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Apple and Google surprised the world last Friday with their COVID-19 announcement to collaborate on a Bluetooth-based proximity contact detection API for iOS and Android. Contact tracing is the identification and tracking of people who may have come into contact with an infected person. We’ve been learning more about the API this week, including that it will work on iOS 13 and Android 6+ devices (through Google Play services), and that only health authorities will be able to access it.
This is a good opportunity to remind companies: technology is a tool, not a solution. New tools require a lot of iteration to function properly. When it comes to medical care, this is doubly true.
Apple and Google technology will fail. Privacy concerns aside, there are too many obstacles for the contact tracking tool to be effective. Let’s count the ways.
First, the API will only be available in mid-May. Second, you need a compatible mobile phone (not a fact for many depending on age, country, income, race, etc.). Third, you will need to update your smartphone. Fourth, health authorities must launch applications that use the API. Fifth, you will have to download and install this application. Sixth, you will have to leave Bluetooth on when you are away. Seventh, the technician will have to correctly identify that you have reached less than 6 feet from other people. Eighth, everyone else you came into contact with must also have done all of the above. Ninth, if the application informs you that it might have COVID-19, it should be tested (not a fact, depending on location). Tenth, if your result was positive, you will have to choose to notify all the people who may have contacted you.
Time, adoption and technology.
This will not happen by the vast majority of people. Especially it will not happen for those more susceptible to contracting COVID-19. This can be reduced to three major obstacles: time, adoption and technology. (Read Khari Johnson’s version of what privacy-preserving coronavirus tracking apps need to be successful.)
At the moment, there is nothing we can do about the fact that the API is not ready today. I am sure that Apple and Google are working very hard to ship it as soon as possible and that it will work the first day.
For adoption, there is nothing we can do about the fact that people don’t like to be told to install updates or apps, and generally to opt for whatever the government tells them to do. (For example, about 12% of Singapore’s population downloaded TraceTogether, the government’s contact tracking app that is also based on Bluetooth.) Adoption could be improved a bit by removing the application requirement. Apple and Google plan to build the Bluetooth-based contact tracking platform directly on iOS and Android “in the coming months.” That’s right, more time.
And finally, this is all based on Bluetooth. Technology that has a history of being unreliable when all you want to do is pair two devices. Even if it was reliable, Bluetooth was not designed for contact tracking or anything remotely related to determine if two devices were separated by a certain distance for a certain time. (Apple and Google are specifically using Bluetooth Low Energy, which has a range of about 30 feet on a typical phone; the theoretical maximum is “less than” 330 feet.)
It doesn’t matter how many of the world’s smartest software engineers have Apple and Google, their combined market capitalization, or their mobile market share duopoly. Even if they can get Bluetooth to do what they want, they can’t solve the time and adoption issues.
False positives
But wait, doesn’t it help a little bit? Let’s say a fraction of a fraction of iOS and Android users end up using this contact tracking tool. Let’s say it “works” for that small group of people.
Isn’t that a good thing? Well yes and no.
The mantra of technology is to move fast and break things. That’s fine for creating a fun mobile game. Not right for a healthcare app that’s supposed to help track the spread of a global pandemic. (For his part, Google CEO Sundar Pichai rightly said this week that tech companies should not be swayed by their role in the fight against COVID-19.)
I am not talking about false positives in which the system indicates that you were in contact with someone who was infected but was not infected. I’m talking about false positives solely because of Bluetooth: you are sitting in your apartment (or in any building) and your device is very close to someone’s device through a wall, above you through the ceiling or below you to through the ground. Two devices could be very close in cars next to each other in a red light. Or you could have your phone with you and simply pass a phone on to someone else.
A bug in an app that supposedly warns you that you may have a life-threatening illness can be serious. False positives in a contact tracking app have consequences. There is a mental cost to learning it could be infected. What happens if you take the test and find that everything is fine? There is an even greater mental cost if you are repeatedly told could be infected. What happens then? The few people who chose to participate decide to choose not to participate.
Future proof
Tracking contacts is not a new idea. Widely used in public health: Identify people who may have come into contact with an infected person, collect information on these contacts, analyze them for infections, treat the infected, and track their contacts in turn. Rinse and repeat to reduce infection in the population. It’s a tough manual detective job.
Humans are good at tracking contacts. We have 0 proofs that the phones are. So, given all the above issues, why should Apple and Google build it anyway? It’s simple: The new coronavirus was not the first pandemic and it certainly will not be the last. This will happen again. We should still be investing in technology that may one day help researchers trace contacts.
It may sound rude, but think of COVID-19 contact tracking from Apple and Google as a beta program. When the next virus appears, the technology will already exist and have been tested. There will still be adoption issues and questions about effectiveness. But Apple and Google, assuming that the Android-iOS duopoly remains until the next virus, may issue updates. And even if Bluetooth no longer exists or if we have all abandoned our smartphones for smart glasses, many of us will remember COVID-19 and all the efforts to flatten the curve. We will have learned what worked, what did not work and what had potential. That’s the good thing about technology: it can be adapted, reused, and improved.
Most importantly, we will not have to wait for a global pandemic to declare. A contact detection API will be one of the many tools in humanity’s toolbox.
ProBeat is a column in which Emil rants about what he comes across that week.
