Coronavirus contact tracing

Statistical inference links data and theory in network science

The number of network science applications across many different fields has been rapidly increasing. Surprisingly, the development of theory and domain-specific applications often occur in isolation, risking an effective disconnect between theoretical and methodological advances and the way network science is employed in practice. Here we address this risk constructively, discussing good practices to guarantee more successful applications and reproducible results. We endorse designing statistically grounded methodologies to address challenges in network science. This approach allows one to explain observational data in terms of generative models, naturally deal with intrinsic uncertainties, and strengthen the link between theory and applications.

Theoretical models and structures recovered from measured data serve for analysis of complex networks. The authors discuss here existing gaps between theoretical methods and real-world applied networks, and potential ways to improve the interplay between theory and applications.

Human-to-Human Position Estimation System Using RSSI in Outdoor Environment

Methods to prevent collisions between people to avoid traffic accidents are receiving significant attention. To measure the position in the non-line-of-sight (NLOS) area, which cannot be directly visually recognized, position-measuring methods use wireless-communication-type GPS and propagation characteristics of radio signals, such as received signal strength indication (RSSI). However, conventional position estimation methods using RSSI require multiple receivers, which decreases the position estimation accuracy, owing to the presence of surrounding buildings. This study proposes a system to solve this challenge using a receiver and position estimation method based on RSSI MAP simulation and particle filter. Moreover, this study utilizes BLE peripheral/central functions capable of advertising as the transmitter/receiver. By using the advertising radio waves, our method provides a framework for estimating the position of unspecified transmitters. The effectiveness of the proposed system is evaluated in this study through simulations and experiments in actual environments. We obtained an error average of the distance to be 1.6 m from the simulations, which shows the precision of the proposed method. In the actual environment, the proposed method showed an error average of the distance to be 3.3 m. Furthermore, we evaluated the accuracy of the proposed method when both the transmitter and receiver are in motion, which can be considered as a moving person in the outdoor NLOS area. The result shows an error of 4.5 m. Consequently, we concluded that the accuracy was comparable when the transmitter is stationary and when it is moving. Compared with conventional path loss, the model can measure distances of 3 m to 10 m, whereas the proposed method can estimate the "position" with the same accuracy in an outdoor environment. In addition, it can be expected to be used as a collision avoidance system that confirms the presence of strangers in the NLOS area.

Checking Contact Tracing App Implementations with Bespoke Static Analysis

In the wake of the COVID-19 pandemic, contact tracing apps have been developed based on digital contact tracing frameworks. These allow developers to build privacy-conscious apps that detect whether an infected individual is in close proximity with others. Given the urgency of the problem, these apps have been developed at an accelerated rate with a brief testing period. Such quick development may have led to mistakes in the apps’ implementations, resulting in problems with their functionality, privacy and security. To mitigate these concerns, we develop and apply a methodology for evaluating the functionality, privacy and security of Android apps using the Google/Apple Exposure Notification API. This is a three-pronged approach consisting of a manual analysis, general static analysis and a bespoke static analysis, using a tool we have developed, dubbed MonSTER. As a result, we have found that, although most apps met the basic standards outlined by Google/Apple, there are issues with the functionality of some of these apps that could impact user safety.

Smartphone-Based Social Distance Detection Technology with Near-Ultrasonic Signal

With the emergence of COVID-19, social distancing detection is a crucial technique for epidemic prevention and control. However, the current mainstream detection technology cannot obtain accurate social distance in real-time. To address this problem, this paper presents a first study on smartphone-based social distance detection technology based on near-ultrasonic signals. Firstly, according to auditory characteristics of the human ear and smartphone frequency response characteristics, a group of 18 kHz-23 kHz inaudible Chirp signals accompanied with single frequency signals are designed to complete ranging and ID identification in a short time. Secondly, an improved mutual ranging algorithm is proposed by combining the cubic spline interpolation and a two-stage search to obtain robust mutual ranging performance against multipath and NLoS affect. Thirdly, a hybrid channel access protocol is proposed consisting of Chirp BOK, FDMA, and CSMA/CA to increase the number of concurrencies and reduce the probability of collision. The results show that in our ranging algorithm, 95% of the mutual ranging error within 5 m is less than 10 cm and gets the best performance compared to the other traditional methods in both LoS and NLoS. The protocol can efficiently utilize the limited near-ultrasonic channel resources and achieve a high refresh rate ranging under the premise of reducing the collision probability. Our study can realize high-precision, high-refresh-rate social distance detection on smartphones and has significant application value during an epidemic.

