As Re-Open Saskatchewan soon enters its third phase of five, officials continue to stress the need for maintaining its three important pillars in combating COVID-19: increased testing, increased contact tracing, and expanding medical care space/critical equipment availability.

Reopening businesses and services are only viable in Saskatchewan because of preparations it has made to ensure adequate health care services are available and mechanisms are in place to limit new flare-ups as they occur.

It is almost a certainty that more cases will result in the coming weeks and months, but the government of Saskatchewan and Chief Public Health Officer, Dr. Saqib Shahab, maintain that if the rate of infections is kept manageable, Saskatchewan can continue to relax public health measures while ensuring a low mortality rate due to highly accessible and effective health care.

As of May 24, Saskatchewan’s testing rate per capita lagged behind the Canadian average by 13 per cent, or approximately 5,000 tests. On average, Saskatchewan performs just under 500 tests per day over the previous two weeks.

At present, contact tracing is a manual procedure, with health officials interviewing those infected in attempt to determine additional people subsequently exposed. In turn, contact is attempted to alert those possibly exposed to self-monitor for symptoms or avail themselves for testing if necessary.

Technology may be introduced in the next month or two, either provincially or nationally, to enable individuals to use their smart phones to automate much of this tracing activity. Alberta has already introduced one such application in late April called ABTraceTogether. Other provinces are observing the effectiveness of ABTraceTogether to either adopt it or similar technologies.

The applications being considered implement the ‘Decentralized Privacy-Preserving Proximity Tracing (DP-3T) protocol.’ The design of the protocol utilizes Bluetooth capabilities of mobile phones to record anonymous handshakes with other mobile phones when in close proximity to each other. The data is only kept on the individual’s phone for 14 or 21 days, depending on the health regions requirements.

Should a mobile user become infected with COVID-19, health officials would then publish the patient’s anonymous identification online. Other users of the application would subsequently obtain the identification of the infected user and determine if it is present in their list of contacts. If a match is found, the user is then alerted to the potential exposure and advised to take further action such as self-monitoring/isolation or testing. Identities of participants is never shared.

Advocates of the protocol champion never having to share one’s contacts while participating in the public health measure. Additionally, it removes the necessity for people to attempt to recall everyone they’ve been in contact with for the prior two to three weeks, and further reduces requirements of health workers to manually contact every possible contact.

The speed of the contact tracing protocol is both a positive and a negative. The speed at which a possible flare-up can be averted is beneficial, while at the same time negatively increases the demand of testing services.

Due to the wireless nature and transmitting range of Bluetooth enabled cellphones, some false positives will undoubtedly occur. One such scenario is when two people are separated by a wall and never come into contact with one another. The protocol has no ability to determine if contact was ever made and it is thereby falsely recorded as a contact.

Critics also point to Alberta for another shortcoming of the technology. In order for mobile contacting to be beneficial, it requires a large percentage of the population to use to application. Estimates suggest an adoption of level of about twothirds of all mobile users. A sufficiently large user base is required to prevent a false sense of security amongst its users and to provide the widest contact trace possible.

In the first week since Alberta released ABTraceTogether, 130,000 users installed the software, or roughly three per cent of its population.

In an unlikely pairing, Apple and Google have joined efforts to release an underlying framework for contact tracing implementing the DP-3T protocol. Working in collaboration with health officials around the world, including Canada’s, the two cellphone giants hope to increase the utilization of the protocol by reducing the technical barriers countries have in arriving at individual solutions.

In June or July, Apple and Google intend to allow countries to make the protocol part of the iPhone and Android phone, thereby not requiring the users to download an application. The stated goal is to remove the functionality once the countries of install request it.

Early adopters of cellphone contact tracing, like Singapore and South Korea, have demonstrated that the technology can play a significant role in resuming reopening of services and entertainment while living in a COVID-19 world.

A recent Mainstreet Research Poll indicates that the majority of Canadians do not approve of a mandatory tracking app. The only province favouring its deployment is Ontario at 51.6 per cent, while Quebec disapproves of such tracking (63.7 per cent). Saskatchewan and Manitoba saw only a 40 per cent approval. For contrast, 80 per cent of Canadians would support requirements to wear a face mask at work.

Although it is uncertain if Canada, or even Saskatchewan, will adopt technology to fight the pandemic, two things remain certain. Technology will not be a panacea and public participation in social distancing, hygiene, and masks will remain vital tools in our arsenal against COVID-19.

-Kevin Gilby