Covid Alert, Covid-19, Ontario, Public health, Toronto

Moving from aspirational to effective contact tracing

How many times have we heard the tune “Shoppers Drug Mart employee test positive for Covid-19 in the Junction”? What are we supposed to do with this information other than sharing it on Facebook hoping your friends who shop at that location are notified. But even if they are informed questions are raised. Which employee tested positive? Because if it was an employee solely moving boxes in storage the clients may not have much to worry about, but if it was someone working as cashier many clients would have been exposed. In summary, the problem with this scenario is that it is aspirational contact tracing. And it fails to answer a key question: how did that employee contract the virus?

https://dailyhive.com/toronto/shoppers-drug-mart-covid-19-december-18

Ideally, everyone who was in the building between the hours the employee worked should be notified of potential exposure. The Covid Alert app could help, but it would require that the employee who tested positive and those exposed have the app running on their smartphones. And since its adoption is voluntary and requires a newer smartphone not everyone has it. Hence this remarkable app should be seen as one of many ways to combat the pandemic and not a silver bullet.

As a Canadian who grew up abroad and has backpacked around our beautiful globe, I tend to ask myself: what else are other countries doing to solve this problem, which by now has affected every corner of the earth. 

Quick Response (QR) codes are effectively being used for contact tracing by businesses in Asia, Europe, and Oceania:

https://esnetwork.ca/briefings/qr-codes-as-an-approach-to-contact-tracing-for-covid-19/

On the local scene, a Canadian company has developed a QR code contact tracing solution to help businesses:

Based on the above study, QR code contact tracing solutions work best when managed by service providers for a specific transaction, for example, a movie night. So when you enter the theatre you would present your tickets and scan a QR code with your smartphone. Cineplex will not get your contact details, all they will see is a randomly generated identification code e.g. UserElVez has entered the theatre. Employees would scan the QR code when their shift begins. So, If Employee007 who later tests positive was working when UserElVez was in the theatre UserElVez would be automatically and confidentially notified of potential exposure. Naturally, all clients and employees who were in the theatre at the same time as Employee007 would also be notified. Since the movie is 2 hours long the system would automatically know when UserElVez left the building. 

Finding out how Employee007 contracted Covid might be best left to contact tracing professionals working for local public health units. However, notifying who may have been exposed by Employee007 at work to Covid can be automatically done by QR code systems, thus allowing contact tracers who are already overworked to focus on other critical matters.

QR code contact tracing is far superior to pen and paper which restaurants in T.O. were using in the summer for contact tracing since pen and paper can easily lead to privacy breaches. It is positive to see many local businesses adopt QR code solutions, but to be truly effective widespread adoption is needed. Here is a situation where local governments can take the lead and encourage the use of QR code contact tracing.

QR code contact tracing is more effective and secure than pen and pencil.
Covid Alert, Covid-19, Ontario, Public health, Toronto

Your bubble is bigger than you think

Contract tracing can be effective if you were exposed to Covid-19 at a restaurant or at your workplace, where your phone number was logged so that you could be called in the event of an outbreak.

However, how would you know if the person you sat next to on the bus or the subway for more than 15 minutes later tested positive for Covid? Or what if you spent 25 minutes shopping and were exposed to multiple asymptomatic people without knowing it.

The reality is that often we cross paths with many people in one day, but unfortunately contact tracing is not always a possibility. We might think of our bubbles consisting of our partner, friends, coworkers, and family, but the truth is our bubbles are bigger than what we think.

But what if you and the person you sat next to on the subway both wore masks and had the Covid Alert app installed on your smartphones? The masks would reduce the risk of transmission, and the Covid Alert app would notify you and others who came in close contact with that person of exposure, thus helping prevent further contagion. To help flatten the curve we must make the Covid Alert app as popular as mask-wearing. Download Covid Alert today and help spread the word.