Social distance "nudge:" a context aware mHealth intervention in response to COVID pandemics

The impact of the COVID pandemic to our society is unprecedented in our time. As coronavirus mutates, maintaining social distance remains an essential step in defending personal as well as public health. This study conceptualizes the social distance "nudge" and explores the efficacy of mHealth digital intervention, while developing and validating a choice architecture that aims to influence users' behavior in maintaining social distance for their own self-interest. End-user nudging experiments were conducted via a mobile phone app that was developed as a research artifact. The accuracy of social distance nudging was validated in both United States and Japan. Future work will consider behavioral studies to better understand the effectiveness of this digital nudging intervention.

Mobile Sensing in the COVID-19 Era: A Review

Background

During the COVID-19 pandemic, mobile sensing and data analytics techniques have demonstrated their capabilities in monitoring the trajectories of the pandemic, by collecting behavioral, physiological, and mobility data on individual, neighborhood, city, and national scales. Notably, mobile sensing has become a promising way to detect individuals' infectious status, track the change in long-term health, trace the epidemics in communities, and monitor the evolution of viruses and subspecies.

Methods

We followed the PRISMA practice and reviewed 60 eligible papers on mobile sensing for monitoring COVID-19. We proposed a taxonomy system to summarize literature by the time duration and population scale under mobile sensing studies.

Results

We found that existing literature can be naturally grouped in four clusters, including remote detection, long-term tracking, contact tracing, and epidemiological study. We summarized each group and analyzed representative works with regard to the system design, health outcomes, and limitations on techniques and societal factors. We further discussed the implications and future directions of mobile sensing in communicable diseases from the perspectives of technology and applications.

Conclusion

Mobile sensing techniques are effective, efficient, and flexible to surveil COVID-19 in scales of time and populations. In the post-COVID era, technical and societal issues in mobile sensing are expected to be addressed to improve healthcare and social outcomes.

A methodology for evaluating digital contact tracing apps based on the COVID-19 experience

Controlling the spreading of infectious diseases has been shown crucial in the COVID-19 pandemic. Traditional contact tracing is used to detect newly infected individuals by tracing their previous contacts, and by selectively checking and isolating any individuals likely to have been infected. Digital contact tracing with the utilisation of smartphones was contrived as a technological aid to improve this manual, slow and tedious process. Nevertheless, despite the high hopes raised when smartphone-based contact tracing apps were introduced as a measure to reduce the spread of the COVID-19, their efficiency has been moderately low. In this paper, we propose a methodology for evaluating digital contact tracing apps, based on an epidemic model, which will be used not only to evaluate the deployed Apps against the COVID-19 but also to determine how they can be improved for future pandemics. Firstly, the model confirms the moderate effectiveness of the deployed digital contact tracing, confirming the fact that it could not be used as the unique measure to fight against the COVID-19, and had to be combined with additional measures. Secondly, several improvements are proposed (and evaluated) to increase the efficiency of digital control tracing to become a more useful tool in the future.

COVID-19 Prediction With Machine Learning Technique From Extracted Features of Photoplethysmogram Morphology

At present, COVID-19 is spreading widely around the world. It causes many health problems, namely, respiratory failure and acute respiratory distress syndrome. Wearable devices have gained popularity by allowing remote COVID-19 detection, contact tracing, and monitoring. In this study, the correlation of photoplethysmogram (PPG) morphology between patients with COVID-19 infection and healthy subjects was investigated. Then, machine learning was used to classify the extracted features between 43 cases and 43 control subjects. The PPG data were collected from 86 subjects based on inclusion and exclusion criteria. The systolic-onset amplitude was 3.72% higher for the case group. However, the time interval of systolic-systolic was 7.69% shorter in the case than in control subjects. In addition, 12 out of 20 features exhibited a significant difference. The top three features included dicrotic-systolic time interval, onset-dicrotic amplitude, and systolic-onset time interval. Nine features extracted by heatmap based on the correlation matrix were fed to discriminant analysis, k-nearest neighbor, decision tree, support vector machine, and artificial neural network (ANN). The ANN showed the best performance with 95.45% accuracy, 100% sensitivity, and 90.91% specificity by using six input features. In this study, a COVID-19 prediction model was developed using multiple PPG features extracted using a low-cost pulse oximeter.

