Predicting Infectiousness for Proactive Contact Tracing

The COVID-19 pandemic has spread rapidly worldwide, overwhelming manual contact tracing in many countries and resulting in widespread lockdowns for emergency containment. Various DCT methods have been proposed, each making tradeoffs between privacy, mobility restrictions, and public health. The most common approach, binary contact tracing (BCT), models infection as a binary event, informed only by an individual's test results, with corresponding binary recommendations that either all or none of the individual's contacts quarantine. BCT ignores the inherent uncertainty in contacts and the infection process, which could be used to tailor messaging to high-risk individuals, and prompt proactive testing or earlier warnings. It also does not make use of observations such as symptoms or preexisting medical conditions, which could be used to make more accurate infectiousness predictions. In this paper, we use a recently-proposed COVID-19 epidemiological simulator to develop and test methods that can be deployed to a smartphone to locally and proactively predict an individual's infectiousness (risk of infecting others) based on their contact history and other information, while respecting strong privacy constraints. Predictions are used to provide personalized recommendations to the individual via an app, as well as to send anonymized messages to the individual's contacts, who use this information to better predict their own infectiousness, an approach we call proactive contact tracing (PCT). Similarly to other works, we find that compared to no tracing, all DCT methods tested are able to reduce spread of the disease and thus save lives, even at low adoption rates, strongly supporting a role for DCT methods in managing the pandemic. Further, we find a deep-learning based PCT method which improves over BCT for equivalent average mobility, suggesting PCT could help in safe reopening and second-wave prevention. Until pharmaceutical interventions such as a vaccine become available, control of the COVID-19 pandemic relies on nonpharmaceutical interventions such as lockdown and social distancing. While these have often been successful in limiting spread of the disease in the short term, these restrictive measures have important negative social, mental health, and economic impacts. Digital contact tracing (DCT), a technique to track the spread of the virus among individuals in a population using smartphones, is an attractive potential solution to help reduce growth in the number of cases and thereby allow more economic and social activities to resume while keeping the number of cases low. All bolded terms are defined in the Glossary; Appendix 1.