Researchers recommend mass installation of single contact-tracing app to boost COVID-19 fight

Even as the debate over the usage of Aarogya Setu is yet to settle, a group of researchers have advocated mass installation of a single contact-tracing mobile phone application to strengthen India's battle against COVID-19. In a study published online in the Indian Journal of Medical Research (IJMR), conducted in the first week of April and updated on May 3, as many as 346 potential COVID-19 apps including Aarogya Setu to deal with this crisis were identified.

While there were differences in state-specific information in the apps developed by states, the system architecture and many of the functionalities, including self-testing, quarantine monitoring, and contact tracing, were common between these apps, researchers found. "The current technological plurality in the absence of robust data exchange mechanisms and Centre-state coordination can be detrimental for technology-assisted contact tracing in a heterogeneous country like India, especially once the lockdown ends and free movement of people starts," the study stated.

"Overcoming this challenge requires Union and state governments to ensure mass installation of a single contact-tracing app collaboratively," it highlighted but stressed on the need for "necessary but least intrusive" measures for disease surveillance. Referring to the Aarogya Setu app, promoted by the Ministry of Electronics and Information Technology, which is currently available in 11 Indian languages, researchers highlighted that penetration of the app is critical to the success of technology-enabled contact tracing.

Evidence suggests that 70 per cent of the population should have the app installed for digital contact tracing efforts to be effective, they said. In terms of privacy, the study said the apps reviewed in this study collected user data such as name, phone number, real-time location, and Bluetooth interactions with other app users.

While the location data is essential for mapping hotspots of disease transmission, privacy experts are concerned about this data being a hazard for an individual's privacy and national security, the researchers said. The Aarogya Setu app's privacy factor was recently questioned by opposition parties, following which the government opened its source code.

The researchers said collection of location data in South Korea and China sparked global concerns related to privacy and potential mala fide use of the data. To counter this, countries like Singapore and Argentina used tracking apps that only collect Bluetooth interaction data to preserve user privacy. Singapore and Israel have shared their app source code with researchers for an independent audit, the study said.

"In the absence of a data protection law in India, the central and state governments need to address these privacy-related concerns to garner public trust that would ensure the deployment of these apps at scale," the study said. The WHO guideline on Digital Health Interventions was also used to classify app functions under the categories of general public, health workers, health system managers, and data services apps in India, it said.

The review of app functionalities further revealed that information dissemination regarding preventative measures was the primary function of a majority of the existing apps in India, it said. The apps reviewed in this study did not have specific strategies to deal with the infodemic.

The Union Health Ministry has formally recognized remote consultation through 'Telemedicine practice guidelines', with growing number of COVID-19 cases, the study said and highlighted the urgent need to create integrated teleconsultation options within these apps to assure quality healthcare services, including those with pre-existing conditions. This study despite limitations has important implications for informing the development of future COVID-19 health initiatives in India.

"In a hysteric environment and a severe shortage of testing facilities, the self-risk assessment function available in the apps may help spot the patients at risk for COVID-19," the researchers said.