Kontakt-Tracing-Apps

Zur Bekämpfung der Coronapandemie wurden erstmals mobile Applikationen zur Kontakterfassung und -nachverfolgung, also dem systematischen Erfassen aller Personen mit zeitlicher und räumlicher Nähe zu einer infizierten Person, eingesetzt. In Deutschland haben hierzu vor allem die Corona-Warn-App und die Luca-App Verbreitung gefunden. Dieser Artikel diskutiert die beiden Apps vor allem im Hinblick auf Datenschutz, Sicherheit sowie deren Effektivität zur Bekämpfung der Pandemie. Im Gegensatz zu der Vielzahl an populärwissenschaftlichen Artikeln liegt der Fokus in diesem Artikel auf den technischen Aspekten der Kontakt-Tracing-Apps.

Development and Evaluation of Bluetooth Low-Energy Device for Electronic Encounter Metrics

The coronavirus disease 2019 (COVID-19) pandemic led to the need for tracking of physical contacts and potential exposure to disease. Traditional contact tracing can be augmented by electronic tools called "electronic contact tracing" or "exposure notification.". Some methods were built to work with smartphones; however, smartphones are not prevalent in some high-contact areas (e.g., schools and nursing homes). We present the design and initial testing of low-cost, highly privacy preserving wearable exposure notification devices. Several devices were constructed based on existing hardware and operated independently of a smartphone. The method (devices and analyses) was not able to reliably use the received signal strength indicator (RSSI) as a proxy for distance between pairs of devices; the accuracy of RSSI as a proxy for distance decreased dramatically outside of the idealized conditions. However, even an imperfect device could be useful for research on how people use and move through spaces. With some improvement, these devices could be used to understand disease spread and human or animal interaction in indoor environments.

A Case Study of Bluetooth Technology as a Supplemental Tool in Contact Tracing

We present results from a 7-day trial of a Bluetooth-enabled card by the New Zealand Ministry of Health to investigate its usefulness in contact tracing. A comparison of the card with traditional contact tracing, which relies on self-reports of contacts to case investigators, demonstrated significantly higher levels of internal consistency in detected contact events by Bluetooth-enabled cards with 88% of contact events being detected by both cards involved in an interaction as compared to 64% for self-reports of contacts to case investigators. We found no clear evidence of memory recall worsening in reporting contact events that were further removed in time from the date of a case investigation. Roughly 66% of contact events between trial participants that were indicated by cards went unreported to case investigators, simultaneously highlighting the shortcomings of traditional contact tracing and the value of Bluetooth technology in detecting contact events that may otherwise go unreported. At the same time, cards detected only 65% of self-reported contact events, in part due to increasing non-compliance as the study progressed. This would suggest that Bluetooth technology can only be considered as a supplemental tool in contact tracing and not a viable replacement to traditional contact tracing unless measures are introduced to ensure greater compliance.

Non-Pharmaceutical Interventions against COVID-19 Pandemic: Review of Contact Tracing and Social Distancing Technologies, Protocols, Apps, Security and Open Research Directions

The COVID-19 Pandemic has punched a devastating blow on the majority of the world's population. Millions of people have been infected while hundreds of thousands have died of the disease throwing many families into mourning and other psychological torments. It has also crippled the economy of many countries of the world leading to job losses, high inflation, and dwindling Gross Domestic Product (GDP). The duo of social distancing and contact tracing are the major technological-based non-pharmaceutical public health intervention strategies adopted for combating the dreaded disease. These technologies have been deployed by different countries around the world to achieve effective and efficient means of maintaining appropriate distance and tracking the transmission pattern of the diseases or identifying those at high risk of infecting others. This paper aims to synthesize the research efforts on contact tracing and social distancing to minimize the spread of COVID-19. The paper critically and comprehensively reviews contact tracing technologies, protocols, and mobile applications (apps) that were recently developed and deployed against the coronavirus disease. Furthermore, the paper discusses social distancing technologies, appropriate methods to maintain distances, regulations, isolation/quarantine, and interaction strategies. In addition, the paper highlights different security/privacy vulnerabilities identified in contact tracing and social distancing technologies and solutions against these vulnerabilities. We also x-rayed the strengths and weaknesses of the various technologies concerning their application in contact tracing and social distancing. Finally, the paper proposed insightful recommendations and open research directions in contact tracing and social distancing that could assist researchers, developers, and governments in implementing new technological methods to combat the menace of COVID-19.

