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NZ considering $100m contact tracing ‘CovidCard’

The Government is considering handing out a Bluetooth-enabled CovidCard to every New Zealander to aid with contact tracing efforts, Marc Daalder reports

A private sector proposal to produce and distribute five million Bluetooth-enabled credit card-sized contact tracing tools at a cost of $100 million is one of "a wide variety of technological solutions to contact tracing", a spokesperson for the All of Government Covid-19 response team has confirmed.

The idea, branded CovidCard, is one of a handful that the Government is considering as it moves to settle on a digital solution for contact tracing. Newsroom understands that the lead candidate remains a Ministry of Health-developed version of Singapore's TraceTogether app, but flaws in the rollout and operation of the smartphone app in Singapore have led to the CovidCard as a potential alternative.

An April 12 presentation obtained by Newsroom was presented to Justice Minister Andrew Little - who is responsible for the Privacy Act - and Communications Minister Kris Faafoi. It makes the case for the project, saying it solves issues of compatibility, public trust and security and privacy, all of which could be present in a TraceTogether-style solution.

The All of Government spokesperson declined to say whether Cabinet would be examining the project, but said: "We are considering a wide variety of technological solutions to contact tracing. It’s unlikely that any one technology will fit everyone’s needs.

"A number of entrepreneurs have been pitching ideas to the Government on what they think we should be doing. All options under consideration must respect people’s privacy and will be put through robust and appropriate testing before being used to ensure they keep data safe. Over the coming weeks we will be testing some applications and products. No final decisions have been made at this stage."

It is unclear at this stage who is behind the CovidCard proposal.

"This is something that needs to be explored," Brainbox Institute public policy and technology expert Tom Barraclough told Newsroom, after being shown the presentation.

"This is the first one that I've seen that proposes using a hardware solution. It's swapping out a phone for a card. That has a lot of benefits to me, as well as raising some other implications too, but it definitely needs to be considered. I think there's really good benefits for people who can just say, 'I'm going to opt out so I will leave my card at home.' At the same time, my grandmother can use it."

Andrew Chen, a research fellow at the University of Auckland's Koi Tū - Centre for Informed Futures, was more cautious.

"This is a proposal worth considering - it has its weaknesses but all of the technology options have their pros and cons. The government has to decide what set of pros and cons are most acceptable in the broader context," he said.

Why contact tracing?

New Zealand's lockdown appears, thus far, to have worked. The number of new cases each day has dwindled into the low double-digits, far outnumbered by the new recoveries. More than half of New Zealand's Covid-19 patients have now recovered from the disease.

In order to preserve these gains when we leave lockdown, however, rapid location and isolation of new cases is needed. Without fast case isolation after restrictions ease, modelling shows that the virus could spread exponentially and ultimately kill 100,000 Kiwis. The lockdown would have merely delayed the inevitable.

While New Zealand's testing regime now appears to be one of the best in the world, the other component of case isolation is quarantining everyone who came in contact with a Covid-19 patient. These people are to be treated as suspected cases and remain home for 14 days, at which point they'll be declared free of the virus. If they develop symptoms, they'll be tested. If they test positive, then their contacts, too, will have to self-isolate.

This is the fundamental principle of Covid-19 epidemiology and the best bet the country has for staying on top of the virus. In order to accomplish rapid case isolation that might be beyond the ability of humans making phone calls and sending text messages, digital solutions have been deployed around the world, to varying degrees of effectiveness.

Why digital contact tracing?

Newsroom has previously reported on the reasons for digital contact tracing and the options available.

The CovidCard presentation makes the case for digital contact tracing by citing an academic article in Science magazine.

The article operates from an assumption that presymptomatic transmission of Covid-19 is widespread - in fact, the authors estimate that presymptomatic transmission is responsible for slightly more infections than symptomatic transmission, even when no measures are taken to contain the virus.

Under such an assumption, rapid isolation of contacts of confirmed cases - in other words, individuals who might be presymptomatic and infectious - is the core of any epidemiological response.

From this model, the authors conclude "that viral spread is too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient and happened at scale. A contact-tracing App which builds a memory of proximity contacts and immediately notifies contacts of positive cases can achieve epidemic control if used by enough people".

The Government in New Zealand certainly seems to see a case for the usefulness of a digital solution, but Director-General of Health Ashley Bloomfield has repeatedly emphasised that such a tool would not replace manual contact tracing, merely supplement.

The Science article's caveat - "if used by enough people" - is the major issue when it comes to contact tracing apps.

What are the options?

Apps are not the only options out there. In Israel, the government has repurposed spy software used to track the movements of suspected terrorists into a widespread surveillance network. When someone tests positive, anyone who their phone had been near in recent days receives a text message instructing them to self-isolate. However, the operation has been plagued with false positives, forcing people who were not at risk of contracting the virus into quarantine.

Jacinda Ardern has also effectively ruled out an Israeli-style solution - or any non-voluntary measure.

"Ultimately, the decision is that we either have something that everyone is forced to use or we have something that people voluntarily use, but we try and get as much uptake as possible," she said on April 9.

"There are huge issues with forcing people to use apps that track their movements, as you can imagine, so we are opting for apps that people choose to partake in."

Singapore, meanwhile, launched TraceTogether with much fanfare. The app, which is voluntary to download, uses Bluetooth to keep a log of other phones with the app that have been nearby. If someone with the app tests positive, then their contacts will be notified. Otherwise, the data is never accessed.

