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Just 5% of Ontario coronavirus cases used COVID Alert app to report infection

Only a fraction of Ontario's COVID-19 cases have used the national COVID Alert app to report their infection, hampering the app's effectiveness in slowing the second wave of the pandemic in the province.

Public health experts say app is a useful tool despite limited uptake

Ontario has had more than 25,000 confirmed cases of COVID-19 since the COVID Alert app was launched in late July. Roughly five per cent of those have used the app to report their infections and trigger exposure notifications about their case. (Morgan Modjeski/CBC )

Only a fraction of Ontario's COVID-19 cases have used the national COVID Alert app to report their infections, hampering the app's effectiveness in slowing the second wave of the pandemic in the province.

Figures provided by the provincial government show COVID Alert users have reported 1,354 cases through the app since its launch on July 31.

Given that Ontario has had more than 25,000 confirmed cases of COVID-19 since then, this means roughly five per cent of those infected with the novel coronavirus have used the app to report their case, which would then warn other users of potential exposure if they had been within two metres of that person for at least 15 minutes in the preceding two weeks.

However, those figures do not mean the app should be written off as a failure, according to public health experts.  

"There's an adage in public health that absolutely no manoeuvre is going to be 100 per cent effective, ever," said Susan Bondy, associate professor of epidemiology at the University of Toronto's Dalla Lana School of Public Health. 

"We should not criticize something for not achieving 100 per cent efficacy, because nothing ever does." 

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Emily Seto, an expert in the use of mobile technologies for health, points out that the app is just one of many measures aimed at slowing the virus's spread.

"I don't think that it was reasonable to think that this app was going to be our silver bullet," said Seto, an assistant professor at the Institute of Health Policy, Management and Evaluation at the University of Toronto.

"This is one tool. We're in a situation right now where we should use every single tool that we have to help." 

Nearly 4.7M downloads

The COVID Alert app has been downloaded to nearly 4.7 million phones across Canada. Statistics breaking down the number of downloads by province are not available. The app is in use in eight of the provinces, with British Columbia and Alberta the sole holdouts. 

The number of downloads is promising, but not enough, said Dr. Barbara Yaffe, Ontario's associate chief medical officer of health.

The COVID Alert app is in use in eight provinces, and has been downloaded to nearly 4.7 million phones across Canada. (Nathan Denette/The Canadian Press)

"We need more people to download the app," Yaffe said Monday during a news conference. She said the app has many good aspects and strong privacy protections, but needs to be used in large numbers to be most effective.   

Bondy suspects the benefit of COVID Alert is greater than what's suggested by the number of users who have reported cases through the app. For instance, cases who had come in contact with a large number of people would trigger a significant number of exposure notifications with the app.

"Potentially, it's a very large number of people whose behaviour has been changed," Bondy said in an interview with CBC News.

"The app is doing its job as a contributing factor in contact tracing. It is not going to resolve the problem of the entire workload capacity issue of contact tracing, but it is one link in the chain." 

The COVID Alert app uses Bluetooth signals to exchange random codes with nearby phones that have the app installed. Users who test positive for COVID-19 are provided with a key code to enter into the app, which triggers a notification to app users who may have been exposed. (COVID Alert)

She describes COVID Alert as having very conservative privacy settings — both the federal and Ontario privacy commissioners endorsed it — and says the app has succeeded in gaining a broad level of trust among Canadians. 

Beyond repeatedly emphasizing the privacy, public health experts say there is a range of ways to encourage more people to download and use the app. 

Endorsements by high-profile, tech-savvy people with influence could help. So would promoting the real-life stories of people who credit the app for discovering that they'd been infected with COVID-19.

"There's a bit of a catch-22 here where people are reluctant to download the app because they may not perceive it to be effective, but at the same time, it's not going to be effective if people don't download it," said Seto in an interview with CBC News.   

While Seto believes the statistics on positive tests reported through the app suggest there is room to improve its uptake, she says she is not disappointed by its contribution in the battle against  COVID-19.

"We've got to temper our expectations of what this app can do," she said. "We're getting some evidence that it is working. With any kind of digital tool, it takes some time to have uptake and to get trust. It's a tool. Why not use all the tools that we have?" 

The province is confident in the app.

"The COVID Alert app has been effective in supporting early detection, testing and self-isolation," said a spokesperson for Treasury Board President Peter Bethlenfalvy, who oversees Ontario's digital government efforts, in an emailed statement.

"The more people who have the app, the more effective the province will be at stopping the spread of COVID-19."  

About the Author

Mike Crawley

Provincial Affairs Reporter

Mike Crawley is provincial affairs reporter in Ontario for CBC News. He has won awards for his reporting on the eHealth spending scandal and flaws in Ontario's welfare-payment computer system. Before joining the CBC in 2005, Mike filed stories from 19 countries in Africa as a freelance journalist and worked as a newspaper reporter in B.C.

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