As coronavirus cases surge to record levels, the pressure is growing on Alberta and British Columbia to adopt Canada’s COVID-19 exposure notification app.
The two provinces have skirted the federal system since its launch in July. Both have their reasons for not signing on, but with contact tracing resources stretched to the max, experts say the merit behind those reasons is weakening.
“We’ve seen B.C. and Alberta become epicentres of infection lately. I think having everyone in on the game would be helpful, even if it’s only used to report four or five per cent of infections at this point,” said Jean-Paul Soucy, an epidemiology PhD student at the University of Toronto.
The pressure is acute in Alberta. Since the province declared its second state of public health emergency on Tuesday, Albertans have used social media to call on authorities to get the province onboard the national app — but they’re not budging.
Alberta Premier Jason Kenney and Dr. Deena Hinshaw’s main argument against COVID Alert is that it only notifies users of exposure and does not connect with the province’s own contact-tracing network.
However, recent data suggests Alberta hasn’t even been using its own app for that purpose.
Alberta’s app, called ABTraceTogether, has about 270,000 registered users in a province of about 4.4 million people, but has only been used to track the close contacts of 19 positive cases since it launched in May, meaning the app has been used in less than 0.05 per cent of all positive cases in Alberta.
The need for a better strategy was underscored Thursday, experts say, when Alberta’s contact-tracing system collapsed after being overwhelmed with cases. Contact tracers are no longer using the app to reach out to an infected person’s close contacts unless that person falls into one of three priority groups.
With widespread tracing temporarily abandoned, collaboration among governments is long overdue, said Prabhat Jha, a professor at the University of Toronto’s Dalla Lana School of Public Health.
Jha said the federal government’s app, COVID Alert, has its issues. Not only being underused, but it’s also become “lost in Twitter opinions” about validity and effectiveness.
“This should have been sorted out on July 1, not nearly December 1,” he said. “Apps work with high coverage, not when jurisdictions fight.”
And there is some merit to Alberta’s concerns, Soucy believes.
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He said he sees the advantage of hooking digital tracing efforts into provincial networks. Transitioning from one app — albeit flawed — to another might be a hard argument to make at this point, he added.
“Changing horses midstream is difficult,” Soucy said.
“There’s some merit to saying, ‘Well, we could go with a less good solution that we already have established rather than changing to what may be a better solution, but having to rebuild the audience and everything else. It’s a complicated question.”
That’s part of the argument British Columbia is making against COVID Alert.
B.C.’s provincial health officer, Bonnie Henry, said she’s concerned about the process of adopting the app “increasing work without benefit.” She said she doesn’t believe the app would make a big impact at this point.
That argument is “mystifying” given the state of the pandemic in the province, said Soucy.
B.C., like Alberta, has seen frightening growth in cases and deaths over the last few weeks. Alberta hit a new, sobering milestone this week, reaching 500 total deaths due to COVID-19 with more than 300 people in hospital. B.C. reported its largest single-day increase in deaths this week, with 13 on Wednesday.
Henry might have a point about short-term impact, said Soucy, but it’s the long-term benefits that should be top of mind.
“It allows you to build up a user base when incidence is high, when awareness is high, when urgency is high,” he said, adding that the app is an easily accessible, low-cost addition to protective measures.
“If B.C. does manage to turn this thing around, then great, now you have this huge installed base of people to this app and you can use that to help keep cases low again.”
Like Albertans, some British Columbians have expressed frustration about the refusal and believe the province is preventing them from accessing a federal service.
Marika Nadeau, the director of Health Canada’s COVID Alert task force, encouraged people in Alberta and B.C. to download the app regardless to be “ready when their province on boards.” She said people can still get notified if they’re in contact with someone from another province.
Nadeau said conversations with transitioning Alberta and B.C. to the app are continuing. The request for “adjustments” by B.C. “needs to be further investigated from a privacy perspective,” Nadeau said, but they remain open to improvements.
“Privacy will remain our top priority,” she told Global News.
The COVID Alert app has come under its own criticism, mainly due to lack of promotion and underwhelming uptake. In part due to increased promotion, Nadeau believes there’s been a push to the app. It’s been downloaded 5.4 million times since it’s launch, she said, about 2.4 million of those downloads since October 1. The Atlantic provinces, Quebec and the Northwest Territories have also recently signed on.
COVID Alert is considered an exposure notification app, not a contact tracing app. Its purpose is to alert people who may have come into contact with someone who tested positive for COVID-19, relying on Bluetooth signals to track a user’s phone in relation to others.
Canadians who test positive voluntarily plug a code into the app, which then sends alerts to phones that were within two metres of the infected person’s phone for at least 15 minutes within the previous two weeks. As of Nov. 26, more than 6,100 one-time keys had been logged into the app. Between Nov. 18 and 24 alone, more than 1,000 keys were entered, according to Nadeau.
“Especially as we enter the holidays, the more people that download the app and enter that code, the more it will help reduce the spread of cases,” she said.
Among Dr. Henry’s concerns are the app’s “parameters.” Henry has criticized the app for its notifications reaching back only by 14 days — as someone with the virus would not necessarily be infectious that whole time. The COVID Alert app has since been amended so infected people can plug in when their symptoms started, or the date of their COVID-19 test.
And it will continue to adapt, said Nadeau.
“We launched it to address a crisis at a time when it was needed and now we’re continuing to assess it,” she said. “Hopefully British Columbia will be responsive to the changes we’re bringing.”
The app will not be without some limitations, Soucy said, but it’s selling point is that it’s “deeply privacy respectful.”
“It’s not a silver bullet, but it can make a difference, especially as traditional contact tracing is failing,” he Soucy.
“It’s not a replacement. But it’s something.”
— with files from the Canadian Press
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