In the three weeks since the launch of Colorado’s new smartphone-based Exposure Notifications system, roughly 3,400 people who tested positive for the coronavirus have used the system to notify others that they may have been exposed, state officials said this week.
As of Nov. 13, more than a million Coloradans had opted in to the system, which was developed by state health officials in concert with tech giants Apple and Google and operates via Bluetooth technology on iOS and Android phones. By automatically logging anonymized digital “tokens” exchanged by phones that come into close proximity with one another, the system is designed to provide an efficient method of contact tracing, alerting people who faced possible COVID-19 exposure to self-isolate and get tested.
The 3,400 people who have submitted a positive test result to the system — a step that requires an 8-digit verification code provided by public health authorities — is only a fraction of the more than 70,000 cases confirmed statewide since its Oct. 25 launch, according to the latest data compiled by the Colorado Department of Public Health and Environment. Officials and experts say that the system can be a useful tool in the state’s coronavirus response even with limited adoption.
With case counts rising rapidly, however, the system has had some early hurdles to overcome. Initially, the process of providing verification codes was overseen by local public health departments as part of their standard contact-tracing efforts. But with those efforts struggling to keep pace with the latest wave of infections, very few codes were provided in the weeks after the system went live, leading the state to adopt a new process on Nov. 9.
“CDPHE is now texting a one-time verification code directly to all people with confirmed positive test results that arrive into the state information system,” a state spokesperson wrote in an email. “Individuals should receive this text message within a few days of their test result.”
“We’ve made huge process improvements,” Sarah Tuneberg, who leads the state’s COVID-19 Innovation Response Team, said in a press briefing Wednesday. “We’ve really automated this, and people should be getting notifications much, much more quickly.”
Only about 400 codes were activated before the state made the switch to the automated text system; since then, users have activated more than 3,000 codes.
Those figures, however, highlight how the system is only as effective as users choose to make it. The state has sent out more than 25,000 codes since making the switch, meaning that the vast majority of Coloradans testing positive haven’t enabled the notification system or aren’t submitting their results after receiving the codes.
“We’re sending more codes than people who actually have the service,” Tuneberg said. “We’re seeing (the number of) people who have the service using those keys align with what we expected.”
Because of the way the system is designed, state officials said, they’re not able to provide data on how many people have received exposure alerts from the 3,400 codes that have been activated.
‘Another tool in the toolbox’
Longmont resident Jose Rodriguez Lopez received a notification on Nov. 10, after a co-worker tested positive. “Once you tapped it, it had instructions to get tested and quarantine as well,” Lopez told Newsline.
But it was a “long process,” Lopez said, for his co-worker to obtain a verification code from Boulder County Public Health. And in a separate instance, Lopez’s brother tested positive but was never able to get a code at all, he said.
“It’s a great idea and I completely support it and encourage everyone to use it,” Lopez said. “But it has to be faster to upload results to be effective at all.”
Boulder County Public Health spokesperson Chana Goussetis confirmed that the agency had struggled to provide codes quickly, because the process was integrated into its standard investigation and contact-tracing procedures, which have been overwhelmed by the number of new cases.
“Due to the surge level of new cases, we aren’t able to conduct disease interviews and contact tracing with every person who newly tests positive,” Goussetis said. “Unfortunately, it’s during these interviews when a person gets the code to enter into the app to notify their close contacts.”
While Tuneberg and many others have billed the Exposure Notifications system as a “game-changer” for coronavirus response efforts since Apple and Google first floated the idea in April, the reality has been more complicated. Privacy concerns continue to be an issue for many users, and several European countries have implemented their own systems with mixed results.
Researchers at Oxford University estimated in an April study that an adoption rate of over 60% would be necessary to “stop the epidemic” — but, importantly, also found that “even with lower numbers of app users, we still estimate a reduction in the number of coronavirus cases and deaths.”
“This is another tool in the tool box,” Tuneberg said Wednesday. “It doesn’t replace traditional contact tracing. … It’s really about being able to notify people you might not know — people you sit next to on public transportation, or in the doctor’s office waiting room.”
Public health officials at the state and local levels are strongly urging people to continue opting in to the system and to submit their verification codes if they receive a positive test result.
“We encourage anyone with a cell phone to download and use the app,” Goussetis said. “The more people who use it, the more quickly it can notify possible close contacts and stop further spread.”