Why exposure notification technology should still be on your agenda for Spring 2021

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Why exposure notification technology should still be on your agenda for Spring 2021

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Right now, healthcare workers across the globe labor to distribute COVID-19 vaccines – giving us much-needed hope that the end of the pandemic is in sight. However, we cannot yet breathe a collective sigh of relief as record numbers of individuals still contract COVID-19 and a new, more contagious strain of COVID-19 emerges.

As colleges and universities prepare for Spring semester, they must plan to continue employing the measures they diligently implemented in the Fall (e.g., enforcing masks, frequent testing, manual contact tracing) and work to strengthen their COVID-19 containment strategy in any way possible. Exposure notification apps¹ – mobile apps that notify users of their exposure to other users who have tested positive for COVID-19 – can prove a valuable addition to any institution’s COVID-19 containment strategy.

How to Plan for the Spring 2021 Semester

Ten lessons learned from Fall repopulation efforts to help you plan for the Spring.

When EAB and other news outlets across the globe first broke news of exposure notification apps and their potential to contain COVID-19 in May 2020, few apps existed and adoption was lukewarm. As we begin 2021, an increasing number of governments have released exposure notification apps and in turn, more people and several campuses now run them. We outline what you need to know about exposure notification technology as you prepare for the Spring semester.

¹Previous publications referred to exposure notification technology as contact tracing technology. However, the industry shifted to the phrasing “exposure notification” because it more accurately describes the technology’s functionality.

“The pandemic is not over, and January through March are going to be especially tough. So to institutions considering adopting exposure notification apps, I want to say that you’re not late to the party, but rather just in time. Join us and help save lives.”

Dr. Curtis A. Carver Jr

Vice President and Chief Information Officer, University of Alabama at Birmingham, Developers of the GuideSafe™ Exposure Notification app

Exposure notification apps are no silver bullet, but they can still save lives

Exposure notification apps can often inform users of possible exposure to COVID-19 much quicker than overburdened manual contact tracers. Earlier detection leads to faster testing, treatment, and quarantining and isolation, which curbs the spread of COVID-19 and saves lives. For example, the University of Arizona reported that 27% of the people campus contact tracers contacted had already been alerted of possible COVID-19 exposure through use of its Covid Watch Arizona exposure notification app. A Pew survey found that 40% of American were unlikely to even answer and speak with manual contact tracers. While apps will not single handedly stop the spread of COVID-19 on campus, their ability to identify and inform users of possible exposure quickly and on a wide-scale will provide an additional level of defense for any institution.

Furthermore, low adoption rates do not negate the benefits of exposure notification apps. Early news reports fixated on the 60% adoption rate an Oxford University study in April contended apps would need to reach to stop the spread of COVID-19. Andrea Stewart, a co-author of the study, responded that “There’s been a lot of misreporting around efficacy and uptake… suggesting that the app only works at 60% - which is not the case … it starts to have a protective effect [at] much lower levels.”

Early Oxford University and Google research predicts app efficacy at lower rates of adoption

  • 0%

Adoption of exposure notification apps

  • 0%

Decrease in infections

  • 0%

Decrease in deaths

The Oxford and Google model predicts the effects of exposure notification app adoption (in conjunction with manual contact tracing) in the three largest counties in Washington state.

Colleges and universities only need to sign up as apps proliferate

At the outset of the pandemic, governments, public health agencies, and higher ed institutions all questioned dedicating limited resources to developing unproven exposure notification apps when resources could be spent on more established solutions. The good news – many governments have now either developed or adopted exposure notification apps. In some cases, governments adopted apps at the behest or with the help of colleges and universities (e.g., University of Alabama at Birmingham, University of California San Diego).

The growth in app usage can be credited in part to Google and Apple, who collaborated to release both an Exposure Notifications System (ENS) API framework that nations and states could use to develop apps and a built-in/ready-made Exposure Notifications Express (EN Express) app of their own. These offerings made it quicker, easier, and cheaper for nations and states to develop and employ apps. 19 US states, in addition to Guam, Puerto Rico, and Washington, DC, now employ exposure notification systems, which the MIT Technology Review estimates covers almost half of the US population. In nations and states with exposure notification systems, all higher ed institutions need to do is endorse and support them on campus.

For example, New York State released the COVID Alert NY app in October. The State University of New York system then encouraged its entire campus population to download the COVID Alert NY app. Similarly, the University of California San Diego (UC San Diego) piloted Google Apple Exposure Notifications Express (EN Express) technology in September.

At UC San Diego, IT support of the app mainly took the shape of helping campus members turn on the feature or install the app and answering any concerns they had regarding privacy or effectiveness. Furthermore, adopting the system did not require any change in manual contact tracing procedure.

“Our IT department did not have to develop the exposure notification technology in any way. All we had to do was market and support the app, which was a minimal lift.”

