There are issues with contact tracing phone applications that mean New Zealanders should continue to keep a log of the daily activities they engage in outside their homes during the pandemic, a researcher says.
A critical area of work for health officials over the last month has been ramping up the country's ability to rapidly trace contacts of people who have contracted COVID-19. Modelling presented to the Government has shown that without the capacity to quickly track down those who may have been exposed, the gains made through lockdown may have been for nothing.
On Tuesday, following the announcement that New Zealand would shift to alert level 3 next Monday night, a report from the University of Otago's Dr Ayesha Verrall was released, which was critical of the country's ability to contact trace and presented eight recommendations to officials. The full report can be found here.
One recommendation was for authorities to rapidly complete the development of a smartphone application which, via Bluetooth, can track individuals' movements and who they may come into close contact with. If someone with the application contracts the virus, a notification can be sent to these contacts, telling them of the need to self-isolate.
As Dr Verrall notes in her report, the success of such technologies relies on the uptake by the population. The TraceTogether application used in Singapore has been discussed as world-leading, but only one-fifth of the population has signed up.
"Assuming random mixing [that] means only 1 in 25 exposures will be captured by the app and public health impact will be negligible," the report says.
University of Canterbury Associate Professor of health and medical geography, Malcolm Campbell, agrees. He told Newshub that while applications can be helpful, they aren't perfect.
"Apps are really quite useful in terms of things like contact tracing and telling us where we have been [but] when we have done research using apps, we often find there is a group in the population who don't engage with apps and that gives us some holes in the data, some gaps in the data," he said.
"Having a serious amount of buy-in from the population is quite important if we were to use a smartphone app."
He also said phone applications don't work if people forget to take their device with them.
Campbell suggested the old-school idea of people keeping a log of their activities outside the house.
"It's a slightly old idea, but it still works… every time you leave your bubble, just think about where you have actually been, who you have been with and actually go and write that down somewhere," he told Newshub.
"You might go out to the supermarket, for example, and write that down in a particular way in your diary or you can use particular types of social media check-ins.
"Whenever we can find out where we have been, if we happen to get infected or come into contact with someone who has been infected, and we need to transfer that information, having that in a format that is really quite easy to find is really key."
He said Google locations, receipts and credit card statements can help Kiwis remember where they have been.
Prime Minister Jacinda Ardern, who has previously encouraged Kiwis to keep a diary of their movements, said on Sunday that any phone application would only support work being done on the ground by officials.
"We do see it as an addition, of course, but it will only ever supplement what needs to be excellent contact tracing on the ground, and that has become clear no matter where you look around the world. Singapore, often referred to as a place using technology as part of their contact tracing, they themselves will be the first to admit that it does not solve all of your problems," she said.
"There’s accuracy over even how Bluetooth works in recognising who you’re in close contact with. It relies on uptake of citizens. There are many reasons why, first and foremost, your foundation needs to be people, supplemented by technology."
Ardern confirmed work was underway on an app and it would "be a feature of New Zealand's response".
Director-General of Health Dr Ashley Bloomfield said on Monday that the country's national contact tracing service now has more than 200 staff.
"Essentially, what we are doing here is transforming what was a very local, manual process into a national, automated system with scale. This is the first time this has been done in New Zealand, and I am proud of what the team has achieved over the last month," he said.
According to Health Minister Dr David Clark, the National Close Contact Service (NCCS) has the ability to make 5000 calls every day, which could be scaled up to 10,000 if needed. That allows public health units (PHUs) to trace 185 cases per day.
"To further strengthen our contact tracing Cabinet today approved up to a $55 million investment. This is on top of the initial $15 million that went to PHUs in March for contact tracing," Dr Clark announced on Monday in response to Dr Verrall's report.
"This funding will mean PHUs can be expanded as required, with additional surge capacity of up to 300 full-time equivalent staff. The NCCS will also get extra resources to manage complex investigations, such as detailed analysis of clusters."
