What's next for COVID-19 apps? Governance and oversight: Many governments have seen digital health technologies as a promising tool to address coronavirus disease 2019 (COVID-19), particularly digital contact tracing (DCT) apps such as Bluetooth-based exposure notification apps that trace proximity to other devices (1) and GPS-based apps that collect geolocation data. But deploying these systems is fraught with challenges, and most national DCT apps have not yet had the expected rate of uptake. This can be attributed to a number of uncertainties regarding general awareness of DCT apps, privacy risks, and the actual effectiveness of DCT, as well as public attitudes toward a potentially pervasive form of digital surveillance. DCT thus appears to face a typical social control dilemma. On one hand, pending widespread uptake, assessing DCT effectiveness is extremely difficult; on the other hand, until DCT effectiveness is proven, its widespread use at a population scale is hard to justify. Recognizing that technological uptake is an open-ended process reliant upon social learning and the piecemeal creation of public trust, we suggest that policy-makers set up mechanisms to test effectiveness, oversee the use of DCT apps, monitor public attitudes, and adapt technological design to socially perceived risks and expectations.
To date, both scholarly and policy debates on DCT have largely overlooked the above dilemma, focusing instead on privacy-related issues as the pivotal element of DCT governance (2). However, although preserving privacy is of the utmost importance, technical safeguards such as encryption, decentralized data architectures, and temporal limits to data storage have not proved sufficient for DCT apps to quickly diffuse at a population scale.
