Government officials rolling out the tools estimate it could take as long as a year for the contact tracing apps to be fully effective.
Apple and Google announced on Wednesday that their coronavirus tracking tools have launched -- putting their digital contact tracing efforts to a public test for the first time. Government agencies rolling out the apps will have to overcome challenges including adoption rates and privacy concerns surrounding the technology.
The tech companies said that 22 countries, along with several US states, have requested and received access to Apple and Google's exposure notification collaboration, which they first announced on April 13.
The states include North Dakota, Alabama and South Carolina, which are all at different stages of rolling out their contact tracing apps.
"As we respond to this unprecedented public health emergency, we invite other states to join us in leveraging smartphone technologies to strengthen existing contact tracing efforts, which are critical to getting communities and economies back up and running," North Dakota Gov. Doug Burgum said in a statement.
The new coronavirus, which causes a respiratory illness called COVID-19, spreads rapidly -- it's already infected more than 5 million people globally. People can spread the disease without ever knowing it, which is why government officials are looking at contact tracing as a possible solution. Notification about exposures will also be important as lockdowns are easing and experts warn of a "deadly resurgence" if restrictions lift too early.
"As we get back to more transmissible moments, more people going to restaurants and bars, if there was a breakout in one of those, we could anonymously notify people," Burgum said at a press conference on Wednesday. "This could be a super helpful tool for you."
Apple and Google's tools work through Bluetooth signals on devices, designed to detect who people have been in close contact with. The technology is supposed to help public health officials by allowing them to notify people if they've been in contact with someone who tested positive for COVID-19 and help stop the spread.
There are no identities or location data tied to these signals, and the software includes strict encryption standards for protecting privacy, Apple and Google said.
While Apple and Google are not creating the apps themselves, they are releasing the infrastructure that public health officials can build these tools on. The apps must be created by government officials, and are limited to one developer per country or state, Apple and Google said.
The tech giants said on Wednesday that they expect to grant access to the API to more states and countries in the coming weeks. That access comes with restrictions like blocking requests for location data and requiring consent to install the apps, the tech giants said.
"User adoption is key to success and we believe that these strong privacy protections are also the best way to encourage use of these apps," Apple and Google said. "Today, this technology is in the hands of public health agencies across the world who will take the lead and we will continue to support their efforts."
Privacy concerns are a major obstacle for every contact tracing app, because the tools rely on mass adoption for them to actually work.
North Dakota had its own app for several weeks called Care19, which only 4.4% of the state's population downloaded. That app was developed without Apple and Google's API, and will be renamed to "Care19 Diary" while the new app will use the tech giants' notification tools under the name "Care19 Exposure."
Gov. Burgum said at a press conference on Wednesday that it's expected to release in the next two weeks.
Getting people to download the new app will be a challenge for all government agencies. North Dakota's government didn't respond to a request for comment, but told MediaPost that it would be rolling out public service announcements about the app, as well as promotions during press conferences by the governor.
The app's developer, Tim Brookins, told CNET that Apple and Google's API needs a "much higher install rate" than the first version of Care19.
"The state has determined that an app like Care19 needs a significant amount of education to explain the value. It's not an app that you can just tell people to install," Brookins said in an email. "Governor Burgum views this as a 12-18 month challenge. If it takes a few months to get adoption up, he is fine with that."
Another challenge for Apple and Google's rollout will be testing capacity. Exposure notifications only work if you're able to get tested and learn that you have been infected with COVID-19. Testing for the disease is still limited in some states and can be flawed depending on what tests you're using.
Public health officials see digital contact tracing like what Apple and Google is supporting as a benefit, but it will only be successful if people want to use it and there's enough testing for the disease.
Early adoption rates of other contact tracing apps have been low, raising concerns about their efficacy in countries like Singapore. There are also issues with contact tracing scams, with the Federal Trade Commission warning of people looking to take advantage of the public health crisis.
Health officials are hoping adoption rates will increase with new public campaigns. Researchers from Oxford University found that contact tracing apps need about half the population to use them to be successful.
"It's still early days, but app-based exposure notification can potentially play an important role in local or national test-trace-isolate intervention strategies," Trevor Bedford, an associate member of the Vaccine and Infectious Disease division of the Fred Hutchinson Cancer Research Center, said in a statement.