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When Considering Contact Tracing, Think Outside the Box
As the world begins the tenuous process of reopening economies following months of lockdowns related to the COVID-19 pandemic, contact tracing will be a critical part of the recovery process.
The purpose of contact tracing is well understood, but there are many misconceptions about how it works, who it should apply to, and how to implement it. This white paper is intended to clarify these issues and recommend additional capabilities business and government organizations should consider when selecting contact tracing solutions.
Many organizations will find reopening to be the most complex project they have ever managed. There is no blueprint for coordinating such a task on a global scale, particularly when the impact of the pandemic has been so variable. Each country is at a different stage of recovery and individual states and regions within those countries are also formulating their own guidelines and milestones.
The global nature of modern supply chains requires even localized organizations to take a big-picture view. Leaders must be conscious of rules that impact customers and employees who live elsewhere, even in the next county, in some cases. Supply chains can be affected by lockdowns and border closings half a world away. Shipments may be disrupted by employee absence or illness. And for at least the next year there will be the overarching threat that new hotspots could throw regions into full lockdown again.
This is a complex process for even a small business to manage. For organizations with locations across multiple regions, the complexity is exponentially greater. How do we return to work when everything is changing not just from place to place, but from day-to-day?
Three Critical Elements of Returning to Work
Organizations that are preparing to reopen need situational awareness, which means knowing the relevant regulations and safety provisions of the regions in which they operate. These regulations are often different and changing as different geographies enter different phases of their reopening plan. They need the testing capabilities to know which employees are infection-free and thus able to return to work. If an infection occurs, they need to be able to identify who may have been exposed so that steps can be taken to prevent additional infections. Finally, they need the capability to dynamically adjust policies if the situation changes.
Three essentials of a successful return-to-work strategy, which apply to nearly every industry and geography:
- Ensure stakeholders have a complete and timely view of risks impacting their assets, including changing conditions from COVID-19 other threats such as civil unrest and natural disasters.
- Protect people by giving them actionable information about developments that impact them directly. Contact tracing plays a pivotal role in this process.
- Develop a reopening strategy that provides for forwarding progress while also allowing for unforeseen setbacks and new COVID-19 outbreaks.
Contact tracing is a set of techniques and tools that enable people and organizations to document contact between individuals in case one or more of them becomes infected at a later time. The process has limited utility during total shutdowns when nearly everyone is isolated, but it is crucial during the re-opening process when the objective shifts to isolated and selective response.
Although identifying potential exposures and notifying affected people are the two essential capabilities of a tracing system, a more comprehensive solution includes tools to prevent new exposures as well as to guide people through the process of identifying symptoms, reporting test results, and managing follow-ups through resolution.
There are four essential steps to implementing end-to-end contact tracing:
1. Keep people safe. The first objective is to prevent people from getting exposed in the first place. This involves a variety of capabilities to keep people out of harm’s way, ensuring they avoid areas of new outbreaks. This also requires creating a structured system of wellness checks, assessing an employee’s risk profile, conducting temperature checks, testing for both infection and the presence of antibodies, and validation that tests have been performed.
2. Identify positive cases. People who test positive to COVID-19 should have the means to self-report their status, obtain ongoing tests, and enable employers and/ or public health officials to track and audit their actions.
3. Identify potential exposures. A critical part of contact tracing is preventing additional exposures. Organizations need to be able to retrace the steps of people who have tested positive to determine who else might have been near them in the past.
4. Manage follow-up. Once people have tested positive, a mechanism needs to be in place to ensure that they are self-quarantining, have access to additional tests, and can consult with experts to guide them to any additional services they may require.
The two most common contact tracing techniques are manual tracing and mobile applications. In the manual approach, people call contacts of newly diagnosed patients, notify them that they are at risk, provide information about testing, and follow up to ensure that recommendations are being followed. While this approach may be practical on a small scale, it is prohibitively expensive and time-consuming for a crisis of COVID-19’s magnitude.
The mobile app-based approach automatically logs contact between two people running compatible apps. Currently, the most talked-about project is an app being jointly developed by Google and Apple that relies upon a proximity-based contact tracing framework. It’s a powerful and sophisticated approach that uses Bluetooth Low Energy technology to automatically and anonymously log any occurrence in which two people pass within a specified distance of each other by placing an anonymized code on each phone and copying it to a central database. If one of those people subsequently tests positive, the app can notify others with whom he or she has come in contact without revealing the identity of the infected person.