The First GAEN-Based COVID-19 Contact Tracing App in Norway Identifies 80% of Close Contacts in "Real Life" Scenarios

The coronavirus disease 2019 (COVID-19) response in most countries has relied on testing, isolation, contact tracing, and quarantine (TITQ), which is labor- and time-consuming. Therefore, several countries worldwide launched Bluetooth-based apps as supplementary tools. The aim of using contact tracing apps is to rapidly notify people about their possible exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and thus make the process of TITQ more efficient, especially upon exposure in public places. We evaluated the Norwegian Google Apple exposure notification (GAEN)-based contact tracing app Smittestopp v2 under relevant "real-life" test scenarios. We used a total of 40 devices, representing six different brands, and compared two different exposure configurations, experimented with different time thresholds and weights of the Bluetooth attenuation levels (buckets), and calculated the true notification rates among close contacts (≤2 m and ≥15 min) and false notification of sporadic contacts. In addition, we assessed the impact of using different operating systems and locations of the phone (hand/pocket). The best configuration tested to trigger exposure notification resulted in the correct notification of 80% of the true close contacts and incorrect notification of 34% of the sporadic contacts. Among those who incorrectly received notifications, most (67%) were within 2 m but the duration of contact was <15 min and thus they were not, per se, considered as "close contacts." Lower sensitivity was observed when using the iOS operating systems or carrying the phone in the pocket instead of in the hand. The results of this study were used to improve and evaluate the performance of the Norwegian contact-tracing app Smittestopp.

Nationwide rollout reveals efficacy of epidemic control through digital contact tracing

Fuelled by epidemiological studies of SARS-CoV-2, contact tracing by mobile phones has been put to use in many countries. Over a year into the pandemic, we lack conclusive evidence on its effectiveness. To address this gap, we used a unique real world contact data set, collected during the rollout of the first Norwegian contact tracing app in the Spring of 2020. Our dataset involves millions of contacts between 12.5% of the adult population, which enabled us to measure the real-world app performance. The technological tracing efficacy was measured at 80%, and we estimated that at least 11.0% of the discovered close contacts could not have been identified by manual contact tracing. Our results also indicated that digital contact tracing can flag individuals with excessive contacts, which can help contain superspreading related outbreaks. The overall effectiveness of digital tracing depends strongly on app uptake, but significant impact can be achieved for moderate uptake numbers. Used as a supplement to manual tracing and other measures, digital tracing can be instrumental in controlling the pandemic. Our findings can thus help informing public health policies in the coming months.

Feature selection for proximity estimation in COVID-19 contact tracing apps based on Bluetooth Low Energy (BLE)

During the COVID-19 pandemic, contact tracing apps based on the Bluetooth Low Energy (BLE) technology found in smartphones have been deployed by multiple countries despite BLE's debatable performance for determining close contacts among users. Current solutions estimate proximity based on a single feature: the mean attenuation of the BLE signal. In this context, a new generation of these apps which better exploits data from the BLE signal and other sensors available on phones can be fostered. Collected data can be used to extract multiple features that feed machine learning models which can potentially improve the accuracy of today's solutions. In this work, we consider the use of machine learning models to evaluate different feature sets that can be extracted from the received BLE signal, and assess the performance gain as more features are introduced in these models. Since indoor conditions have a strong impact in assessing the risk of being exposed to the SARS-CoV-2, we analyze the environment (indoor or outdoor) role in these models, aiming at understanding the need for apps that could increase proximity accuracy if aware of its environment. Results show that a better accuracy can be obtained in outdoor locations with respect to indoor ones, and that indoor proximity estimation can benefit more from the introduction of more features with respect to the outdoor estimation case. Accuracy can be increased about 10% when multiple features are considered if the device is aware of its environment, reaching a performance of up to 83% in indoor spaces and up to 91% in outdoor ones. These results encourage future contact tracing apps to integrate this awareness not only to better assess the associated risk of a given environment but also to improve the proximity accuracy for detecting close contacts.

