The frontline of the fight against Covid? There’s an app for that

Ireland’s fight against the spread of Covid-19 is stepping up a gear, and it seems that technology will play its part.

At the end of March, the HSE said it was planning a contact tracing app to help reduce the spread of coronavirus in Ireland, following the lead of countries including South Korea, the UK and Germany.

The app is expected to use Bluetooth technology to detect devices that are in close contact with each other. When the owner of a device with the app installed tests positive for Covid-19, the data could enable a more efficient contact tracing process.

The HSE has tasked Nearform with developing the app. The Co Waterford-based company may not quite be a household name, but it has been working with more than a few recognisable companies behind the scenes for quite some time. It specialises in bringing cloud computing to large enterprises, building faster, more stable, more versatile business platforms.

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Founded in 2011 by programmers Cian Ó Maidín and Richard Rodger, Nearform's growth has been significant in recent years. The Waterford Institute of Technology spin-out's first client was the Sunday Business Post; a year after it was founded, Nearform signed up Conde Nast. These days, it counts the New York Times, Intel, IBM and Microsoft among its paying customers. It also works on open source projects, and hosts a major European conference for node.js developers, Nodeconf EU, every year (the 2020 event will be held remotely).

Nearform has seen significant growth over the years. In 2015, it announced it would increase its workforce by 100, primarily recruiting software developers as demand for its services increased.

Surprisingly, a shift to the US – almost expected for companies in the tech sector – was not on the cards. “We were strongly urged by many parties to relocate to the US,” Ó Maidín said at the time. “We chose to stay here and build our company in a place where we wanted to raise our families.”

The strong ties to Co Waterford give Nearform a unique selling point when it comes to recruiting. The company not only has the benefit of being out of the Dublin-focused tech industry’s battle with both residential and commercial accommodation, it can offer a work-life balance that many employees can only dream of.

High enough quality people

The company was adamant it could build a strong global business from Waterford. “You can be anywhere in the world if you have high enough quality people,” Ó Maidín said.

Those employees often come from contributions to the company’s open source projects, or attend their events, rather than from a formal recruitment process. It has worked in its favour; the Tramore company has attracted employees from all over the world.

While many companies have found themselves in unfamiliar territory in the current pandemic, rushing to turn employees into remote workers with only a few days to prepare, Nearform has a distributed workforce already; although it has an office in Waterford, it has employees based all over Ireland and around the world, and 90 per cent of its workforce was remote before coronavirus shut down the country.

With its CV, it is no real surprise that Nearform was awarded the contract. It likes to keep things simple too, but that doesn’t mean taking shortcuts. These things take time. Perhaps somewhat optimistically, the HSE estimated it would have an app within 10 days of the announcement on March 29th that it was developing contact tracing software; as of April 20th, it had not been released.

The benefits of developing an app that will help with the contact tracing process are clear: technology can speed up the process, enabling people to be alerted earlier and isolate themselves until the incubation period has passed or a test confirms the presence of a coronavirus infection. That potentially means fewer people exposed to the virus during the asymptomatic period, and hopefully fewer people infected with the virus. The current methods of tracing contacts is painstaking and may not gather everyone the patient has had contact with.

Adapted for use

That the HSE has decided to develop its own app may come as a surprise. There are others out there that could have been adapted for use here; the Sunday Times reported the HSE was offered a version of an app developed by Accenture and the Austrian Red Cross, the Stopp Corona app – and other developers have also come up with their own Bluetooth-enabled apps they feel would fit the bill without compromising user privacy.

Accenture said it did not have anyone available to discuss contract tracing apps, when approached by The Irish Times.

Privacy is a key issue with the apps. The EU is clear on this score: any app that is released to deal with coronavirus must meet the privacy guidelines that govern states. Concerns have already been raised by privacy advocates about the use of apps to collect data, and what may happen to that data once the pandemic has passed and the apps are no longer needed.

Seven countries have either formally supported the Pan-European Privacy Preserving Proximity Tracing (PEPP-PT) initiative, a European technology platform to support smartphone apps to help trace those at risk of infection, or tasked one of its members with developing a national app.

Austria, Germany, France, Italy, Malta, Spain and Switzerland have already expressed their interest in the platform, with another 40 countries currently in the process of being brought on board and registered.

