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Early within the pandemic, the COVIDSafe app was designed as a software to enhance contact tracing. And a multimedia marketing campaign promoted it as serving to to search out extra COVID contacts sooner.
Now, virtually two years after its launch in April 2020, we publish in The Lancet Public Well being our analysis of the app’s effectiveness and usefulness in New South Wales.
We analysed knowledge from all 619 COVID circumstances recorded in NSW above the age of 12 and their contacts between Might and November 2020. We additionally interviewed contact tracers about whether or not they thought-about the app helpful.
Our evaluation confirmed the app didn’t add a lot worth to the prevailing, typical contact tracing system.
A complete of twenty-two% of circumstances had been utilizing the app. Most (61%) contacts the app registered as “shut contacts” turned out to not be epidemiologically linked to a case. The app detected solely 15% of true shut contacts recognized by typical contact tracing.
In whole, COVIDSafe detected solely 17 further true shut contacts in NSW throughout the six-month analysis interval.
It induced substantial further work for contact tracers and total, didn’t make a significant contribution to the COVID response in NSW.
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Tracing takes time
Interviewing new circumstances to determine, hint and isolate their shut contacts is an important public well being exercise. However that is time-consuming and speak to tracers can turn out to be quickly overwhelmed when case numbers rise.
Digital contact tracing apps had been enthusiastically embraced early within the COVID pandemic in lots of nations, together with Australia.
Like many different tracing apps, COVIDSafe makes use of smartphones’ built-in Bluetooth perform to trade alerts between telephones.
The length, frequency and transmission energy of those “digital handshakes” are used to find out whether or not two smartphone customers have come into “shut contact” with one another.
Low skill to detect and determine shut contacts appropriately
Throughout our research interval, lower than 1 / 4 of all circumstances had been utilizing the app. That is half the proportion of the Australian normal public who did so.
Of these circumstances who used the app, many had not a single contact registered by the app. For others, contact tracers couldn’t entry the app knowledge.
Contact tracers may use app knowledge for 32 (5%) of the 619 circumstances over our research interval. Of these circumstances, solely 79 (39%) of the 205 contacts the app registered as “shut contacts” might be verified as true shut contacts. This implies poor constructive predictive worth of the app.
Examples of false shut contacts the app registered had been:
neighbours in numerous flats in condominium buildings
workplace staff in adjoining rooms
prospects in neighbouring eating places
individuals ready in separate vehicles at COVID drive-through testing clinics.
The overwhelming majority (85%) of shut contacts recognized by typical contact tracing weren’t detected by the app, indicating low sensitivity.
A number of further contacts detected
Throughout the six months of our research, there have been solely 17 true shut contacts recognized by COVIDSafe who would have in any other case been missed – a tiny fraction of the greater than 25,300 shut contacts detected and adopted up by typical contact tracing in NSW throughout the identical interval.
None of those 17 contacts turned constructive. So COVIDSafe didn’t contribute to stopping any new exposures in NSW throughout our analysis interval.
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Technological flaws
Contact tracers didn’t discover the app simple to make use of. Some mentioned the app didn’t appear to work as reliably on all kinds of telephones. The variety of contacts on iPhones had been considerably underestimated, whereas these from Android telephones had been overestimated.
Contact tracers additionally famous the app’s obvious incapability to correctly register contacts except it was open. This would possibly clarify the massive variety of circumstances with none registered contacts in our research.
The method of cross-matching shut contacts recognized by the app with these recognized by case interviews was seen as time-consuming, notably as most contacts picked up by the app had been probably not shut contacts.
Interviewed employees mentioned this might simply overwhelm the contact tracing system had case numbers been larger, paradoxically resulting in a discount in usefulness of the app when it will be most wanted.
General, contact tracers’ perceptions of the app ranged from “not impacting a lot” to being a further step that elevated workload with out including a lot worth.
The app recognized 17 contacts that will have been in any other case missed.
AAP Picture/Scott Barbour
Little added worth at excessive prices
In our research, COVIDSafe didn’t make a significant contribution to the COVID response in NSW throughout 2020. As a substitute, the app created a excessive workload for no clear profit.
This stands towards the A$7.7 million it has value to develop and run COVIDSafe till the top of April 2021, with an estimated $60,000-$75,000 monthly in upkeep since.
The arrival of the extremely transmissible Omicron variant in late 2021 in Australia, coinciding with the lifting of most public well being restrictions, led to large growth in case numbers, forcing a collection of main changes to contact tracing.
Learn extra:
Australia has all however deserted the COVIDSafe app in favour of QR codes (so ensure you test in)
In most elements of Australia, contact tracing now has a really restricted function in COVID management. Nonetheless, it’s prone to stay a key public well being intervention for infectious illnesses sooner or later.
For digital contact tracing apps to be efficient and helpful, it will likely be vital to contain contact tracers when designing the system, to highway check the underlying know-how in real-life settings, and to guage the app frequently after roll-out.
Dr Anthea Katelaris, a public well being doctor who labored on the Western Sydney Native Well being District public well being unit on the time of the research, co-authored the analysis talked about on this article.
Florian Vogt receives a fellowship from the Australian Partnership for Preparedness Analysis on An infection Illness Emergencies (APPRISE) Centre of Analysis Excellence (CRE), funded by the Nationwide Well being and Medical Analysis Council (NHMRC) of Australia. The Kirby Institute, College of New South Wales acquired funding from the New South Wales Ministry of Well being for his involvement on this analysis.
Bridget Haire has acquired funding from the Nationwide Well being and Medical Analysis Council and NSW Well being. She is a volunteer with the Australian Federation of AIDS Organisations..
John Kaldor's college acquired funding from the New South Wales Ministry of Well being to assist members of his workforce to conduct this analysis. His college analysis place is funded by a Nationwide Well being and Medical Analysis Council Fellowship.
Linda Selvey receives funding from the Nationwide Well being and Medical Analysis Council.
