For instance, app users might practise more social distancing and thus have fewer social contacts than non-users 10, which would link app usage unfavourably to exposure and transmission risk. Not only does unequal access to smartphone technology exacerbate existing inequities and raise ethical concerns 7, but the overall effectiveness of DCT apps depends on the users’ contact network structures and mixing behaviour 8, 9. Minimizing uptake differentials across social groups is also important. Apparently successful rollouts in Singapore and South Korea 4 have, at the time of writing (17 December 2020), encouraged more than 40 countries to introduce DCT apps 5.īroad uptake in the population is considered key for DCT app effectiveness an influential study suggested that a 60% adoption rate would be sufficient 3, although the simulations excluded supporting measures such as facial masks and social distancing 6. An early influential modelling study 3 suggested controlling the epidemic with digital contact tracing (DCT) that is, mobile apps that log and report encounters between infected persons and mobile users to prevent onward transmission. As governments around the globe are seeking targeted exit strategies from lockdown measures to contain coronavirus disease 2019 (COVID-19), evidence of widespread pre-symptomatic transmission and short generation times 1, 2 calls into question traditional containment measures based on symptomatic surveillance.
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