TCN Coalition Member Spotlight: CoEpi

Our members are the heart of the Coalition, putting in the hard work to build the apps to help combat COVID-19 around the globe. We’re introducing a new series to spotlight our members and the work they are doing in exposure notifications technology, 

Meet Dana Lewis of CoEpi.

Which exposure notification app are you working on? 

CoEpi, which is an open-source Bluetooth proximity-based exposure alerting and symptom sharing app that provides a personal early warning system for detecting exposure to and helping reduce the spread of any infectious disease, such as influenza (flu) & COVID-19.

Is it out in the app stores, if not, when do you anticipate it being available? 

It’s currently in beta testing, with the goal to make it more widely available in the coming weeks. (Although anyone who is comfortable building from source code for iOS or Android is also welcome to test it!)

How did you get involved in creating an app focused on exposure notifications? 

We (Dana Lewis and Scott Leibrand) began discussing in February what we could do as individuals to help reduce our risk of getting or transmitting COVID-19, and how we could leverage our skills and experience to help others do the same. We recognized early on that testing and traditional contact tracing would be crucial for reducing the spread of COVID-19 across the entire population, but we wanted to also build a tool to empower individuals to better protect themselves. We envisioned a tool that would let individuals better manage interactions and exposures around COVID-19 and other transmissible diseases, like flu. We began working on exposure notification technology in late February as a result – and teamed up with Covid Watch early on to implement the technology as a shared library so others could also do open source, privacy-preserving exposure notifications, which later led to TCN. 

From our initial discussions we realized that while most others would focus on notifying about exposures based on confirmed test results, there was a benefit and opportunity to focus our efforts on anonymous symptom sharing based exposure notifications. Individuals who receive symptom reports via symptom-based exposure alerts can choose to adjust their behaviors – anything from being more diligent about mask-wearing to choosing to limit interactions in the community – more quickly than the typical timeline for receiving an exposure alert from a confirmed test result of COVID-19, especially given the limitations around testing access in many communities. 

What’s your role in the team? What do you do at CoEpi?

I’m one of the co-founders (along with Scott Leibrand), and I do a little bit of everything – project management, outreach and communications, helping with development and supporting our developers and designers, etc. I have previous experience leading an open-source technology/health project, so I’ve applied everything I learned from the first years of OpenAPS (an open-source diabetes project) to aid the community as we develop the CoEpi app. 

How big is the team you’re working with to create this tool? Do you anticipate growing the team? 

CoEpi is an open-source project – there’s no organization behind it, so we have a diverse set of volunteers ranging from developers to designers who are all kindly helping us build it! We have a few dozen active volunteers at any given time and are always looking for more volunteers (especially experienced iOS, Android, or Rust developers) who would like to become open-source contributors (you can fill out this form to let us know if you’d like to get involved).

What do you see as the biggest hurdle to consumer adoption for your app and how do you plan to overcome it? 

We are not focused on large scale consumer adoption. CoEpi is designed to be useful for individuals and the small communities around them, such as their family and friends circle or a group of coworkers. If individuals who are at higher risk for worse outcomes from COVID-19 are able to use this app to help them adjust behaviors and mitigate risks as communities reopen, then CoEpi will be a success, whether that means 50, 500, or 5,000+ clusters are using the app. 

Are you working with any governments or corporations to help with EN? If so, what can you share about the experience? Insights? Challenges? Accomplishments?  

We are not directly working with any governments or corporations at this time. We would like them to consider adding symptom reporting for the reasons described above, in addition to doing exposure notifications on confirmed test results, which many of them are focusing on. 

One observation we have based on dozens of conversations in the past few months is that many organizations or government representatives seem to be worried most about over-notification – at the risk of halting all exposure notification. While there is a risk of over-notification and notification fatigue for individuals depending on how this type of technology is deployed, the risk of COVID-19 and the cost of COVID-19 spreading across our communities is significant. Since nearly everyone is now highly aware of the health risks of every interaction, it’s likely that individuals who choose to download an exposure notification app will find it useful to be informed of situations in which they should be particularly careful. We also need to be sensitive to differences across communities: in those where testing is not widely available and accessible, and/or those that have a low level of trust in public health or local governments who might not feel safe coming in to get tested, there is an even bigger need for any exposure notification technology to be privacy-preserving and anonymous. Ideally, exposure notification should be available to everyone, even without government interaction. 

Do you have any predictions on exposure notifications, both in the short-term and long term as we continue to overcome COVID-19? 

Exposure notification technology can be used to halt the spread of other transmissible diseases, too – like flu. Flu was often what people compared COVID-19 to in early discussions as more people began learning about COVID-19, and many of the public health approaches we are focusing on for COVID-19 will also help reduce the severity of the upcoming flu season. Similarly, exposure notification technology based on symptom sharing, such as CoEpi is doing, can also help us reduce the spread of flu. It’s important not to legislate or mandate restrictions of this technology, such as requiring apps to stop using exposure notification technology after the COVID-19 pandemic ends: this technology can and should remain available as a tool to help communities reduce the spread of other diseases as well. 

Is your team solely focused on creating an app, are you providing Professional Services to Public Health Authorities (e.g. customization of the app, running the servers to support the app, etc.), or are you doing both?

We have focused heavily on creating the technology (both the Bluetooth proximity detection and the exposure notification and matching, which became the TCN protocol) and developing a user-focused app that allows anonymous symptom reporting and alerting. We plan to make this available to any individual who wants to use it worldwide, but also have ideas for how organizations, institutions, and specific communities could leverage the CoEpi code. We specifically made the app open source in order to allow such groups to create a custom version if they’d like, for example with customized information and recommendations about what that particular community should do for various types of exposure notifications. We are happy to partner with and support or advise organizations that would like to do this.