Digital exposure tools: Design for privacy, efficacy, and equity

[Figure: see text].

Using Privacy Respecting Sound Analysis to Improve Bluetooth Based Proximity Detection for COVID-19 Exposure Tracing and Social Distancing

We propose to use ambient sound as a privacy-aware source of information for COVID-19-related social distance monitoring and contact tracing. The aim is to complement currently dominant Bluetooth Low Energy Received Signal Strength Indicator (BLE RSSI) approaches. These often struggle with the complexity of Radio Frequency (RF) signal attenuation, which is strongly influenced by specific surrounding characteristics. This in turn renders the relationship between signal strength and the distance between transmitter and receiver highly non-deterministic. We analyze spatio-temporal variations in what we call "ambient sound fingerprints". We leverage the fact that ambient sound received by a mobile device is a superposition of sounds from sources at many different locations in the environment. Such a superposition is determined by the relative position of those sources with respect to the receiver. We present a method for using the above general idea to classify proximity between pairs of users based on Kullback-Leibler distance between sound intensity histograms. The method is based on intensity analysis only, and does not require the collection of any privacy sensitive signals. Further, we show how this information can be fused with BLE RSSI features using adaptive weighted voting. We also take into account that sound is not available in all windows. Our approach is evaluated in elaborate experiments in real-world settings. The results show that both Bluetooth and sound can be used to differentiate users within and out of critical distance (1.5 m) with high accuracies of 77% and 80% respectively. Their fusion, however, improves this to 86%, making evident the merit of augmenting BLE RSSI with sound. We conclude by discussing strengths and limitations of our approach and highlighting directions for future work.

Landmark-Assisted Compensation of User's Body Shadowing on RSSI for Improved Indoor Localisation with Chest-Mounted Wearable Device

Nowadays, location awareness becomes the key to numerous Internet of Things (IoT) applications. Among the various methods for indoor localisation, received signal strength indicator (RSSI)-based fingerprinting attracts massive attention. However, the RSSI fingerprinting method is susceptible to lower accuracies because of the disturbance triggered by various factors from the indoors that influence the link quality of radio signals. Localisation using body-mounted wearable devices introduces an additional source of error when calculating the RSSI, leading to the deterioration of localisation performance. The broad aim of this study is to mitigate the user’s body shadowing effect on RSSI to improve localisation accuracy. Firstly, this study examines the effect of the user’s body on RSSI. Then, an angle estimation method is proposed by leveraging the concept of landmark. For precise identification of landmarks, an inertial measurement unit (IMU)-aided decision tree-based motion mode classifier is implemented. After that, a compensation model is proposed to correct the RSSI. Finally, the unknown location is estimated using the nearest neighbour method. Results demonstrated that the proposed system can significantly improve the localisation accuracy, where a median localisation accuracy of 1.46 m is achieved after compensating the body effect, which is 2.68 m before the compensation using the classical K-nearest neighbour method. Moreover, the proposed system noticeably outperformed others when comparing its performance with two other related works. The median accuracy is further improved to 0.74 m by applying a proposed weighted K-nearest neighbour algorithm.

Contact Tracing Apps: Lessons Learned on Privacy, Autonomy, and the Need for Detailed and Thoughtful Implementation

The global and national response to the COVID-19 pandemic has been inadequate due to a collective lack of preparation and a shortage of available tools for responding to a large-scale pandemic. By applying lessons learned to create better preventative methods and speedier interventions, the harm of a future pandemic may be dramatically reduced. One potential measure is the widespread use of contact tracing apps. While such apps were designed to combat the COVID-19 pandemic, the time scale in which these apps were deployed proved a significant barrier to efficacy. Many companies and governments sprinted to deploy contact tracing apps that were not properly vetted for performance, privacy, or security issues. The hasty development of incomplete contact tracing apps undermined public trust and negatively influenced perceptions of app efficacy. As a result, many of these apps had poor voluntary public uptake, which greatly decreased the apps' efficacy. Now, with lessons learned from this pandemic, groups can better design and test apps in preparation for the future. In this viewpoint, we outline common strategies employed for contact tracing apps, detail the successes and shortcomings of several prominent apps, and describe lessons learned that may be used to shape effective contact tracing apps for the present and future. Future app designers can keep these lessons in mind to create a version that is suitable for their local culture, especially with regard to local attitudes toward privacy-utility tradeoffs during public health crises.

