How Fragmentation Can Undermine the Public Health Response to COVID-19

TL;DR

This paper examines how fragmentation in digital contact tracing systems can hinder effective COVID-19 public health responses, highlighting the importance of coordination and user experience.

Contribution

It analyzes the evolution of digital contact tracing in New Zealand, illustrating how system fragmentation impacted response effectiveness and how coordination improved outcomes.

Findings

Fragmentation initially caused poor contact tracing outcomes.

Better coordination led to improved digital contact tracing effectiveness.

User experience significantly influences technology adoption in public health.

Abstract

Responses to COVID-19 have largely been led by local, national, and international public health agencies, who have activated their pandemic plans and opened the epidemiological toolkit of modelling, testing, isolation and movement restrictions, surveillance, and contact tracing. In the contemporary tech-heavy world, many assumed that the common manual process of human investigators and phone calls could or should be replaced by digital solutions. But it's not as simple as "add more technology" - the complex way in which users and societies interact with the technology has significant impacts on effectiveness. When efforts are not well co-ordinated, fragmentation in system design and user experience can negatively impact the public health response. This article briefly covers the journey of how contact tracing registers and digital diaries evolved in New Zealand during the COVID-19 pandemic, the initial poor outcomes caused by the lack of central co-ordination, and the later improvement.