Humanity is going through one of its most testing adversities in the recent months. In a few months since it started, the spread of the COVID-19 has brought the entire world under its vicious grip. WHO situation report 782 of 07 Apr 2020 reports only five countries that do not have confirmed infections. To date, the virus has infected 1.3 million people and has claimed 73,000 lives. These numbers are growing by the day. Most countries have locked down international borders and have imposed internal restrictions in varying degrees, to improve the chances that the pandemic does not go to Phase 3. The critical change when a country or region goes from Phase 2 to Phase 3 is the inability to trace sources of infection, making the contagion extremely difficult to control. Social distancing, widely adopted around the world, is one way to try and prevent a country or region from slipping into Phase 3. The wisdom behind the effectiveness of social distancing as one among key weapons to fight pandemics comes from our history of having fought and won several pandemics in the past.
The approach to containment during Phase 2 – tracing the sources of infections, isolating and treating infected subjects, identifying potential subjects who are likely to be infected in the near future through the infected subject’s social contact history, and quarantining/ monitoring them – breaks down when a country slips into Phase 3. It is no more possible to trace back and forth from new infected subjects to those who are at high risk of getting infected. Thankfully, mankind today has a new weapon that it can bring to this battle – location tracking and location-based services.
Technically, it is now possible to track the location of every subject – healthy, at risk or infected – through their mobile phone, with minimal additional investments or time-to-build. It is also not difficult to tag subjects into these three categories, since mobile numbers of infected and at-risk subjects are being gathered by healthcare workers. What’s missing is the tagging of healthy subjects and the location history of all. Say these data are also available. Upon identifying an infected subject, it would be possible to quickly retrieve the identity of all healthy subjects with whom he/she had come into contact in the past few weeks – social contact history of the infected subject for a period of time in the past. The healthy subjects who came in contact with the infected subject can be alerted of a potential risk of infection and can be prioritized for testing. Using other data self-reported by subjects, it would be possible to come up with tailored recommendations and requirements for individual subjects including prioritised testing, quarantine and so on. It would also be possible to keep tab on the location of newly quarantined. Unlike our past battles with pandemics, this new weapon can be a game changer in terms of how we fight community level contagion and can become a key pillar of our strategy to avoid slipping into Phase 3.
Enter Aarogya Setu2, a digital platform launched by the Government of India on 02 Apr 2020 with a mobile app for residents, which aims to do precisely this. The app uses close proximity of two smartphones and duration of proximity along with pseudonymised identity of users to build a history of social contacts over a 30-day period3. Using this data, subjects at potential risk of infection from a subject newly tested positive can be readily identified. This would enable the administrative and healthcare workers to take follow-on actions such as prioritised testing.
The timing of the launch of this platform is critical. India is still in Phase 2, but the risk of slipping into Phase 3 seems to be climbing up. Central and state governments are figuring out what next as the 21-day lockdown is to end in a week. There is resentment about impaired livelihood as well as lost income and economic opportunity in sections of the society. This will only heighten with even partial or selective extension of lockdown. Aarogya Setu platform can be the safety net with which less affected geographic areas can see relaxation of restrictions in the coming weeks. If most of the people in the areas that move to less stringent lockdowns are in the platform by using the app, the platform can provide early warning on any future relapse to growing spread in these areas. This can in turn trigger appropriate and prompt action to renew the battle against further spread.
The power of this platform lies in its network effect. It is most effective when all residents in a geographic area are signed up and using the app, capturing data on their contact history. With low penetration – the current 2%, the platform is not of much use as the data on social contact history will be too thin to provide any meaningful and actionable insights.
For the platform to be effective in any geographic area, two things need to happen. First high proportion of (ideally all) residents of the area must be present in the platform. Second, users must install the app and start using it at the earliest. The app can start capturing data only after it’s installed, so earlier the residents come in, more days of social contact history will there be, just in case. There is the risk that the platform turns out useless when we need it most, just because the data on social contact history is too thin as enough users are not present. That’s what we as a community and country need to avoid. There are several challenges on the way, even for small geographic areas like a locality or a local administration ward, but there are ways to tackle these challenges as well.