Dr. Vince Kellen

Chief Information Officer, University of California San Diego

Who is using Google Apple Exposure Notification technology?

Google Apple Exposure Notifications System (ENS) API
Google Apple Exposure Notifications Express (EN Express)

In May 2020, Google and Apple collaborated to release an API framework that governments could use to develop their own exposure notification app.

 

  • Select countries employing the ENS API: Australia², Austria, Belgium, Brazil, Canada, Cyprus, Czech Republic, Ecuador, Finland, Germany, Ireland, Lithuania, New Zealand, Peru, South Africa, Russia, Saudi Arabia, Switzerland, United Kingdom²
  • US states employing the ENS API: Alabama, Delaware, Guam, Hawaii, Michigan, Minnesota, Nevada, New Jersey, New York, North Carolina, North Dakota, Pennsylvania, Puerto Rico, Virginia, Wyoming

²These nations replaced or altered existing exposure notification apps to incorporate the Google Apple ENS

Students show willingness to install exposure notification apps

Many governments across the world have struggled with low adoption of exposure notification apps. For instance, only 8.1 million people in the US adopted apps by late November 2020 and apps in Germany and England have just reached 20 million installations. However, many college and university campuses that either piloted or endorsed apps have seen adoption rates so encouraging they often eclipse what we have seen from nations and states worldwide. Students are acutely aware that campus settings, where thousands may be clustered within a few miles, are potential hotbeds for virus transmission. In addition, this generation of students are technological natives. They are better able to understand how exposure notification apps are set up to preserve privacy and are in turn, less apprehensive of using them.

  • 50%

    of UCSD's population activated EN Express

hover over

Take for example UC San Diego, the first of the University of California campuses to pilot the Google Apple EN Express technology that is now available throughout California as CA Notify. At UC San Diego, just over 50% of the campus population (~18,000 users) activated EN Express. UC San Diego reported that the system has thus far sent over a dozen verification codes to COVID-19 positive students, enabling them to voluntarily log their positive status in the app so the app could alert anyone who was previously in close contact. At UC San Diego and beyond, keeping test result reporting in apps voluntary has been essential to building trust in apps and avoiding any privacy backlash. As a result, UC San Diego’s infection rate has stayed at less than one half percent since classes started back on campus in late September, whereas the surrounding San Diego county’s infection rate has hovered around six percent. UC San Diego’s success is no anomaly, as the MI COVID Alert exposure notification app Michigan State University piloted has been downloaded 46,000 times on its campus and the surrounding Ingham County.

Success of any exposure notification app hinges on your campuses’ commitment to marketing

Higher ed institutions need to market exposure notification apps on campus if they wish to achieve meaningful adoption. For proof, colleges and universities need only look at the marketing and outreach campaigns nations and states have launched, such as Virginia, which has spent $1.5 million to raise public awareness for its COVIDWISE Exposure Notifications app that has been downloaded by over 900,000 people.

EAB recommends the following as you plan your marketing strategy:

The University of Alabama at Birmingham (UAB) promoted the GuideSafe™ Exposure Notification App to its campus community by proclaiming that any user to install and run the app was a “citizen hero” because doing so would save lives.

Dr. Vince Kellen noted that UC San Diego strongly messaged CA Notify as an exposure notification app rather than a contact tracing app, because some negatively associated the term “contact tracing” with location tracking – which most apps do not do. Exposure notification apps only notify users of possible exposure to COVID-19, whereas manual contact tracers specifically try to ascertain where COVID-19 was spread and contact those who might have been exposed to or exposed others to infection.

The initial announcement and rollout of exposure notification apps is an essential opportunity to quickly gain a large number of downloads and embed an app on campus. For example, when Michigan State University piloted the MI COVID Alert app in October, it was downloaded almost 10,000 times within three days of launch and 30,000 times after two weeks. UAB announced its GuideSafe™ Exposure Notification App in a formal press release and conducted additional press conferences with the mayors of Birmingham and Hoover, as well as with local celebrities such as UAB’s football coach. Other institutions distributed university-wide emails, video announcements from staff and student leaders, or a message from the President. While announcements should highly encourage app installation to curb the spread of COVID-19 and save lives, institutions should also make it clear that app use is still voluntary.

UAB allocated ~$200K to market the GuideSafe™ Exposure Notification App. UAB’s communications department, in collaboration with the state, spearheads the campaign. At this point, everyone from UAB’s president to student club leaders have formally endorsed the app. UAB incorporates app messaging in mass communications and promotes the app across campus and beyond using posters and digital displays with scannable QR codes to download the app. Auburn University endorsed the GuideSafe™ Exposure Notification App developed by UAB on its campus and created a how-to PDF to help students download and run the app. UC San Diego continues to market its CA Notify app in its recurring Faculty, Staff, and Student Town Halls. In these virtual meetings as well as others, many in leadership use a CA Notify virtual background, which are also offered to others on campus.

Sources:

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