Digital Exposure Notification Tools: A Global Landscape Analysis
Authors: Nebeker Camille , Kareem Daniah , Yong Aidan , Kunowski Rachel , Malekinejad Mohsen , Aronoff-Spencer Eliah 
Published: June 2022

AbstractBackgroundAs the COVID-19 global pandemic continues, digital exposure notification systems are increasingly used to support traditional contact tracing and other preventive strategies. Likewise, a plethora of COVID-19 mobile apps have emerged.ObjectiveTo characterize the global landscape of pandemic related mobile apps, including digital exposure notification and contact tracing tools.Data Sources and MethodsThe following queries were entered into the Google search engine: “(*country name* COVID app) OR (COVID app *country name*) OR (COVID app *country name*+) OR (*country name*+ COVID app)”. The App Store, Google Play, and official government websites were then accessed to collect descriptive data for each app. Descriptive data were qualified and quantified using standard methods. COVID-19 Exposure Notification Systems (ENS) and non-Exposure Notification products were categorized and summarized to provide a global landscape review.ResultsOur search resulted in a global count of 224 COVID-19 mobile apps, in 127 countries. Of these 224 apps, 128 supported exposure notification, with 75 employing the Google Apple Exposure Notification (GAEN) app programming interface (API). Of the 75 apps using the GAEN API, 15 apps were developed using Exposure Notification Express, a GAEN turnkey solution. COVID-19 apps that did not include exposure notifications (n=96) focused on COVID-19 Self-Assessment (35·4%), COVID-19 Statistics and Information (32·3%), and COVID-19 Health Advice (29·2%).ConclusionsThe digital response to COVID-19 generated diverse and novel solutions to support non-pharmacologic public health interventions. More research is needed to evaluate the extent to which these services and strategies were useful in reducing viral transmission.Research in ContextEvidence before this studyThe COVID-19 pandemic created a role for technology to complement traditional contact tracing and mitigate the spread of disease. How countries responded with technology - specifically, how they utilized mobile apps to support public health was a focus of this research. The search process consisted of searching the Google Search Engine using queries “(*country name* COVID app) OR (COVID app *country name*) OR (COVID app *country name*+) OR (*country name*+ COVID app).” Apps that were found on the App Store, Google Play, and official government format that fit the pre-defined eligibility criteria were included in the Apps list considered in this search. Apps that did not match those criteria were excluded from the process. All 195 countries and associated COVID-19 apps were considered for inclusion if they were official COVID-19 apps adopted by the governments of those countries.Added value of this studyFindings from this research contributes to the literature by providing a synthesis of how technology is being used to support public health authorities in reducing the spread of COVID-19. The results of this global landscape analysis of COVID 19 mobile apps, included both COVID-19 Exposure Notification Apps and non-Exposure Notification Apps.Implications of all the available evidenceThe findings of this research can provide the foundation for future studies to assess adoption rates and, subsequently identify app features that lead to increased adoption of both Exposure Notification and non-Exposure Notification Apps. Only when a product meets the needs of consumers will it be adopted and utilized, and in the case of exposure notification tools, save lives.Eligibility CriteriaThe study eligibility criteria included any COVID-19 mobile applications and COVID-19 Exposure Notification (EN) systems that were downloadable or activated on a mobile device. The search process involved using queries “(*country name* COVID app) OR (COVID app *country name*), OR (COVID app *country name*+) OR (*country name*+ COVID app)” in Google search engine to identify COVID-19 apps in each country. The data included active and inactive apps discovered during the data collection period of June 2021 - July 2021.