Awareness & Adoption
The app has seen 10 million+ downloads on Android phones during the first six days. While this is much higher than the 1 million+ downloads of MyGov.in app, it’s still just 2% of the 500 million smartphones4 in use by Indian residents. Various media sources and the government have been spreading word on the app in the past few days. The central government has been sending SMS messages about the app, but that would reach only those residents whose mobile number is available in government databases such as through the records of income tax returns, or those who have signed up for MyGov app. These are likely a small share of the population. There is a dire need to spread the word and drive up presence of all Indian residents in the platform, and fast.
Indian Railways, the largest organised sector employer in India with a workforce of 1.3 million, urged all its employees and family members to install Aarogya Setu two days after it was launched5. While passing the message through employers is a promising idea, the organised sector employs only 6% of the workforce in India. In front of us is the humungous task of creating awareness and promoting adoption by most of us in the country. The central government can look at several ways to boost adoption. It can explore ways to make use of the app mandatory for all residents in geographic clusters already identified to be at high risk of slipping into Phase 3. Intensive communication effort may be appropriate for prioritised geographic areas that are likely to develop into clusters. State governments can be co-opted to spread the message.
Local administrations can own the task of spreading the word in their communities, allaying apprehensions and ensuring adoption. Several local administrations have started door-to-door surveys to gather data on residents and related information. This effort can be double up as an out-reach channel for Aarogtya Setu adoption. The government can think of building an app for local administrations which automates the task of door-to-door surveys by linking with Aarogya Setu apps of residents for capturing data. Police across the country are on constant vigil to restrict the bored and brave venturing out of homes. They are using innovative ways to create awareness about social distancing. The police can use this contact opportunity with public to create awareness about the necessity to be present in the platform.
Police or local administration grant permission for businesses involved in essential services to operate. Presence of staff members offering essential services in the Aarogya Setu platform can be made a pre-condition for grant of permission to operate. Delivery teams of digital businesses such as Swiggy, bigbasket, Zomato are gearing up to deliver essentials such as medicines, vegetables and groceries. APIs can be released for use by these companies to ensure that their delivery agent apps mandatorily share social contact history data to the platform
As lockdown conditions are relaxed, presence of staff members in the platform can be made mandatory for businesses to resume functioning. This will also serve as a reassurance for the returning staff members that their safety is not left to chance.
We all play different roles in our daily lives, as members or influencers in residential communities, as members of organisations where we work, as employers of our domestic help, driver etc. We can each make sure that all those whom we can influence are encouraged to become part of the Aarogya Setu platform.
Each of us, not just celebrities and those with large number of followers, can harness the potential of social media in spreading the message by posting messages about Aarogya Setu and its importance in fighting the pandemic.
The app is likely to invoke Orwellian apprehensions that the big brother will now have us under his thumb. Rahul Matthan, a member of the team that designed the app, tried to allay privacy concerns in an Op-Ed article in LiveMint on 07 Apr. Key privacy features that he highlighted were pseudonymisation to protect user identity, local storage of data collected in the phone itself and strict data retention policies. He further recommended that the code for the app be released under open source license so that privacy protection claims can be verified independently. This is an essential next step for the government. In addition, knowledgeable public including IT cells of various political parties can be invited to validate the app’s privacy features and provide feedback and suggestions for updates and improvements. Endorsement of the urgent need and safety of using this app by various stakeholder groups including parties across the political spectrum would greatly diminish opposition to adoption of the app.
Currently, only smartphone users can be part of the Aarogya Setu platform. There are close to 400 million feature phone users in the country7 – almost a half of our mobile user base. Unfortunately, the necessary condition of universal adoption will fail just on account of this design characteristic of the platform. There is an urgent need to come up with technical solutions to bring feature phone users into the platform. USSD and location tracking using cell towers can be used to overcome this challenge. It may be impossible to track all feature phone users in this way due to technical and logistical challenges. However, feature phone tracking can be deployed in prioritised geographic areas that are under high and imminent risk of going to Phase 3.
