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SPECIAL SECTION: The COVID-19 Crisis


dreamstime In L.A. County, Public Health Leaders Take


Another Swing at Contact Tracing There doesn’t appear to be a one-size-fi ts-all solution to contact tracing in the U.S., and L.A. County offi cials are now turning to a digital platform that enables anonymous notifi cations to a positive case’s close contacts By Rajiv Leventhal and David Raths


In this recurring section, Healthcare Innovation editors take an in-depth look into the numerous ways the COVID-19 pandemic is impacting the healthcare ecosystem. In this issue, we specifi cally look at recent digital contact tracing efforts, and the core ethical and logistical questions around vaccine distribution.


C


ontact tracing has been a massive undertaking in the U.S. so far, and with COVID-19 cases continuing to surge


upwards of 200,000 per day, the job won’t get any easier. Although identifying indi- viduals who may have come into contact with an infected person and then collecting data on these contacts is considered a key element to help curtail the pandemic, these efforts have been littered with challenges to date. A recent survey from Pew Research Center


of more than 10,000 U.S. adults, for instance, found that only half of respondents said they would be comfortable or likely to engage on the three key steps involved with con- tact tracing—speaking with a public health offi cial, or contact tracer, who reached out to


them about COVID-19; sharing the names of people they have had close contact with as well as the places they have recently visited; and willing to quarantine for 14 days if they were advised to.


Indeed, contact tracing is the last two-


thirds of public health leaders’ “test-trace- isolate” strategy, but in the U.S. so far, the results have not been there. A Reuters survey of 121 local agencies, published in August, concluded that the U.S. “badly lags other wealthy countries in contact tracing, includ- ing South Korea and Germany, which ramped up their programs months ago. Contributing to the faltering U.S. response is the govern- ment’s failure to provide accurate and timely diagnostic testing, something other countries were able to roll out much faster and more broadly,” that report noted. In California, healthcare leaders recently


rolled out CA Notify, a new digital contact tracing tool that was made available to all Californians starting Dec. 10. The tool was developed in partnership with Google and Apple, and piloted with the help of the University California, San Diego and the University of California, San Francisco.


20 hcinnovationgroup.com | JANUARY/FEBRUARY 2021


California residents can enable CA Notify in their iPhone settings or on Android phones by downloading the CA notify app from the Google Play Store, and when the app is downloaded, users can opt-in to receive COVID-19 notifi cations informing them if they have been exposed to someone who has tested positive for the virus. State offi cials contend that the digital tool protects privacy and security, does not collect device loca- tion to detect exposure, and does not share a user’s identity. Back in April, Apple and Google announced a joint effort around contact tracing leveraging Bluetooth technology. As of late-November, only a handful of U.S. states had contact tracing options for iOS and Android, although several more deploy- ments could be in the works. California, via its CA Notify solution, has now become the largest state to join the Apple-Google contact- tracing initiative thus far. When individuals voluntarily activate CA


Notify, the tool uses Bluetooth technology to exchange random codes between phones without revealing the user’s identity or loca- tion. If a CA Notify user tests positive for


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