Covid Alert, Covid-19, Ontario, Public health, Toronto

Covid Alert prevents further infections

The cancellation of a curling event in Waterloo after a player was notified by the Covid Alert app that they had contact with a person who tested positive for Covid-19 is a win for the hard-working team that developed this app. A win because this cancellation is a case study of exactly how the app should work.

Imagine we did not have the Covid Alert app and the player was infected. The player could transmit the virus to the other players, the players could transmit the virus to patrons and employees at their local pub, the patrons and employees could transmit the virus to their partners who teach at the local school, and the teachers could transmit the virus to students and other teachers. The curling event would be a bubble connected to the pub’s bubble, which in turn is connected to the school’s bubble. And without Covid Alert we could have had yet another dreaded super spreader event. However, what Covid Alert achieved was to separate the curling event, the pub, and the school into separate bubbles.

Hopefully, the player will not test positive. However, close contact presents a risk which the event organizers did not want to take. Kudos to them for showing a level of responsibility commensurate with the potential gravity of the circumstances. Perhaps they adverted several infections in great part thanks to the Covid Alert app. Certainly, the event organizers have set an example in caring for the safety of their community.

The news is bad these days. Ontario is in a second wave, the contact tracing team in Toronto is overwhelmed, but we can still take positive action: please download the Covid Alert app today. It works.

Covid Alert prevents further infections
Covid Alert, Covid-19, Public health, Toronto

Covid Hotspots in T.O.

Last month, we saw two trends in T.O.:

This week we are seeing a familiar and sad pattern, new cases are concentrated in North Etobicoke and North Scarborough. For example, the postal code M9R in North Etobicoke has had 66 reported cases since August 1, 2020. In contrast, postal codes in Central Toronto are in the single digits for the same timeframe.

We have heard that density is one possible reason why there are Covid hotspots in Toronto. However, when we see far more dense cities like Taipei having defeated Covid, we quickly realize that density is not an excuse.

Certainly, there is a link between Covid cases and income. However, we have the means to help North Etobicoke and North Scarborough. Consequently, we should act by demanding the following from our governments:

Together we have managed to slow the spread of Covid down significantly, together we can defeat it.

Covid cases by postal code T.O.
Covid Alert, Covid-19, Ontario, Public health, Public safety, Toronto

The case for Canada’s Covid Alert app

There are five reasons why we should all be optimistic about Canada’s new Covid Alert app:

  1. An Oxford study indicates that Contact Tracing apps have the potential to significantly reduce Covid transmission (noting that half of transmission cases occurred before symptoms were present);
  2. Both, Korea and Taiwan have implemented highly successful Contact Tracing apps;
  3. The low level of virus exposure notifications by some European Contact Tracing apps can be explained by the fact that social distancing measures are still in effect and these apps are still in the early stages of adoption;
  4. The Bluetooth technology used to determine “close contact” might be new, but is continuously improving; and
  5. Apple and Google, which developed the Application Programming Interface (API) used by Covid Alert, prioritized privacy.

Critics of the new app are correct to point out that many essential workers and retired folks might not be able to afford a smartphone to run this app. Nonetheless, these problems can be resolved by implementing new laws requiring employers to provide smartphones to essential workers, just like they are required to provide them with Personal Protection Equipment (PPE). Furthermore, governments should strongly consider providing free smartphones to seniors and anyone who cannot afford them in their efforts to turn the tide against Covid.

Engineers, scientists, and those working with new technologies understand that no innovation is perfect from the get-go. In fact, several iterations may be required to have a successful Covid Alert program. It is not in our spirit to give up when the going gets tough. Otherwise, Canadians would not have invented the electric wheelchair, the pacemaker, or the telephone just to name a few of our innovations.

This blog post is a call to all engineers, programmers, scientists, technologists, and innovation enthusiasts in Ontario to download the Covid Alert app today, and to please help your co-workers, family and friends install it as well. The science says Contact Tracing apps have the potential to significantly reduce Covid transmission. Now it is our turn to use Covid Alert, help improve it, and do what we do best which is to protect the public.

CovidAlert