As the United States breaks records on COVID-19 case counts and Congress weighs a new economic stimulus, Congress should look for approaches that also aid public health. Particularly, a new economic stimulus could pay every American $1,000 to download and use a digital contact tracing application.
Contact tracing applications, such as Google and Apple’s joint solution, enable smartphones to track physical proximity to other smartphones via Bluetooth. When one smartphone stays in proximity to another, they exchange random tokens. If I am diagnosed with COVID-19, I input that into an application built on Google/Apple’s system. Everyone with the application and my token on their phone will receive notification that they were near someone with COVID-19. They can then get tested, quarantine, and take other preventative action hopefully before spreading the disease themselves.
In theory, digital contact tracing can create what is effectively digital herd immunity. New cases are identified and contained so quickly that the disease cannot survive. But such immunity requires an estimated 60 percent of the population to use the solution, and reality may show the estimates are low—we may need more than 60 percent of people to use it. While lower adoption rates still improve public health, they are not enough to defeat the disease.
Global experiences with similar tools show limited public adoption. In France, less than 3 percent of the population downloaded their contact tracing application, while in Germany only 14 percent have. Some of this is likely due to declining case rates in those countries (by contrast, cases are spiking in the United States), but some hesitation is due to privacy concerns. People understandably do not want to lose control over sensitive health information.
So far, the United States contact tracing plans have gone poorly too. A particular challenge is that instead of a nationwide approach, each state has to make its own decisions. Politico reports most states do not currently have plans for contact tracing apps, and the apps that do exist cannot necessarily communicate with one another. Even states with a deployed solution have faced low adoption: Less than 5 percent of North Dakota’s population had downloaded the state app as of June 11. (More recent data does not seem to be available.) Americans just do not seem interested in the technology. In a June survey, 71 percent of Americans were not planning to download a contact tracing application. Americans who did not wish to use a contact tracing application cited privacy as a primary concern. Others surveyed said that they did not believe contact tracing applications would be successful.
Paying Americans to download and keep the application changes the equation. In a working paper, Johns Hopkins University’s Jemima A. Frimpong and Stephane Helleringer found cash payments up to $100 “were more than twice as important in the decision-making process about [digital contact tracing] app downloads than privacy and accuracy.” No doubt much larger cash payments would be even more desirable. In exchange for downloading an application, your rent is paid.
A high cash payment would also help folks who do not have smartphones. According to Pew Research, most people over 65 have cellphones, but only 53 percent have smartphones. Smartphone ownership is also much lower among lower income brackets, with 71 percent of people earning less than $30,000 per year owning smartphones. But numerous smartphones are available for only a few hundred dollars. A $1,000 payment would cover this cost and likely any increase in monthly fees, at least initially. Alternatively, people in those groups could receive tax write-offs or vouchers for smartphone purchase and monthly payments to avoid worsening income inequality, however marginally.
The stimulus may also pay for itself. The Congressional Budget Office estimates COVID-19 is likely to shave $8 trillion off the economy through 2030. Preventing even a tenth of this cost would massively outweigh the $330 billion in paying every American $1,000 for the application. Plus, millions of new cases might be prevented and hundreds of thousands of lives saved.
No doubt, there will be implementation challenges to work through. The system would need to ensure I did not download the application on five devices and claim five checks. It would also need to discourage me from downloading the application, accepting payment, then deleting it the next day. Likewise, the system would need to protect from nefarious actors seeking to steal my identity, violate my privacy, or just create mayhem.
Creating a separate website to check who you are could resolve these challenges. The platform could be linked to Internal Revenue Service databases to verify user identity and provide a single-use verification code. Once the code was used, the user would be paid $500. New verification codes could be required monthly to receive future payment.
In practice, Congress likely needs to establish a single, nationwide application. Digital contact tracing applications need to talk to one another to be effective. If Deborah’s great “John Gates University COVID-19 Tracking” application cannot talk to Norman’s also great “Stop COVID-19 NOW!” application, Deborah would still not know Norman contracted COVID-19, and the public health benefits would be lost. A nationwide solution would ensure the applications can communicate and be useful for states without applications. Congress would need to ensure any application is secure—not a small feat. The new website would require rapid and extensive penetration testing, vulnerability assessment, bug bounty programs, and other security measures. Application-based authentication also would be needed to confirm any COVID-19 test results to prevent trolls from creating fake outbreaks.
Google and Apple’s joint solution could work for a national standard. Google and Apple use a privacy-preserving decentralized approach: Data on a user’s COVID-19 testing status is shared only among users with the same random token. This means the data is not stored on a central server that could be compromised. Other contact tracing applications, by contrast, collect location data, posing greater risks to privacy. If the Google/Apple approach is adopted nationwide, public education about the privacy protections within the system may offset this concern. While Americans still may not believe the application is effective in combating COVID-19, I don’t need to believe in the power of contact tracing applications to believe in a month of free rent.
There still may be too few Americans who download the application to develop true digital herd immunity, but the approach is self-correcting. If the stimulus is tied to download and adoption, low download rates mean less money spent. Fewer lives would be saved, but some still would be saved through earlier warning and delayed spread. A single community may adopt the application at high rates, creating pockets of digital herd immunity. But if enough Americans do download the application, the disease could be defeated.
If Congress pays every American to download a digital contact tracing application, it could stimulate the economy, improve public health, and save thousands of lives.
The views expressed are the author’s and not those of any current or future employer, funder, or affiliate.
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