Government-backed research has found Australia’s national contract tracking app to be unnecessary and ineffective for the country’s response to the COVID-19 pandemic.

A A study funded by Australia’s National Health and Medical Research Council and the New South Wales Department of Health evaluated the effectiveness and usefulness of COVIDSafe, a smartphone-based proximity tracing app introduced in April 2020.

RESULTS

Recently published in the journal The Lancet Public Health this month, the study was carried out in New South Wales, the country’s most populous state, and involved 619 confirmed cases of locally acquired COVID-19 with more of 25,300 close contacts identified through conventional contact tracing between May 4 and November 4. 2020. Semi-structured interviews with state public health personnel were also conducted to assess the perceived usefulness of the app.

The study identified three big issues that seemed to make the app useless for COVID-19 contact tracing in NSW:

• Lower than expected absorption among the population at risk;

• Poor diagnostic performance; and

• Low perceived usefulness by public health staff.

Of the positive cases, more than one in five or 137 people were using the COVIDSafe app. Only 79 people were considered their close contacts, giving the app a positive predictive value of 39%. Its estimated sensitivity, meanwhile, is 15% since only 35 of the 236 identified close contacts were detected by the application. Additionally, the app spotted 17 other close contacts who were not identified by conventional contact tracing.

Meanwhile, the overwhelming response from interviews was that COVIDSafe was not helpful in contact tracing. In addition to its cumbersome interface, some healthcare staff required substantial assistance in accessing and interpreting the data, leading to delays in rollout and notification of close contacts. The app, respondents said, did not shorten the time to detect close contacts. Additionally, they noted a difference between the ability of iPhone and Android devices to detect contacts and the poor ability to save contacts when the phones are locked.

WHY IS IT IMPORTANT

According to the researchers, this is the first study of its kind that has examined the potential benefits of digital contact tracing apps for the public health response to COVID-19.

It concluded that the COVIDSafe app was “not effective enough to make a meaningful contribution to COVID-19 contact tracing” in New South Wales due to low app usage, poor performance of diagnosis and challenges for public health personnel.

Given the high operating costs of such a digital tool, the study suggests integrating effective assessments into the implementation of proximity contact tracing systems to justify the investments. A government filing showed the estimated cost of developing and operating COVIDSafe to be A$6.75 million ($4.7 million) with monthly maintenance costs of around A$100,000 ($70 000 dollars). The study also suggests using real-world piloting and post-implementation user input to ensure the “added value” of digital tracing technology for public health.

THE GREAT TREND

There was a similar review of the COVIDSafe app which covered the period from March to November 2020. Conducted by consultancy firm Abt Associates, the an independent study also found the app unnecessary for contact tracing while putting more pressure on already overworked health workers.

While the the federal government’s review of the app admitted that the app had been “rarely” used due to the relatively low cases of COVID-19 recorded between May 2020 and May 2021, it still considered the app a ” important addition” to the suite of tools that complements conventional contact tracing efforts.