Systematic Innovation @ MedCity News

Approaching a Fork in the COVID Road: Apple + Google or 1984

MedCity News is a niche publication on business and innovation in med tech / biotech / bio services

A sustainable approach to contact tracing is becoming a central factor in economic recovery. We have a limited range of social interventions for responding to the COVID-19 crisis. Although our options are limited, we can identify a path that effectively mediates between the complexities of biological forces and economic forces. This approach identifies “what’s missing” from conventional approaches. It solves the contradiction between economic recovery and biological stability; between private rights and the public interest; and between the effectiveness and intrusiveness of contact tracing. We need to make a sustainable decision — and soon.


Top epidemiologist Michael Osterholm confirms that a manual approach to contact tracing at this stage is not sustainable. Our only hope is an automatic approach that is non-intrusive. Yet public-health agencies seem to be leaning toward a manual approach with “armies” of contact tracers. No doubt that a manual approach is appropriate for pockets of opportunity, but it is not adequate for the heavy lifting that lies ahead.

“Early on, if you had a small number (of infections), you can get in and you can control it to the extent that you can’t get rid of it, but you can surely minimize it. Once it hits a level like it is in most countries right now, contact tracing plays almost no role. Once you see a big escalation in cases, you’ll be having contacts by the many thousands and thousands and thousands, and it’s just not going to work.”

(Michael Osterholm started the first program in the world for HIV contact tracing in 1985)

Coronavirus epidemiologist Q&A @ USA Today (5/12/20)


Q:  You’ve indicated that a manual approach to contact tracing is not effective at this stage; what is the potential for an automatic approach like the Apple / Google connection-based initiative?

A:  The electronic device approach is an important question; conventional methods won’t work for thousands of contacts per day; we don’t have time for elaborate studies / we can’t throw everything at the problem without thinking — it’s an opportunity for the creative aspect of contact tracing — we haven’t seen it yet — we need to evaluate our options

Q&A with Michael Osterholm @ “Living in a COVID-19 World“, hosted by the Federal Reserve Bank of Minneapolis + Center for Infectious Disease Research and Policy @ University of Minnesota (5/26/20; 2:44:06 – 2:26:24)


As of 5/20/2020 — Alabama, North Dakota, and South Carolina have adopted the Apple + Google solution for non-intrusive contact tracing in a distributed (Bluetooth) architecture.