The exec who was the Apple exposure notification lead when he headed up the company’s strategic health initiatives has described his frustrations with attempting to persuade governments to adopt the technology.

He says that the situation in the US remains a mess today, and that the single biggest missed opportunity was a federal exposure notification app …

Myoung Cha was Apple’s head of health strategic initiatives at the time the joint Apple/Google exposure notification API was created. He tweeted about his experiences, saying that it was one of the most exciting projects he had ever worked on, but that it was enormously frustrating trying to persuade governments and US states to adopt it.

He said European countries were the most open to the approach, and the quickest to adopt it, while it was much harder work in the US.

It was always a challenge to convince someone that it was “as good as” contact tracing, which was like asking whether an email is as good as a nice holiday card. Of course they’re not the same, but I can send a nice e-card instantly to 100 people to get mostly the same result.

The biggest pushback we got was why we wouldn’t allow governments around the world to use the API to collect a ton of data about users who had opted in since traditional contact tracing provided more precise insights on who had been exposed to the index case.

Our reply of course was to protect user privacy since the identity and whereabouts of all of your friends could be sucked up by a bad government actor a with a more centralized design to build a social graph of all users with the pandemic as the justification.

“Trust us, we are the government” was often the pushback. But of course, this wasn’t a theoretical concern but something that actually happened in both Singapore and Australia with systems that did not adopt our privacy-preserving approach.

He said he’d hoped that the Biden White House would be more amenable, but that instead the administration seems to think a mass vaccination program is all that is needed. He argues that three other things are needed to prepare us for the long haul.

Most people we talked to in the US couldn’t be bothered as they stood up contact tracing call centers [instead] […]

Eventually, a patchwork of US states adopted the EN technology through their own apps or EN Express. Unlike most countries, we lacked a federal approach which could ensure a uniform message and rollout. This was probably the single biggest detriment to adoption in the US.

When the public health experts at the CDC and other agencies asked for papers that we had published or evidence that we had gathered showing the technology saved lives, I could only silently scream, “it was just invented a few months ago”.

Photo: Martin Sanchez/Unsplash

The trifecta of mass rapid testing, EN, and oral therapies could be the killer combination against omicron and future variants. Anyone who gets an EN should get tested immediately, isolate/quarantine to break transmission, and get rapid a access to a therapy if positive.