virus in Australia, China, and India have worked. A centralized system runs the risk of losing track of the many people a sick person can come into contact with if they travel across counties, states, or nations. [..]

Due to the lack of overarching guidelines for mobile software, there can also be compatibility issues when data is not stored with the same format. For health records, patient information is not always saved in a way that is consistent with a common standard [..].

[3] How well do these apps actually work?

Early on in the pandemic, coronavirus apps were widely deployed, but there was a dearth of research on how well they were working. And studies of contact tracing apps, for example, were not always unbiased, said Pandit, “because many times they were released by for-profit companies.” Even today, China’s Health Code app, which has over 900 million users, does not have published outcomes data. [..]

[4] How should regulators be involved?

[..] “There needs to be, from the government level, some sort of committee set up,” [Stanford pediatrician and health policy professor C Jason] Wang said. He suggested that could be something like an Advisory Committee on Digital Health Practices, akin to the panel that reviews data on vaccines and makes recommendations to health policymakers on their use. [..]

A patchwork of laws exists to protect health information and maintain data security, but policy researchers feel they should be more specifically tailored to the new use cases arising from the pandemic. A bad actor or adversary could hack into poorly protected systems, send out false alerts of a positive contact, and trigger mass panic, said Wang.”

Full article, E Chen, STAT+, 2022.6.20