Background

The novel coronavirus or COVID-19 was declared a pandemic by the World Health Organization on March 11th, 2020 (World Health Organization, 2020). The COVID-19 virus transmits early in its life cycle relative to other coronaviruses, (e.g., SARS), during which time many individuals present as asymptomatic (Zhou et al., 2020). In many countries, including the United States and the UK, COVID-19 has spread at an exponential rate (see Figure 1). As of 07/05/2020, the number of deaths attributed to COVID-19 worldwide stands at 263,501.

Figure 1. Cumulative cases of COVID-19 by country. Note, Australia, New Zealand and Taiwan appear identical when plotted on this scale.

Figure 1. Cumulative cases of COVID-19 by country. Note, Australia, New Zealand and Taiwan appear identical when plotted on this scale.

In Australia, lock down measures and physical distancing have already had an impact on the spread of COVID-19, slowing the rate of transmission and helping to “flatten the curve” - the process of slowing the exponential transmission rate of the virus (blue line, Figure 2). Fortunately, Australia’s intensive care units have not been overwhelmed by COVID-19 cases, ensuring that those who show signs of respiratory distress can get access to life saving interventions (red line, Figure 2).

Figure 2. COVID-19 cases and deaths in Australia. Key dates relating to COVID-19 and Australian Government policies are labeled. Waves 1, 2, and 3 of the current study are illustrated in green. COVIDSafe app launch is highlighted in yellow.

Figure 2. COVID-19 cases and deaths in Australia. Key dates relating to COVID-19 and Australian Government policies are labeled. Waves 1, 2, and 3 of the current study are illustrated in green. COVIDSafe app launch is highlighted in yellow.

Although Australia is working hard to flatten the curve, it is unclear whether current government policies will be effective as non-essential individuals re-enter the workforce and face the prospect of a second outbreak of COVID-19, (e.g., Singapore). The moderate to high transmissibility of this virus has required governments to consider technological solutions to prevent further transmissions. Indeed, the nature of the COVID-19 pandemic may require governments to use big data technologies to help contain its spread (Bonsall, Parker, & Fraser, 2020).

On April 26th 2020, the Australian Government released its own contact tracing app: ‘COVIDSafe’. The COVIDSafe app uses Bluetooth technology to establish an anonymous contact registry to identify which phones (and people) you have been collocated with and for how long. If a user voluntarily self-identifies as testing positive to COVID-19, they may upload their contact registry to a centralised repository only accessible by the Health Department. Contact tracers will then distribute alerts to those individuals who have been collocated with this individual for a period of 15 minutes or longer within the time-frame that individual was considered to be contagious. Every 21 days, your encrypted COVIDSafe ids are deleted off your phone, preserving your privacy. Only data from the past 21 days can be uploaded via the app if you report as testing positive to COVID-19.

The effectiveness of the COVIDSafe collocation tracking relies on the willingness of the population to support such measures, implying that government policy-making should be informed by the likelihood of public compliance. Estimates of the necessary compliance for COVIDSafe to work effectively range from 40-60% of the population. Gaining the social license - broad community acceptance beyond formal legal requirements - for collocation tracking requires the perceived public health benefits to outweigh concerns of personal privacy, security, and any potential risk of harm.

Results

Status of the initial data collected

The results presented in this preliminary report represent a snapshot from 536 participants collected on the 05-07-2020 during the third wave of data collection for the project ‘Establishing the social licence for Government tracking in Australia’.

The reported representative sample was gathered through the data collection platform Dynata. 500 participants reported their demographics and their perceived severity of the COVID-19 outbreak in Australia and around the world. They then viewed a description of the COVIDSafe app, before answering questions about their attitudes towards the app. Finally, participants responded to questions about the introduction of a theoretical immunity passport and their world views.

Notes on cleaning the data.

  1. Of the initial 536 participants collected, 7 participants were removed prior to analysis for indicating a country of residence other than Australia.
  2. A further 2 participants were removed prior to analysis for indicating they were below the age of 18.
  3. An additional 67 participants did not pass the attention check.
  4. Finally, 21 participants began and did not complete the survey.

After cleaning the data for the above participants, the final sample at analysis was 439 participants.

Descriptive Statistics

Gender was evenly divided between men (49%) and women (51%), and 93% of participants reported that they currently use a smartphone. Within our sample, participants most frequently reported as having a university education (49%) or a higher school education (41%). Ages ranged from 18 years to 84 years (M = 47 years, SD = 17 years). The distribution of reported ages was roughly uniform within the age range 20–80, and under represented for ages 80+.

Gender identification: Percentages
 Percent 
 Gender 
   Men  49.0
   Women  50.8
   Other  0.2
   Prefer not to say 
   #Total cases  439
Level of education: Percentages
 Percent 
 Education 
   Did Not Graduate High School  10.5
   Graduated High School  40.5
   Graduated University  49.0
   #Total cases  439

Impacts of COVID

Participants reported as being under lock down for an average of 24 (SD = 25) days, with the most frequent amount of time in lock down reported as 0 days (n = 127, 29%). 17% of participants reported as having lost their job due to COVID-19. The most common source of COVID-19 information came from TV (57%) and newspaper (15%), followed by social media (13%). Of the 439 participants, 7 (2%) reported that they had tested positive with COVID-19, and 36 (8%) indicated they knew someone who had tested positive with COVID-19.

