To What Effect? COVID-19 Mobile Apps, Public Health and the Need for Sound Policy

Abstract

In the early days of the COVID-19 pandemic, a multitude of mobile apps were deployed to complement manual contact tracing, quarantine and isolation efforts by central, state and local authorities in India. This was the first time that digital tools were used to augment disease surveillance efforts on a large scale. At the time of deployment and even today, these mobile apps remain experimental tools with no conclusive evidence of their effectiveness, but with known risks to privacy and data security. The public discourse examining these mobile apps has also raised several privacy and data security concerns. We add to this literature through an examination of COVID-19 mobile apps deployed by state governments and local authorities, using public health perspectives on infectious disease surveillance. We develop a framework of analysis that factors state capacity concerns, public engagement, processes and methods that facilitate continuous effectiveness evaluation, and privacy and ethical concerns. We then examine COVID-19 mobile apps against this framework of analysis. Our analysis highlights several instances of duplication due to lack of coordination amongst various stakeholders engaged in COVID-19 disease surveillance; absence of any oversight and public engagement in the development and deployment processes; mixed evidence on the integration of COVID-19 mobile apps with public health protocols, a prerequisite for conducting any effectiveness evaluation; and, weak data protection. Our findings underscore the need for a systems level approach to deploying digital disease surveillance tools, particularly the need for integrating effectiveness evaluations in the implementation process.

Keywords: Digital health, mHealth, contact tracing, quarantine, disease surveillance, infectious diseases, COVID-19