The more the merrier! Barriers and facilitators to the general public's use of a COVID-19 contact tracing app in New Zealand

Contact tracing for infectious diseases can be partially automated using mobile applications. However, the success of these tools is dependent on significant uptake and frequent use by the public. This study explored the barriers and facilitators to the New Zealand (NZ) general public's use of the COVID-19 contact NZ COVID Tracer app. Adults (≥18 years, N = 373) in NZ. Qualitative and quantitative data were gathered from a nation-wide online survey. App use and frequency of use were presented as descriptive statistics. Qualitative data were analyzed thematically. 31% reported using the app frequently, 24% used it sometimes, 21% had installed but not used it, and 24% had not installed it. Barriers to use include technical issues, privacy and security concerns, forgetfulness and a lack of support from businesses. The perceived risk of contracting COVID-19, government recommendations and communications, and the importance of contact tracing facilitated use. Technical, user, business, and government factors influenced the public's use of a COVID-19 contact tracing app. The development of apps requiring minimal user effort and initial user testing may improve uptake. Enabling environments and better risk communication may improve uptake of similar community-driven contact tracing apps during future pandemics.

Effectiveness modelling of digital contact-tracing solutions for tackling the COVID-19 pandemic

Since the beginning of the coronavirus (COVID-19) global pandemic, digital contact-tracing applications (apps) have been at the centre of attention as a digital tool to enable citizens to monitor their social distancing, which appears to be one of the leading practices for mitigating the spread of airborne infectious diseases. Many countries have been working towards developing suitable digital contact-tracing apps to allow the measurement of the physical distance between citizens and to alert them when contact with an infected individual has occurred. However, the adoption of digital contact-tracing apps has faced several challenges so far, including interoperability between mobile devices and users’ privacy concerns. There is a need to reach a trade-off between the achievable technical performance of new technology, false-positive rates, and social and behavioural factors. This paper reviews a wide range of factors and classifies them into three categories of technical, epidemiological and social ones, and incorporates these into a compact mathematical model. The paper evaluates the effectiveness of digital contact-tracing apps based on received signal strength measurements. The results highlight the limitations, potential and challenges of the adoption of digital contact-tracing apps.

How detection ranges and usage stops impact digital contact tracing effectiveness for COVID-19

To combat the COVID-19 pandemic, many countries around the globe have adopted digital contact tracing apps. Various technologies exist to trace contacts that are potentially prone to different types of tracing errors. Here, we study the impact of different proximity detection ranges on the effectiveness and efficiency of digital contact tracing apps. Furthermore, we study a usage stop effect induced by a false positive quarantine. Our results reveal that policy makers should adjust digital contact tracing apps to the behavioral characteristics of a society. Based on this, the proximity detection range should at least cover the range of a disease spread, and be much wider in certain cases. The widely used Bluetooth Low Energy protocol may not necessarily be the most effective technology for contact tracing.

Measurement-based evaluation of Google/Apple Exposure Notification API for proximity detection in a commuter bus

We report on the results of a measurement study carried out on a commuter bus in Dublin, Ireland using the Google/Apple Exposure Notification (GAEN) API. This API is likely to be widely used by Covid-19 contact tracing apps. Measurements were collected between 60 pairs of Android handset locations and are publicly available. We find that the attenuation level reported by the GAEN API need not increase with distance between handsets, consistent with there being a complex radio environment inside a bus caused by the metal-rich environment. Changing the people sitting in a pair of seats can cause variations of ±10dB in the attenuation level reported by the GAEN API. Applying the rule used by the Swiss Covid-19 contact tracing app to trigger an exposure notification to our bus measurements we find that no exposure notifications would have been triggered despite the fact that all pairs of handsets were within 2m of one another for at least 15 mins. Applying an alternative threshold-based exposure notification rule can somewhat improve performance to a detection rate of 5% when an exposure duration threshold of 15 minutes is used, increasing to 8% when the exposure duration threshold is reduced to 10 mins. Stratifying the data by distance between pairs of handsets indicates that there is only a weak dependence of detection rate on distance.