I have lost my job: Percentages
 Percent 
 I lost my job 
   No  82.9
   Yes  17.1
   #Total cases  439
Information source: Percentages
 Percent 
 Information source 
   Newspaper (printed or online)  15.5
   Social media  12.8
   Friends/family  2.5
   Radio  5.7
   Television  57.2
   Other  2.7
   Do not follow  3.6
   #Total cases  439
Somebody I know tested positive for COVID-19: Percentages
 Percent 
 Tested pos someone I know 
   No  91.8
   Yes  8.2
   #Total cases  439

Compliance with COVID Restrictions

When asked what percentage of the population was complying with government policies regarding social distancing, the average estimate was 73% (SD = 21%; see below figure). When asked if they were complying with Governmental lockdown policies, 72% of participants indicated that they were either completely complying or going beyond policy suggestions. 0% indicated they were not complying at all, while 28% indicated some degree of partial compliance.

Perceived Risk of COVID

We asked participants about the perceived risk COVID-19 poses for themselves and those around them. Responses were made on a likert scale with values:

  1. Not at all,
  2. Slightly,
  3. Somewhat,
  4. Very,
  5. Extremely.

When asked about COVID-19 within the Australian population, participants most frequently reported the virus to be moderate in severity and that the virus posed a ‘somewhat’ or ‘very’ harmful risk to their personal health. 95% of participants reported the virus to be at least ‘a little severe’ (2) for the population and at least ‘a little harmful’ (2) to their health.

When asked about their concern over testing positive to COVID-19, responses were skewed and participants reported as being less concerned than during previous assessments. When asked about their concern over someone they know testing positive to COVID-19, participants responses were negatively skewed. This indicates a bias towards concern over others in their community, such as the elderly or nurses and doctors, testing positive to COVID-19. This trend has remained stable across our three waves of data collection. A strong correlation was observed between concern for others and concern for self (r = .79), and between risk of personal harm and concern for self (r = .64).

Finally, we asked participants to report their estimates on the number of fatalities across a range of countries with moderate-to-high media coverage in Australia. Responses were made on a sliding scale ranging from 0 - 50,000; results are reported in estimated deaths per 1000 (see violin plot).

The COVIDSafe App

COVIDSafe - App Perception

The Australian Government has recently released the COVIDSafe smartphone app to trace the spread of COVID-19. We asked participants to assess their understanding of the COVIDSafe app, before presenting them a factual description of the app.

When asked what technology does the COVIDSafe smartphone app use, 60% of participants responded Bluetooth, 19% responded Location data, 5% responded Mobile phone tower, and 16% responded that they did not know. In a later section of the survey, we ask if participants have downloaded the COVIDSafe app - we will now report the same results broken down by those who have and have not downloaded the app.

Of the 439 participants, 44% did download the COVIDSafe app. Of these participants, 81% reported that the app uses Bluetooth, 11% location data, 4% mobile network data, and 4% reported that they did not know.

Of the 439 participants, 56% did not download the COVIDSafe app. Of these participants, 43% reported that the app uses Bluetooth, 25% location data, 6% mobile network data, and 26% reported they did not know.

COVIDSafe - App Description

Participants were provided the following description of the COVIDSafe app before they proceeded to answer the remaining survey questions.

“The COVID-19 pandemic has rapidly become a worldwide threat. Containing the virus’ spread is essential to minimise the impact on the healthcare system, the economy, and save many lives. The Australian Government has recently released the COVIDSafe smartphone app to help identify and contact those who may have been exposed to people with COVID-19. The use of this app is completely voluntary, but the government has explicitly stated that easing social distancing restrictions depends at least in part on the degree of community uptake of this voluntary app. This is because, the more people that download and use this app the more effectively it will help to contain the spread of COVID-19. The app works with bluetooth and no location data is collected: when two people are near each other, their phones connect and keep a record of all these connections. If a person is later identified as being infected, that person may voluntarily upload their bluetooth contacts to a secure server accessible only to the Health Department of the Australian Government. This data would only be used by the Health Department of the Australian Government to contact those who might have been exposed to COVID-19.

COVIDSafe - The Current Effective Use

44% of participants downloaded the COVIDSafe app, however, downloads do not always translate to effective usage. We examine whether these participants:

  1. Are registered on the app?
    • Yes 90%
    • No 4%
    • Don’t know 6%
  2. Keep the app installed on their phone?
    • Yes 96%
    • No 4%
  3. Keep Bluetooth on?
    • Yes 77%
    • Only when I leave the house 15%
    • No 5%
    • I don’t know 3%
  4. Have the app downloaded, are registered and have bluetooth switched on?
    • Yes 76%
    • Only when I leave the house 15%
    • No 7%
    • I don’t know 3%
  5. Would upload their data if they tested positive to COVID-19?
    • Yes 99%
    • No 1%
  6. Have tried to share the app with others?
    • Yes 58%
    • No 42%

Our findings suggest that up to 91% of COVIDSafe app users are registered & have bluetooth switched on when they leave the house and interact with members of the general public. Although only 2% of our sample have received a COVID-19 diagnosis, 99% indicated they would upload their contact information through COVIDSafe if they were diagnosed with the virus. 58% of COVIDSafe users have tried to share the app with others.

COVIDSafe - Reasons for downloading the app

It is important to understand why individuals choose to download and use the COVIDSafe app. Below, we present the results of a rank ordered question set where participants indicated from most-to-least those factors that convinced them to download COVIDSafe. Options included:

  1. To return to normal activities
  2. To protect my health
  3. To protect the health of others
  4. To follow Government recommendations
  5. To help the economy

In general, we observe that participants were most motivated to download the app so as to return to normal activities, and then to protect their health and the health of others. Participants were least motivated by the prospect of helping the economy, and only slightly more motivated by Government recommendations.