South Korea flattened the COVID-19 curve to a shocking extent. Essential to this strategy was something as important but far less discussed than lockdown and testing: contact tracing.
The key to stopping the pandemic is stopping transmission. Contact tracing breaks that down into the most simple steps: Who has symptoms and who did they run into? Get in touch with those contacts and make sure they self-isolate.
Public health officials do not know the names of every person who has COVID-19 or their whereabouts, much less who they were in contact with. Some might say we are too late for contact tracing. To the contrary, we need the power of contact tracing now more than ever. Indeed Massachusetts recently launched a new high-touch campaign to call people who have been in contact with confirmed cases.
So how can the power of contact tracing be used to flatten the curve across the United States? Facebook.
America’s highly popular social media platform is well-positioned to do contact tracing. Nearly 70 percent of US adults are on Facebook and, of those, about 75 percent visit the site every day. Perhaps more, now that so many people are working from home.
Using options already in use by millions of Americans, Facebook could tweak its algorithms so that users could self report COVID-19 symptoms and allow them to mark themselves in a way akin to the Facebook safety-check feature, which allows users to mark themselves as safe during dangerous incidents, such as mass shootings, hurricanes, and earthquakes. Users could then tag people they were in contact with and places they visited over the previous 14 days.
At a time when cases are skyrocketing and no one knows the full list of everyone who is sick, officials will need to move fast. Self-reported contact tracing would have been helpful, for instance, when 10 people at a lab near me recently had shortness of breath but didn’t realize they all had the same symptoms until someone mentioned it days later on a group text.
Collaborative self-disclosure and contact tracing can complement the recent initiative by Apple and Google for proximity tracking via Bluetooth and later via apps for confirmed cases. The Centers for Disease Control and Prevention has recommended that anyone who self-reports symptoms of fever and lower respiratory symptoms should assume they have COVID-19 and self-isolate. Widespread symptom self-disclosure is key to making contact tracing work in the context of limited testing. Facebook would allow people to be in the driver’s seat, to use their social networks to protect each other.
Self-reported contact tracing would enable public health officials to gauge how many people have COVID-19 symptoms beyond those being tested. It would also allow people to know if they were exposed.
Unlike adding your name to a long list for testing, these are personalized action steps. With this setup, it would be easy to see how, for a given exposure, your time clock can be set to day zero, then allow people to count up to 14 days — the incubation period the CDC cites for COVID-19 before symptoms appear. During this time, people could implement strict self-quarantine protocols to avoid spreading the disease. And for any new exposures, it resets your timer to zero.
Facebook has been slammed for not protecting individuals’ privacy. That may make some people shy about declaring their COVID-19 status. However, this can be an opportunity for Facebook to redeem itself. Facebook should guarantee that users dictate the level of disclosure — including providing the tip anonymously to contacts (as has been successfully done for sexually transmitted diseases by other companies) or providing a centralized mechanism if users ask that it be shared with health care workers. As Google and Apple have agreed to do, Facebook can openly publish information detailing the mechanics of the contact tracing so users can verify that the information they provide is indeed being kept private. The government could do its part by mandating that health insurance companies cannot discriminate on the basis of self-declared symptoms.
With a Facebook network of awareness, recommendations are grounded in the specific circumstances of a user’s life and can be easily updated with new data. While the 14 day quarantine is correct for exposure to symptoms, if a person actually has COVID-19 symptoms, the quarantine guidelines change, based on their reported symptoms. Facebook could make it such that when people report symptoms, the day counter adjusts accordingly.
While Google and Apple’s initiative will be live beginning in mid-May, a safety check-style feature on Facebook could be implemented nationally in time to catch and flatten the crest of cases expected over the coming weeks.
In true American fashion, this is the bootstrap, do-it-ourselves way to trace contacts and avoid letting the coronavirus pandemic go unchecked.
Facebook has tools to tackle COVID-19 that our government does not. It should let us use them.
Rebekah Emanuel is head of Social Entrepreneurship at the Harvard Innovation Labs.