PEPP-PT

"A lot of larger countries have dedicated their app teams to build on top of what we're supplying," German tech entrepreneur Chris Boos, a co-initiator of PEPP-PT and founder of business automation startup Arago, said.

It’s a significant endeavour. There are more than 200 scientists and technologists collaborating on PEPP-PT. The initiative is a proponent of the use of Bluetooth short-range communications between personal devices as a proxy for measuring the risk that a person infected with coronavirus can pass it on.

The crisis has also prompted some unlikely alliances. Apple and Google have teamed up to allow public health apps on their respective platforms to talk to each other, to alert people who have come in contact with someone subsequently diagnosed with Covid-19 to be notified. The companies plan to build the technology into their underlying operating systems, on an opt-in basis.

However, there are issues with the app approach too. It requires a large take-up among the population, who must trust the app and give it the correct information for it to be of use. Researchers at Oxford University's Big Data Institute argue that 60 per cent of the population using such an app would be enough to suppress the pandemic.

And then there is the issue of access to the correct equipment. While it is admirable that Apple and Google are getting involved with the war against the pandemic, the plan is not flawless. As many as two billion mobile phone owners around the world will be unable to use the smartphone-based system, because they do not have compatible phones.

It’s particularly an issue for older people and those in poorer areas of the world, where limited access to smartphones will create a digital divide.

Despite the issues, apps may prove to be a useful weapon for public health authorities – as long as they are used in the right way.

What are other countries doing?

China
Authorities began rolling out a health screening app, integrated into popular apps such as AliPay and WeChat, that assigned citizens a health QR code. Based on a short survey of potential symptoms, the app assigned a code tagged green, orange or red. Access to public transport, public buildings, even apartment buildings and moving around the city, is dependent on having a green code. The apps can also share data with the police.

Hong Kong
Hong Kong is using an app and electronic monitoring bracelet to enforce quarantines for those entering the country. The wristband pairs to the app and alerts authorities if the app and band go too far apart. There are stiff penalties for breaching quarantine, including a €3,000 fine and a spell in prison.

South Korea
Held up as the standard to meet in terms of contact tracing in the Covid-19 pandemic, the South Korean approach has been thorough. The app facilitates twice-daily check-ins with case officers, and collects location data. Officers are alerted if the phone leaves the quarantine area.

Israel
Israel's contcat tracing app may be voluntary, but the government is also using mobile phone data to track those who test positive for Covid-19 and enforce quarantines.

Australia
The Australian government released its app Coronavirus Australia at the end of March, initially as a repository of links to official government websites. An update saw a voluntary "isolation registration" form, gathering details such as location, name, age and mobile number.

Austria
StoppCorona, which was developed by Accenture in partnership with the Austrian Red Cross, helps people to keep track of who they meet. If you contract coronavirus, it informs all your contacts over the past 48 hours anonymously.

Singapore
Singapore's TraceTogether app is taking a privacy-first approach. It collects information only once, when registering, and that information is only used to contact potentially infected patients. Users are assigned time-sensitive anonymous temporary IDs that identify the patient to third parties, exchanging temporary IDs with other app users as they pass in close contact. That list of IDs is stored in a log, which can be used to contact everyone the patient has had contact with in a 21-day period. It is stored on the user's device, and can only be handed over to authorities with the permission of the user. The system is opt-out too, so if you decide you no longer want to use the app, the contact information is deleted from the app.

UK
The UK has the Covid Symptom Tracker, developed by Zoe Global with King's College London, Guy's and St Thomas' Hospitals, asking users to log how they feel each day. The idea is to track symptoms and potentially flag areas where coronavirus may erupt next. An NHS app is also under development.

Italy
In March, the Innovation Ministry launched a tender last month for app developers volunteering their services, receiving hundreds of proposals before it settled on the Milan-based developer Bending Spoons, part of the PEPP-PT.

The app, initially named Immuni, uses Bluetooth technology to record when users are in close proximity with each other. If someone tests positive for coronavirus, the app could send an alert to users who have been in contact recommending actions such as self-quarantine and virus testing while preserving anonymity. It will be a voluntary endeavour, and will be in line with recommendations by Italy’s data protection authority and European privacy rules.

The app will be tested in some Italian regions before being rolled out to the whole country.