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September 14, 2020

There is no silver bullet for the second wave

Bloomberg reports that some European countries hit hardest by the Covid-19 pandemic are also those where uptake of government contact-tracing apps is lowest. But trust between governments and citizens may play a more decisive role in the success of a pandemic response.

France and Italy recorded the lowest known adoption levels of Covid-19 apps as of 8 September. In France, where daily cases recently surpassed 10,000 for the first time, just 3.7% of the population had downloaded the StopCovid app. In Italy, where millions of children are set to return to school today, only 8.9% of the population has downloaded the Immuni app. The highest adoption level for any European country surveyed was Finland, at 32.7%.

Source: Bloomberg/national health authorities

Annelies Blom, a researcher at the University of Mannheim in Germany, told Bloomberg the problem is that people don’t trust either the apps themselves or the governments operating them. Norway and Iceland pulled their Covid-19 apps entirely for that reason.

Questions still remain over whether apps have the capacity to reduce the pandemic's impact. In Finland, daily infections have dropped significantly from their April peak. In Germany, where just 21.4% of the population has downloaded the government tracing app, infections have risen nearly eight-fold from their June lows. Harvard professor Miguel Hernán tweeted that low levels of contact tracing are one reason why Madrid’s infection rates surged over the summer while New York’s did not.

A surge in new cases cannot be attributed entirely to low app adoption. But, as we see with the example of Sweden, mandatory masks and lockdowns may not play a decisive role either.

Swedish authorities adopted a controversial pandemic response strategy early on. Authorities kept shops, schools, and restaurants open and no national lockdown was imposed. They asked only that people wash their hands frequently and follow social distancing rules. Face masks were never mandatory, nor even recommended. The government has not launched a track-and-trace app.

This strategy yielded mixed results. The country’s infection rate was the highest in Europe in mid-June, and it has recorded more deaths than Norway, Denmark and Finland combined, mainly in care homes. Now, however, Sweden is back in the headlines for its record low numbers of infections and deaths.

As we recently warned, using infection rate comparisons to make real-time policy decisions is a risky endeavour. It is impossible to say whether Sweden’s pandemic response has been a success because the pandemic is ongoing. But we’ve also argued that a lockdown is an extreme policy measure, the consequences of which will not be known for some time.

The Swedish government’s strategy relies on mutual trust between authorities and citizens to ensure softer voluntary protocols will be followed for longer. The World Health Organization recently praised this strategy, because it allows citizens to go on living their lives and reduces economic harm. With countries including the UK and France now contemplating a new wave of lockdowns and restrictions, governments might do well to consider the Swedish case. 

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