A Bluetooth-Based Architecture for Contact Tracing in Healthcare Facilities

With the latest standard releases, Bluetooth technology is becoming more and more relevant for building and industrial automation. At the same time, Bluetooth is now becoming fundamental for contact tracing applications, to support monitoring and containment of the COVID-19 pandemic. Critical facilities such as nursing homes and hospitals have been severely exposed to the pandemic, but the currently available short-range wireless technology still faces the fundamental limits of proximity accuracy, battery lifetime, and privacy in those complex indoor environments. The aim of this paper is to investigate effective ways of building an architecture with heterogeneous devices to support contact tracing in critical scenarios such as healthcare facilities, while meeting the required level of accuracy and privacy. A framework based on standard Bluetooth mesh networking technology is proposed, and the research challenges are discussed.

Citizen-Centered Mobile Health Apps Collecting Individual-Level Spatial Data for Infectious Disease Management: Scoping Review

BACKGROUND

The novel coronavirus SARS-CoV-2 rapidly spread around the world, causing the disease COVID-19. To contain the virus, much hope is placed on participatory surveillance using mobile apps, such as automated digital contact tracing, but broad adoption is an important prerequisite for associated interventions to be effective. Data protection aspects are a critical factor for adoption, and privacy risks of solutions developed often need to be balanced against their functionalities. This is reflected by an intensive discussion in the public and the scientific community about privacy-preserving approaches.

OBJECTIVE

Our aim is to inform the current discussions and to support the development of solutions providing an optimal balance between privacy protection and pandemic control. To this end, we present a systematic analysis of existing literature on citizen-centered surveillance solutions collecting individual-level spatial data. Our main hypothesis is that there are dependencies between the following dimensions: the use cases supported, the technology used to collect spatial data, the specific diseases focused on, and data protection measures implemented.

METHODS

We searched PubMed and IEEE Xplore with a search string combining terms from the area of infectious disease management with terms describing spatial surveillance technologies to identify studies published between 2010 and 2020. After a two-step eligibility assessment process, 27 articles were selected for the final analysis. We collected data on the four dimensions described as well as metadata, which we then analyzed by calculating univariate and bivariate frequency distributions.

RESULTS

We identified four different use cases, which focused on individual surveillance and public health (most common: digital contact tracing). We found that the solutions described were highly specialized, with 89% (24/27) of the articles covering one use case only. Moreover, we identified eight different technologies used for collecting spatial data (most common: GPS receivers) and five different diseases covered (most common: COVID-19). Finally, we also identified six different data protection measures (most common: pseudonymization). As hypothesized, we identified relationships between the dimensions. We found that for highly infectious diseases such as COVID-19 the most common use case was contact tracing, typically based on Bluetooth technology. For managing vector-borne diseases, use cases require absolute positions, which are typically measured using GPS. Absolute spatial locations are also important for further use cases relevant to the management of other infectious diseases.

CONCLUSIONS

We see a large potential for future solutions supporting multiple use cases by combining different technologies (eg, Bluetooth and GPS). For this to be successful, however, adequate privacy-protection measures must be implemented. Technologies currently used in this context can probably not offer enough protection. We, therefore, recommend that future solutions should consider the use of modern privacy-enhancing techniques (eg, from the area of secure multiparty computing and differential privacy).

Digital contact tracing and exposure notification: ethical guidance for trustworthy pandemic management

There is growing interest in contact tracing apps (CT apps) for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. We will discuss some trade-offs that arise from this perspective. We then suggest that public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely undermine public trust, and as such, risk impeding general effectiveness.

Measurement-based evaluation of Google/Apple Exposure Notification API for proximity detection in a light-rail tram

We report on the results of a Covid-19 contact tracing app measurement study carried out on a standard design of European commuter tram. Our measurements indicate that in the tram there is little correlation between Bluetooth received signal strength and distance between handsets. We applied the detection rules used by the Italian, Swiss and German apps to our measurement data and also characterised the impact on performance of changes in the parameters used in these detection rules. We find that the Swiss and German detection rules trigger no exposure notifications on our data, while the Italian detection rule generates a true positive rate of 50% and a false positive rate of 50%. Our analysis indicates that the performance of such detection rules is similar to that of triggering notifications by randomly selecting from the participants in our experiments, regardless of proximity.