Why are Corona virus cases surging in the U.S. and Canada whereas in many other countries like South Korea, Taiwan, Japan, Australia and New Zealand the pandemic is under control?
A big part of the reason is that these countries have succeeded in testing and contact tracing to control outbreaks before they spread throughout the broader population.
Why didn’t Canada and the US exercise such policies?
It’s not as if this strategy has been a secret. In April 2020, WHO published guidelines for lifting restrictions used to limit the spread of Covid-19. Many of these guidelines were used during the Spanish Flu in 1918 and are part of standard public health principles. The ability to test and trace every infection are critical conditions.
https://nationalpost.com/news/canada/covid-19-the-who-has-issued-guidelines-for-lifting-restrictions-but-is-canada-ready
In both the U.S. and Canada, public health policy for opening the economy after the first lockdown in the spring of 2020 was to follow the WHO guidelines and have sufficient testing and contact tracing in place to contain Covid-19 outbreaks. But public health utterly failed to build the infrastructure to do this. Part of the problem may have been their failure to convince their governments and/or “cheap” governments who would not provide sufficient funding. As a result, there were not enough people in place to do contract tracing in the first coronavirus wave and not enough new people were hired in advance of the second wave. In Asia, the people who do contract tracing are experienced and have been doing this work for many years.
https://www.nytimes.com/2020/10/03/world/europe/covid-contract-tracing.html
When case counts exceed a certain level, contact tracing cannot keep up with the number of new cases and identify them early enough to contain the outbreak. This has happened in most of the U.S. and Europe and contact tracing has been largely abandoned. Canada has fared better in some regions, such B.C. and Atlantic Canada. But it was recently revealed that Toronto has suspended contact tracing.
https://globalnews.ca/news/7376562/toronto-public-health-coronavirus-contact-tracing-suspension/
How can contact tracing be fixed?
By far the best way to provide critical contact tracing is by using a smartphone app. The app runs in the background on your phone. It continually sends out Bluetooth signals to locate other users of the app within close range and stores a record of these users. When someone using the app contracts Covid-19, they enter this into the app. Then all other users of the app who were in close proximity get an alert that they may have been exposed. Users who receive such a notification are advised to self-isolate and get a Covid-19 test.
This is instant and automatic. Compare this to traditional contact tracing. First someone gets tested for Covid-19. After a delay the result is reported. If it is positive, a contact tracer will spend at least 24 hours (a target that is not always achieved) making phone calls to try and identify anyone who was in contact with the infected person. Many phone calls are not answered or the respondent will not provide full information. Manual contact tracing is slow and unreliable. A smartphone app is fast and reliable.
A study done by Oxford University estimated that if 56% of the total population used a smartphone app (alongside other interventions) it could stop the epidemic.
https://www.research.ox.ac.uk/Article/2020-04-16-digital-contact-tracing-can-slow-or-even-stop-coronavirus-transmission-and-ease-us-out-of-lockdown
In the U.S. the federal government had no plans to create a national contact tracing app. Each state needed to create its own, leading to a patchwork of apps across the country that used different technologies and couldn’t communicate with each other. State apps effectively became useless as soon as the user crossed a state line.
https://www.vox.com/recode/2020/10/2/21497729/covid-coronavirus-contact-tracing-app-apple-google-exposure-notification
Apple and Google developed the core code for a smartphone app as their contribution to the pandemic. Together they account for 99% of smartphone operating systems (iPhone and Android).
Canada developed a smartphone app, COVID Alert, using this code framework and made it available to people in Ontario on July 31, 2020.
https://en.wikipedia.org/wiki/COVID_Alert
This was late. The Google/Apple Exposure Notification code was released on May 20, 2020. Italy had an app for their citizens June 1. Twelve other countries released apps before Canada.
https://en.wikipedia.org/wiki/Exposure_Notification#Adoption
As of Nov 25, COVID Alert is available in only 8 of the 10 provinces. It has been downloaded 5.5 million times, about 15% of the population. This is yet another failing of our leaders and public health. All of the provinces should have been pressured into getting on board and preparing for a nationwide release with a program to heavily promote the app as soon as it was available.
https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/covid-alert.html
It has been reported that a lot of people do not trust the app for privacy reasons. This is not well founded. The app was developed from the ground up with security in mind by Google and Apple, who have the most skilled software developers in the world. Privacy protection is well explained for anyone who makes the effort to read it.
https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/covid-alert/privacy-policy.html
What needs to be done is to provide a real incentive for people to install COVID Alert. A rebate of $25 should be offered to anyone who installs the app. If a target 50% of Canadians followed up on this to stop the epidemic spread, the cost would be less than $500 million. Compared to other Covid-19 costs, such as the various employment subsidies which are in the billions of dollars, this is an insignificant amount, especially compared to the benefits it promises.