Current design of the platform restricts storage of data to the subject’s smartphone. Most smartphones run on subsistence levels of free memory, what with multiple good morning, good evening and good night images and videos, not to mention messages on homemade COVID-19 remedies and keep safe messages. Some users may be able to use cloud backup, but many users wouldn’t be using the feature. There is a potential catastrophe that the platform turns out ineffective, as most users cleared Aarogya Setu data manually to make space for their daily media use. Cloud storage of data by the government, with user consent, especially for users in prioritised geographic areas, can avoid this. Resistance to allowing cloud storage of data needs to be addressed as part of the larger approach to allaying privacy concerns. Mandatory cloud storage of data can be bundled with compulsory presence in the platform, for subjects in high risk geographies.
In addition to end user device capacity, there is also the need for adequate capacity of computing, storage and connectivity at the back end for processing the data. There is also the need for appropriate analytical tools and communication channels to deliver timely and actionable insights for the administrative setup and healthcare providers. It would be reasonable to assume that these are already taken care of by the architects of the platform.
Caring for the Corona Warriors
any of our fellow country people are putting themselves and their families at risk by providing us with much needed essential services. The doctors and paramedics, the police, government, local administration and sanitation staff are doing more than their routine job to keep all of us safe. The platform can provide them better visibility on the risks they are taking and can be used to trigger R&R for those exposed to too much risk.
The environments in which the corona warriors work see a constantly changing mix of people, most of them strangers. Our warriors currently have no clue about the risks they are exposing themselves to. Through a special app restricted to this subset of users, heat maps can display the proportion of people in an area present in the platform. If most people in the area are in the platform, our warriors are assured that they are in a locality that has minimal untracked subjects.
The corona warriors frequently come into contact with many people in the course of their daily routine. If most of these people track their social contact history through the platform, any future infection can be traced back to these warriors. Such trace backs accumulated over multiple days and cases of infection will serve as an indicator of the risk these people are taking. People who cross a threshold of risk must be pulled out of service in their own The corona warriors frequently come into contact with many people in the course of their daily routine. If most of these people track their social contact history through the platform, any future infection can be traced back to these warriors. Such trace backs accumulated over multiple days and cases of infection will serve as an indicator of the risk these people are taking. People who cross a threshold of risk must be pulled out of service in their own
Game Changer or Wasted Opportunity?
Use of location data to track COVID-19 and arrest its spread has been talked about for a while now. China used location data coupled with other data sources like CCTV cameras, credit card transactions to track subjects in its fight against COVID-198. Anonymised location data at an aggregate level is being used to study patterns and risks of the spread of contagion. The Aarogya Setu platform tries to take it one notch up. It can potentially delay or thwart the onset of Phase 3 in India by being able to trace sources to potential future infections by enabling accurate capture of social contact history going back a month, for large number of people. The most critical challenge is that almost 45% of mobile users can’t be part of the platform as they use feature phones. They need to be brought into the platform. Without that, the effectiveness of this platform as a weapon against the pandemic is likely to be seriously undermined. Maybe efforts in this direction are already underway. If so, well and good. If not, it’s high time to start efforts in this direction.
Whether Aarogya Setu proves to be a game changer or ends up a wasted opportunity will depend on how fast Indian residents come into the platform and how quickly its user base covers all Indian residents. While we can expect the government to do what it takes, each of us can help by signing up and using Aarogya Setu and encouraging our relatives and friends to do so. If you haven’t done yet, get on to the platform right away
- https://apps.apple.com/in/app/aarogyasetu/id1505825357, Android: https://play.google.com/store/apps/details?id=nic.goi.aarogyasetu
- Op. Cit. LiveMint article
About the contributor
Prof. Sai Prakash Iyer is an Adjunct Professor of Strategic Management at IIM Udaipur. A keen follower of all things digital, his teaching and consulting focuses on the business impact of digital technologies and its implications for business strategy, competitive dynamics and organizations.