However, TraceTogether has had its own share of issues. On iPhones, security measures prevent the app from running in the background, meaning that Apple TraceTogether users are unable to make phone calls, browse the internet or find directions while the app is running. This has led to many people who download the app not using it, as have complaints of interference with other Bluetooth devices, such as headphones, and a drain on battery life.

Perhaps the largest flaw in TraceTogether, however, is that it requires massive uptake to be effective. If 10 percent of the population downloads it and uses it properly, just 1 percent of contacts will actually be logged.

Ayesha Verrall, a senior lecturer at Otago University who specialises in infectious diseases and who has been commissioned by the Government to complete a report on New Zealand's contact tracing capabilities, told Newsroom on April 3 that she favoured the Bluetooth app solution. She said that it would be helpful even if it only covered 10 to 25 percent of contacts.

Such coverage, however, would still require between 31 and 50 percent uptake. That means between 1.5 and 2.4 million New Zealanders downloading the app and using it correctly. Even Singapore has managed just 15 percent uptake.

CovidCard to the rescue?

This issue is highlighted in the presentation put together by the private sector group backing CovidCard. The presentation states that 60 percent uptake would be required and that New Zealand cannot get there.

Ardern, when asked about the issue of uptake for a potential TraceTogether-style app, said "I think if people understand that it's one of the things that will help us stay out of stringent measures like Alert Level 4, then they might be encouraged to take it up".

The CovidCard backers take a gloomier view of the situation. First, they say 19 percent of New Zealanders don't have a smartphone. Then, they say 51 percent of smartphone users download zero new apps in any given month.

For those who do own a smartphone and do download apps, there will be "too much friction" preventing people from doing so. Users may be afraid of Google having their data, of the Government knowing what they are up to. They may forget their password or turn off the app because it interferes with their Bluetooth headphones.

With some back-of-the-napkin math, the presentation estimates just 20 percent uptake in New Zealand - meaning just 4 percent of contacts would be traced.

That's where CovidCard comes in. Built using the same underlying technology as Tile Bluetooth trackers, the tool would be the size of a credit card and distributed to every New Zealander. This helps solve the issue of uptake, Barraclough told Newsroom.

"I perceive there to be really significant digital inclusion and privacy benefits to using a hardware solution like this that will gracefully dismantle, as people describe it. So, the battery will die," he said.

Chen was more cautious.

"I understand the argument that this card design makes it easy to opt-out of participation and makes it simple to use, but I think it's hard to prove that you will get more uptake or less uptake than an app-based solution. I think that it is likely that a different group of people will miss out if a CovidCard is used in comparison to an app-based approach," he said.

"However, if the Covid Cards can be programmed to be compatible with any app plus Bluetooth-based protocol, then this might offer a really good way to cover many of the people who would otherwise be missed out by an app-based solution alone. This presents different IT risks around integration and increases the difficulty and scale of the challenge."

The presentation notes that such items can be manufactured at scale for cheap and that batteries can last 12 or more months. While Tile broadcasts up to 61 metres, this would be reduced for the CovidCard to ensure only close contacts are logged.

How does it work?

The idea is simple, if ambitious: Every New Zealander would pop their CovidCard in their wallet and go about their daily business. The card would log close contacts locally, but store only the ID numbers of the cards it came in contact with - no personal or contact information.

Contacts are only kept for 30 days, after which point they are no longer relevant and are deleted. If someone tests positive, the Ministry of Health downloads the data from that person's CovidCard and relevant contacts are notified by text message.

CovidCards won't store your location, but technology could be used by bars, restaurants and retail shops to log the card of everyone who enters, in the event that a patron later tests positive.

The presentation states the CovidCard would solve issues of privacy and security because the data would be anonymised and encrypted. The only central register of card IDs would be held by the Government and isolated from other Government databases, so it could not be used for anything other than Covid-19 contact tracing.

Lastly, the card's battery would die in around 12 months and all cards would be destroyed after the Covid-19 situation abates.

"We are aware of the CovidCard concept and are working with the developers, and officials to ensure decision makers have good information about the strengths and weaknesses and privacy implications of a range of potential technological aids to contact tracing," Privacy Commissioner John Edwards said.

"As far as we are aware, the CovidCard is the only initiative of its type in the world, in that it proposes a new hardware solution, as opposed to working with the hardware most of us already carry, the phone. What has been proposed for the CovidCard at this stage leaves a lot of detail yet to be worked through. We will continue to contribute to the development of the concept and to provide advice on the relative privacy implications of different proposals, and the likely impact of those on uptake and efficacy."

The rollout of such hardware on a national scale would be difficult from an operational perspective. It would require mailing items to every New Zealander's last known address and likely some sort of hotline for questions and troubleshooting.

"I think that any solution that proposes new hardware and distributing that to all people will also face challenges - they may be different challenges to using an app with Bluetooth, but still challenges. In particular, there are supply chain issues for electronics worldwide, and I'm not sure we have the capability to make all the devices locally in New Zealand and would likely rely on supply from China. There will also be challenges for the government to distribute these devices to everyone quickly, and to ensure they are registered and used correctly," Chen said.

The presentation notes that launching and testing the project would require a $2 million investment. The production of five million cards would run to about $60 million, plus between $5 and $10 million on "project costs". Combined with a $25 million marketing campaign, the full bill could end up at around $100 million.

There's also a possibility, the presentation notes, that businesses could purchase the cards for their employees.