Apple and Google are refining their COVID-19 contact tracing framework to fast-track enrollment and, for Apple device owners, completely forego the need to download a separate app, representatives of the companies announced today.

Launched today on iPhones with the iOS 13.7 update, "Exposure Notifications Express" sends device owners in participating states a push notification with the option to opt into the Bluetooth contact tracing system. If users consent, they are enrolled in the feature without the need to download a public health agency-developed app.

Android users, meanwhile, will see a similar functionality go live on their devices later this month. That notification, however, will bring users to a download page for their state's exposure notification app.

Across both platforms, Exposure Notifications Express also cuts down the time public health authorities will need to spend developing, implementing and maintaining a custom app for their state, representatives of Apple and Google said.

Rather, authorities can have a system or app generated for them by the tech companies so long as they provide an organization name, contact information, local guidances, logos, exposure notification criteria and other educational materials to be presented to users when an exposure is triggered.

As before, the companies said that this upgraded version of the technology on both platforms still won't collect identifying data from the user. The systems are fully interoperable across platforms and with existing or in-development custom apps made using Exposure Notifications.

Maryland, Nevada, Virginia and Washington D.C. have already agreed to be the first states in the U.S. to roll out the new contact tracing system, Apple and Google have also been teasing additional state deployments to come in the fall.

“Exposure Notifications Express will help to save lives, greatly enhance our contact tracing operation, and advance our statewide COVID-19 recovery," Maryland Governor Larry Hogan said in a statement provided by the companies. "We appreciate our collaboration with Apple and Google, and look forward to launching this state-of-the-art technology in Maryland.”

WHY IT MATTERS

Since their announcement in April and release in May, Apple and Google's opt-in contact tracing tools have been adopted by a handful of countries' public health systems, and now appears to be gaining steam within the U.S.

The companies said that 25 U.S. states, territories and the District of Columbia have explored the technology, with six states having already launched a custom app built on the framework. Virginia was the first of these to release an Exposure Notifications app about a month ago, and has so far seen nearly a half a million downloads according to a statement from Virginia Department of Health Commissioner Dr. Norman Oliver that was provided by Apple and Google.

Experts have warned that digital contact tracing systems such as these can only make an impact if they're distributed widely and downloaded by a substantial portion of the general population. In theory, Exposure Notifications Express works to address both of these concerns by reducing the burden on public health authorities to adopt and implement the system, and by lowering the barrier of entry for users to opt into the effort (although it likely won't do anything to win over those with privacy concerns).

THE LARGER TREND

Contrasting the 20-plus countries and regions that Apple and Google say have adopted their tools are a handful of public health groups and organizations that decided to put together their own digital contact tracing systems from scratch.

Some of these rollouts ran into hiccups. Norway's contact tracing app was temporarily banned based on privacy concerns from the Norwegian Data Protection Authority, while South Korea's quarantine enforcement app was updated to fix security flaws allowing access to names and real-time locations. And in the U.S., a location-tracking COVID-19 app required by Michigan's Albion College received flak from students, parents and security experts.

That's not to say that Apple and Google's implementation has been free of drama. In July, some users and countries' public health groups became concerned that a device location setting requirement in the Android version could be generating identifying data despite the companies' promises. Despite this, Google responded that such information was never made available to app developers without user permission, and later updated the system's settings to reflect that stance.

ON THE RECORD

“As the next step in our work with public health authorities on Exposure Notifications, we are making it easier and faster for them to use the Exposure Notifications System without the need for them to build and maintain an app," Apple and Google said in a statement. "Exposure Notifications Express provides another option for public health authorities to supplement their existing contact tracing operations with technology without compromising on the project’s core tenets of user privacy and security. Existing apps using the Exposure Notification API will be compatible with Exposure Notifications Express, and we are committed to supporting public health authorities that have deployed or are building custom apps.”

"Any effort to embed this type of capability directly into the OS of the mobile device versus relying on a user locating, downloading and registering an application will result in a massive increase in the adoption rate of contact tracing," Robin Cavanaugh, CTO of digital patient engagement fcompany GetWellNetwork, commented to MobiHealthNews. "Lowering barriers to data exchange will likely have a positive effect on data collection, and in turn, help halt the transmission of this (or future) infections."