Irish app helping to trace Delaware’s COVID spread
NearForm may not be an easily recognized name in Delaware in the fight against COVID-19, but according to its chief commercial officer Larry Breen that’s nothing new for the company.
Headquartered in an Irish seaside town of Tramore, NearForm’s past work includes e-commerce sites and other behind-the-scenes software for highly visible companies like Condé Nast and IKEA’s holding company Ingka. But now, NearForm is best known for building out contract tracing apps, like the COVID Alert DE in Delaware.
“Most people have used a component of NearForm at some stage, they just aren’t aware of it,” Breen said. “The work we do is awesome and we’re really good at it, but it’s just not the same as doing something that’s affecting people’s lives in real-time.”
This summer, the Irish government approached NearForm to quickly develop a contract tracing app that would keep users’ information private. Within 10 days, NearForm created the first concept and got to work. The app was released in Ireland on July 7, and 35 million people in the country downloaded it.
Roughly two months later, NearForm’s COVID tracker app was launched in the United States, including Delaware, New York, New Jersey and Pennsylvania. In October, NearForm’s COVID tracker app became one of the first national apps linked with other nations in the European Union.
Delaware paid NearForm $250,000 in one-time start-up costs and $30,000 in monthly operational costs, all paid from the state’s CARES Act allocation, according to Jill Friedel, spokesperson for the state’s Department of Health and Social Services (DHSS).
Despite that success, the company also decided to release the app open source, making its coding freely available for redistribution or modifications, in order to push contact tracing as a viable tool to manage the epidemic.
“That was to give transparency, like there’s nothing to be afraid of when it comes to the app … and why sit back and watch other people create the same thing over and over again? We want to put this pandemic behind us, and help people embrace this tool,” Breen said.
App at work
Using the Bluetooth signal from a user’s smartphone, contact tracing apps send anonymized keys to other people who also have the app on their phone. If another app spends 15 minutes within 6 feet of another, the phones swap random contacts to remember the phone.
Each state and country has different regulations, but NearForm developed the app through technology to make contract tracing work across jurisdictions. At first, NearForm focused on a centralized app, but once Apple and Google rolled out technology to allow the app to continue to work uninterrupted, the company moved to a decentralized approach.
Each COVID Alert app is customized for each jurisdiction, depending on what state or national officials request, he added. That includes how it looks like, user flow, which symptoms to be monitored and attenuation value – the or the threshold for “contact events” of 6 feet for 15 minutes.
“Everyone has pretty much adopted that, but the state can change that value,” Breen said. “We bring that global piece to the table and show the best practices. But at the end of the day, each state has control over their own system.”
Recently, NearForm added a new component to its COVID alert apps: a business check-in. The concept is to allow businesses to keep track of whether someone who tested positive for COVID-19 shops at their store.
“The QR scanner is built into the contact tracing piece of this, so the health department has a dashboard that sits behind this, which helps them identify what business needs more support to open up safely,” Breen said. “It’s all in continuation of the journey in collaboration with officials and needs.”
Delaware is not considering upgrading the COVID Alert DE app to include the business QR code function, according to Friedel.
How to measure success
NearForm estimates that fewer than 16 million people have the app available in their communities. In Delaware, 81,449 people have downloaded the app, or about 8.3% of the state’s total population, as of Dec. 8, according to Friedel. The state also has an additional $110,00 set aside from the CARES Act funding to market the app.
Friedel pointed out that COVID Alert DE is targeted to users ages 18 and older, which leaves a potential pool of 770,192 users. DHSS set an internal goal to reach 10% of the adult population, so the progress is encouraging.
In Delaware, almost 10% of the people who tested positive and who talked with state contact tracers had the COVID Alert DE app on their phones. Of that group, 75% put in the six-digit code to trigger an exposure notification, which signals that those who download the app know how to use it and are willing to properly share the information.
But about 14% of users with close contacts have the app on their phone, Friedel said.
“Today, two barriers remain: awareness of the app and people’s concerns about privacy,” she told DBT in an email. “COVID Alert DE uses Bluetooth technology, not GPS navigation, so the app doesn’t know where people have been or who they’ve been with; no such data is collected. We will keep working to get out that word.”
With the 16 states and Guam and the District of Columbia that have access to a COVID alert app, a combined 8.1 million people use them as of late November, according to an Associated Press analysis. With an estimated population of 110 million people in those areas, about one in 14 people are using the app.
Even with the tools available, Breen said the biggest challenge might be people’s willingness to use it, possibly amplified by the misinformation surrounding the app and the coronavirus.
“You hear all these messages and these talking heads popping up on screens saying ‘you shouldn’t wear a mask, you shouldn’t believe in COVID,’” he said. “The fact of the matter is that the app helps you combat it, and it’s not exposing your truth. You have nothing to lose to have it downloaded. It’s that messaging on how do you get the citizens engaged in this?”