Acceptability of App-Based Contact Tracing for COVID-19: Cross-Country Survey Study

Abstract

Background The COVID-19 pandemic is the greatest public health crisis of the last 100 years. Countries have responded with various levels of lockdown to save lives and stop health systems from being overwhelmed. At the same time, lockdowns entail large socioeconomic costs. One exit strategy under consideration is a mobile phone app that traces the close contacts of those infected with COVID-19. Recent research has demonstrated the theoretical effectiveness of this solution in different disease settings. However, concerns have been raised about such apps because of the potential privacy implications. This could limit the acceptability of app-based contact tracing in the general population. As the effectiveness of this approach increases strongly with app uptake, it is crucial to understand public support for this intervention. Objective The objective of this study is to investigate the user acceptability of a contact-tracing app in five countries hit by the pandemic. Methods We conducted a largescale, multicountry study (N=5995) to measure public support for the digital contact tracing of COVID-19 infections. We ran anonymous online surveys in France, Germany, Italy, the United Kingdom, and the United States. We measured intentions to use a contact-tracing app across different installation regimes (voluntary installation vs automatic installation by mobile phone providers) and studied how these intentions vary across individuals and countries. Results We found strong support for the app under both regimes, in all countries, across all subgroups of the population, and irrespective of regional-level COVID-19 mortality rates. We investigated the main factors that may hinder or facilitate uptake and found that concerns about cybersecurity and privacy, together with a lack of trust in the government, are the main barriers to adoption. Conclusions Epidemiological evidence shows that app-based contact tracing can suppress the spread of COVID-19 if a high enough proportion of the population uses the app and that it can still reduce the number of infections if uptake is moderate. Our findings show that the willingness to install the app is very high. The available evidence suggests that app-based contact tracing may be a viable approach to control the diffusion of COVID-19.

Drivers of Acceptance of COVID-19 Proximity Tracing Apps in Switzerland: Panel Survey Analysis

“…Overall, our findings also correspond well with other international population surveys of DPT app use, most of which were performed before [ 23 - 29 ], and some after app release [ 30 ]. For example, several studies confirmed the finding that higher education status [ 25 ], and younger age [ 23 ] were associated with a higher willingness to use DPT apps. Of note, these characteristics could reflect the profile of typical early adopters of technology [ 31 ].…”

“…Our observations of technical problems and persistent privacy concerns as reasons for nonuse or uninstallations of the SwissCovid app are consistent with those of a study in Australia [ 30 ], which reported similar user complaints. Furthermore, (a lack of) government trust emerged as a strong influencing factor for app usage in our and other surveys [ 23 ]. For example, approximately 11% of the respondents of the Australian survey cited government mistrust as a reason for not using the app [ 30 ].…”

Team contact sports in times of the COVID-19 pandemic- a scientific concept for the Austrian football league

“…These technical solutions are designed to enable faster identification and isolation of infected persons, but users' concerns about privacy and governmental handling of personal data may hinder their application. It has been reported that the acceptance of app-based contact tracing is increased in persons who have comorbidities and always carry their phone [14]. Usually, young people like professional football players have greater technically affinity and should not encounter any difficulties in the installation of smartphone applications.…”

Evaluation of the Design and Implementation of a Peer-To-Peer COVID-19 Contact Tracing Mobile App (COCOA) in Japan

“…Residents’ perception of privacy and trust in public authorities can vary from culture to culture, which can impact the captured definition of individual privacy preservation [ 39 - 41 ]. A survey conducted in five other countries (ie, France, Germany, Italy, the United Kingdom, and the United States) found that people in settings with stronger public privacy and security concerns are relatively less supportive of app-based contact tracing, and individuals with less trust in public authorities are also less supportive [ 46 , 47 ].…”

“…Second, the delays in data sharing could allow the spread of COVID-19 to continue, increasing the time and effort needed to contain it [ 9 , 46 , 47 ]. If infectious individuals and their close contacts could be identified with efficacy, the effectiveness of digital health could be increased remarkably, and limited health care resources could thus be prioritized for the quarantining and treatment of the most severe cases [ 42 ].…”