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COVID Tracing Challenges

How far may individual expectations of confidentiality be compromised to enable public health authorities to track those who have been exposed to COVID-19?   And, once health authorities have identified exposed individuals, how will those individuals be notified, and may they be ordered to take steps such as self-quarantining?  How will this affect the older population?

The federal Center for Disease Control and Prevention (CDC) reports that 80% of all COVID-19 deaths occur among those aged 65 and older     Recent reports said that two-thirds of all COVID-19 deaths in Pennsylvania occurred in nursing homes.  It seems clear where the focus of the fight against COVID-19 should be centered.

Google and Apple, which control the operating systems for 99% of all smart phones, downloaded software updates to their devices on May 20.  This new application enables one person’s device, which has had close contact with another person’s device, to use Bluetooth technology to exchange information between the devices to indicate that a close contact has occurred. 

Google says that a user must opt in to use the software on android phones.  If a user opts in and tests positive for COVID-19, anyone within close contact within the past 14 days will get a notification on their smartphone about the potential exposure.  Individuals who want to avoid such COVID tracing data may turn off the Bluetooth technology. 

The technology giants claim that their new COVID tracing app does not use Global Position System (GPS) technology to document where a COVID-infected person has been, but rather only what individual devices have been in close contact.   The results of close contacts will not be stored centrally, but on individual phones and devices. 

Only public health authorities will be able to access the data that the Google/Apple app can provide.   But will political and Constitutional concerns prevent public officials from fully utilizing available information?   And, in absence of a unified plan that addresses interstate travel issues, how effective can tracing really be?   Should society really care about tracing all positive COVID-19 testees, or should we focus on those who interact with the frail, older population, and especially residents of licensed care facilities?

Probably, many of us know a young family which will travel on a summer vacation with their children who are not wearing masks, rationalizing that they are not at personal risk.  They are breaking no laws, and feel no concern about contributing to the spread of COVID-19.   Do they need to sacrifice their freedom to travel for recreation?

The states of New York, Connecticut and New Jersey have issued a self-quarantine policy for travelers who originate or are returning from 16 states which are experiencing COVID-19 spikes.  Only in New York is the quarantine mandatory and subject to a $10,000 penalty for a violator.   Those who travel interstate for business reasons are exempt from self-quarantine policies.

Business Insider recently reported that only Alabama, South Carolina, and North Dakota will use the new app created by Apple and Google.  COVID data tracing apps have been created by other software developers, including some that use GPS information.  Of the other states, 19 are considering or using other contact tracing apps, 17 don’t plan on using contact tracing apps, and 11 have not clarified their contact tracing plans.  Can such a fragmented approach to COVID tracing function effectively?

Where is Pennsylvania on the issue of contact tracing?   On May 6, Governor Wolf announced plans to create the Commonwealth Civilian Coronavirus Corps (CCCC).   Governor Wolf’s proposed CCCC evoked comparison to the federal Civilian Conservation Corps (CCC) that in 1933 created jobs for thousands of young men as part of President Roosevelt’s New Deal. 

The language of Governor’s Wolf’s press release about the CCCC called for “leveraging and coordinating existing resources . . . to provide a unique opportunity for Pennsylvania . . . to recruit and train COVID-19-impacted dislocated and unemployed workers . . . into public service for contact tracing roles . . . by engaging partners in the workforce development system.”  Similar platitudes have been overused before in the context of other social issues.  

A recent internet search revealed little content about either Pennsylvania’s CCCC or plans to implement the digital app developed by Google and Apple. So, if Pennsylvania is faltering with developing contact tracing, certainly the federal government is on top of this, right?  Not exactly. 

There is no apparent federal leadership on either gathering or using data as part of a unified digital tracing system.   CDC’s website says that its primary role in contact tracing is to provide guidance and support to help State, Tribal, Local, and Territorial (STLT) health departments to manage disease outbreaks and launch effective contact tracing programs.  

If you are contacted by a tracing employee, will it be a phone call, text message or email?  Will the contact be initiated by a government employee or a private firm?  How will you differentiate a legitimate contact from a scammer who is trying to steal your identity by getting you to share your date of birth and social security number? 

If you are told that the identity of the COVID-positive person who was within close contact of you is confidential, will you be able to accept that?  Is there any way that such a contact will motivate you to self-quarantine in place for two weeks?  Even if you would be willing to self-quarantine, would your employer or family cooperate? 

Dr. Tony Fauci, the director of the National Institute of Allergy and Infectious Disease, said earlier this week that he’d “settle” for a COVID-19 vaccine that is between 70% and 75% effective.  He went on to admit that, if 25% of the population opts not to get the vaccine, then the ability to achieve a level of herd immunity to deter the spread of the virus is not probable.

It certainly seems like it is time to focus resources on deterring the introduction and spread of COVID-19 among our older population, and especially within licensed care facilities.

Dave Nesbit, Attorney