Contact tracing is an old and time-tested tactic of managing outbreaks involving infectious diseases. By keeping records of the infected’s contact with other individuals, public health organizations and governmental agencies can accurately track the spread of infectious diseases to manage the spread of sickness and coordinate pandemic responses.
Contact tracing is not exactly new. People throughout history have understood that contact with a disease was a way to catch it and that avoiding contact with others could prevent the spread. However, the modern age affords several technologies and infrastructures to handle contact tracing on a much larger and rigorous scale than ever before.
However, contact tracing still faces difficulties in its implementation, especially in developing countries. The challenges facing contact tracing in developing countries are varied and there is no singular factor affecting pandemic response in those areas. However, there are several identifiable factors that contribute to the difficulty of employing contact tracing measures in developing countries.
Lack of Infrastructure (Communications, Medical, etc.)
Perhaps the single largest issue affecting contact tracing efforts in developing regions is the lack of reliable and sophisticated s infrastructure. Lack of communications and networks to identify persons, track their movements, and report information on population infection rates limit the amount of information that public health organizations have to work with, which is inimical to effective pandemic response.
One major factor affected by a lack of communication is an inability to identify, locate, and communicate with infected individuals. Many people in the developing world do not have a regular means of making contact with others over distances.
Similarly, deficiencies in other civic infrastructure such as public transportation or a lack of accurate administrative records further hinder contact tracing strategies. Patients identified as sick are often unable to make it to a hospital to receive adequate treatment due to a lack of transportation. In cases where they can actually reach hospitals, medical personnel are often ill-equipped to handle care demands.
Low Smartphone/Internet Penetration Rates
Another major challenge contact tracing in developing countries faces is comparatively low smartphone penetration rates. According to Pew, smartphone penetration rates in emerging economies have a median value of 45% compared to a median of 76% in advanced economies. This means that, on average, people in developing countries are less likely to have regular access to a smartphone.
Many companies are developing smartphone apps to be used for contact tracing. These smartphone-based apps work by recording patterns of interaction between people who have the app enabled on their phones. When two people with the app come into contact, a key code is exchanged between the two and data is sent to a server. If one person develops symptoms of the virus, then the server combs through contact data to see who the infected person has come into contact with. Through this mechanism, public health agencies can get ahead of the spread of viruses.
The problem with this setup is that it relies on a population with very high smartphone penetration rates. Simply put, smartphone-based contact tracing apps will not be as effective in regions that have low smartphone penetration rates. Additionally, communicating information via smartphones often relies on cellular networks and other communications infrastructure. Developing countries that lack these sorts of installations are less able to use cell phone-based contact tracing methods.
Lack of Trust in Public Health Organizations
One other major issue affecting contact tracing efforts in developing countries is a lack of trust in governmental agencies and public health organizations. This lack of trust is often exacerbated when a foreign country is assisting with public health programs. A clear example of this disconnect is from the 2014-2015 outbreak of Ebola in West Africa. CDC officials report facing trust issues with local communities, and a reluctance to comply with screening and quarantine procedures.
Here is an example of the effects of this lack of trust. According to the WHO, one major challenge affecting contact tracing efforts in the case of the Ebola outbreak in Guinea was communities’ refusal to cooperate with WHO teams. Contact tracing lists were interpreted by the public as “death lists” and some communities believed that WHO teams were intentionally spreading the disease in order to harvest organs from the infected.
There are many causes of a lack of trust in public health agencies. Traditional belief systems that attribute disease to magical or mystical causes are important factors in some regions, while lack of disease education and literacy are factors in other regions. Other communities look to what they perceive as delayed or ineffective responses as a reason to resist programs.
Careband’s SafeTrack solution is a low-cost low-power solution to deploying contact tracing responses in rural and underdeveloped areas. Safetracks works utilizing low-power wide-area networks (LPWAN) and wearable devices to track and manage the spread of disease. SafeTrack operates on a simple cloud architecture that continuously monitors and updates information based on population infection rates.
SafeTrack’s key innovation is that its wearable devices do not have to rely on cellular networks to communicate with each other. LPWANs can transmit data across long distances while using relatively little power. This allows SafeTrack devices to send regular location and health status updates without having to piggyback the signal off of an existing cellular network.
Further, SafeTrack devices essentially eliminate any technological boundaries to operating medical devices. Patients do not have to do anything except wear the devices. The devices and network handle all relevant information gathering.
CareBand’s SafeTrack wearable public health devices are a potential solution to overcome the barriers that developing communities face to contact tracing. The discreet nature of the devices and the low power/cost requirements make them an effective and scalable solution for monitoring public health. SafeTrack devices can be configured using nothing but a smartphone and each device has long battery life.
In the face of global pandemics, a proper unified response must be presented. SafeTrack offers a convenient and scalable solution for public health management.