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Why the existing contact tracing apps could worsen the COVID-19 situation

April 23, 2020

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The COVID-19 pandemic has come as a huge wake-up call to governments all around the world. This outbreak has made us realize that we are nowhere near prepared to handle a contagion of this scale. The brightest minds from various research facilities, organizations, and hospitals have been called upon to figure out a way to combat this disease.

In order to respond to COVID-19, it is important to strike a balance between planning and action. Several countries are using a blend of containment and mitigation activities with the goal of preventing an influx of patients and reducing the burden on healthcare systems. The precautionary measures used in order to achieve these aims are different and are based on national risk assessments that include approximate numbers of patients requiring hospitalization and availability of hospital beds and ventilation support.

Most national response strategies include varying levels of contact tracing and self-isolation or quarantine; promotion of public health measures, preparation of health systems for a surge of infected patients who will need to be kept in isolation, oxygen, and mechanical ventilation.



Contact Tracing, Why is it important?


People who come in close contact with a person who has tested positive for the coronavirus, are at a high risk of becoming infected themselves, and of potentially further infecting others. Hence, it is of paramount importance to monitor these contacts after they have been exposed to an infected person. This will ensure that they get the right care and treatment if they have contracted the infection. This method of identifying the people who have come in contact with a potential COVID-19 case is known as contact tracing. It is an extremely powerful tool that is being used to curb the spread of the virus.

There are a number of contact tracing apps that have been developed by different organizations.These apps and protocols provide a secure, easier and faster way to carry out the contact tracing process. But, can we solely depend on contact tracing alone?



The Missing Link

The COVID-19 infection can occur mainly through two different methods-

Human-to-human transmission

This is when the virus is transmitted from an infected person to a healthy person through close contact or exposure to coughing, sneezing, respiratory droplets, or aerosols. These aerosols can penetrate the human body (lungs) via inhalation through the nose or mouth.

Human-to-surface-to-human transmission

Studies say that coronavirus may continue to stay on surfaces for a couple of hours or up to many days. This may change according to different conditions (e.g. type of surface, temperature, or humidity of the environment).

  • Airborne droplets – 3 Hours
  • Hard and shiny surfaces (Glass/Countertops/Plastic/Stainless steel) – Upto 72 hours
  • Porous surfaces (Cardboard/Paper/Fabrics) – Up to 24 Hrs
  • There is a large chance for coronavirus to persist in surfaces of facilities present in a hot zone. Because of this, a person who goes to a hot zone has a larger probability of being infected with COVID-19. For example, if a person who has tested positive for COVID-19 goes to a restaurant and touches the handrails, door handles, benches, or any such object, the virus can be transmitted to these surfaces and could persist on such a surface based on the above-mentioned points. Meanwhile, someone else could visit the same restaurant and come in contact with any of these surfaces to be exposed to the virus. It is extremely important for governments to act in a proactive manner by making calculations according to these exposures and subsequently identify micro hotspots and alert users to stay away from such hotspots. The owners of these infrastructure owners can also be notified to disinfect these infrastructures. This is a major component of exposure analysis which a lot of software systems out there don’t take into account.



    The danger in plain sight


    If governments solely rely on contact tracing apps, then several people would be misled into believing that they are safe from infection when in reality, they may have been exposed to the virus from an infected surface. And they’d unknowingly keep on spreading the disease to others. And for governments, no matter how effectively they do contact tracing, the COVID-19 curve would keep on curving rather than flattening.

    So, how does one account for both methods of infection?

    The simple answer to this is to carry out automated exposure analysis. It is crucial for governments to make calculations based on the exposure of citizens to infected surfaces as well. Exposure analysis enables the dynamic creation of micro hot zones (like restaurants, bus stands, etc) as well as macro hot zones (like places, junctions, etc). These hot zones refer to areas that have been visited by a COVID-19 positive patient. Having a contact tracing app that could carry out exposure analysis would mean that users can get alerts to keep a distance from such hot zones. An app like this could also send out a notification to the infrastructure owners so that they can organize for the area to be disinfected.

    In order to flatten the COVID-19 curve, contact tracing and exposure analysis must be carried out together. Location-based alerts can alert users when they are in high-risk areas and contact tracing apps would alert them if they are near a primary or secondary contact. Combining both of these alerts would ensure that people can take the required precautions to prevent infection from both methods of transmission.



    How to enable automated exposure analysis?

    Automated exposure analysis can be done by tracking the GPS location data of the citizens. Obviously, this would raise data privacy concerns. RebuildTheChain – the pandemic management system launched by Accubits Technologies offers a privacy-preserving exposure analysis mechanism. It enables governments to perform automated exposure analysis without compromising the citizens’ data privacy. When a new person is tested positive for COVID-19, the authorities can request the person to upload their location data log via the application. Location data uploaded by all infected people are uploaded to a common server. The rest of the users’ app constantly pulls this data based on location batches and cross-check the local data and pulled data to identify if there is a match. Through this approach, the user’s GPS data is not transmitted to the server-side. Instead, a user’s mobile application pulls the hot zone information from the server to the app to perform a decentralized exposure analysis.

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