Digital contact tracing/notification for SARS-CoV-2: navigating six points of failure

Abstract: Digital contact tracing/notification was initially hailed as a promising strategy to combat SARS-CoV-2, but in most jurisdictions it did not live up to its promise. To avert a given transmission event, both parties must have adopted the tech, it must detect the contact, the primary case must be promptly diagnosed, notifications must be triggered, and the secondary case must change their behavior to avoid the focal tertiary transmission event. If we approximate these as independent events, achieving a 26% reduction in R(t) would require 80% success rates at each of these six points of failure. Here we review the six failure rates experienced by a variety of digital contact tracing/notification schemes, including Singapore's TraceTogether, India's Aarogya Setu, and leading implementations of the Google Apple Exposure Notification system. This leads to a number of recommendations, e.g. that tracing/notification apps be multi-functional and integrated with testing, manual contact tracing, and the gathering of critical scientific data, and that the narrative be framed in terms of user autonomy rather than user privacy.