# From Symptom Tracking to Contact Tracing:
## 4 Discussion  
The framework utilized in this paper, derived from the M-Health Index and Navigation Database (MIND) at apps.digitalpsych.org, prompts users to consider various dimensions of the COVID-19 app space: app accessibility, app origin, app functionality, app features and app use, and privacy and \begin{table}
\begin{tabular}{c c} \hline \hline
**Privacy Policy** & **51** \\ \hline Declare data use/purpose & 45 \\ Security measures & 35 \\ Personal health information shared & 13 \\ De-identified data shared & 8 \\ Anonymized/aggregated data shared & 18 \\ Opt out of data collection & 8 \\ Delete your data & 21 \\ User data stored only on device & 35 \\ User data stored on server & 11 \\ Crisis management feature & 0 \\ Claim to meet HIPAA & 4 \\ Average reading level (avg) & 11.7 \\ App uses third party vendors & 36 \\ \hline \hline \end{tabular}
\end{table} 
Table 2: Privacy Policies for Non-Contact-Tracing Apps (\(N=65\)). HIPAA, Health Insurance Portability and Accountability Act. \begin{table}
\begin{tabular}{c c} \hline \hline
**Privacy Policy** & **12** \\ \hline Declare data use/purpose & 11 \\ Security measures & 9 \\ Personal health information shared & 7 \\ De-identified data shared & 2 \\ Anonymized/aggregated data shared & 5 \\ Opt out of data collection & 2 \\ Delete your data & 6 \\ User data stored only on device & 4 \\ User data stored on server & 8 \\ Crisis management feature & 0 \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Privacy Policies for Contact-Tracing Apps (\(N=12\)). security. Our results revealed high heterogeneity of these apps, as well as propose considerations for the next generation of these tools. While smartphone apps continue to assume new roles in the international response to COVID-19, our results suggest their purpose is still evolving. Our findings of 20% turnover of these apps within one month as well as changes in functions offered by newer apps highlight the dynamic nature of digital health marketplaces, as apps try to evolve to the changing needs. In contrast to this change, we noticed few differences concerning privacy flaws in these apps, with equal concerns for both contact tracing and non-contact-tracing apps. As these apps continue to evolve to meet the global needs, our results highlighted trends towards more comprehensive apps with features ranging from educational resources and updated statistics to local news and governmental updates and a need for both stronger privacy policies that protect users' data and more educational material and resources to support users' mental health. In terms of app accessibility, we found a significant portion of the top 100 COVID-19 apps to be inaccessible to the general public, which may indicate great confusion for a user that stems from the oversaturation of the app space, with so many COVID-19 apps returned in a search. It also raises questions about how research in the space is being disseminated and translated to the broader public, since so many of the top-returned apps from the U.S. store were not actually available in the United States, making it difficult for an individual searching in the app store to come across a research-supported and available app. Utilizing the framework, we found that the majority of apps in the COVID-19 space are being created by the government, with an upsurge of apps created by for-profit or individual developers in the past month. However, with the exception of non-profit apps being more likely to offer symptom tracking or participation in a research study, we found no strong correlation between the origin of the apps and the presence of certain features or privacy policies, which may indicate a more uniform response among the different types of developers.