The situation in Italy remains one of the most under control and from which, eventually, to take inspiration. In fact, it seems that (slowly) Italy is seeing some daylight; so much so that the “calculated risk” of the second step of reopening has officially begun; one in which bars and restaurants reopen their doors, even if faced with very tight restrictions such as plexiglas dividers and social-distancing.

The Italian government, among its various attempts to avoid a second wave, is promoting an app for download on smartphones, called “AppImmuni” (the “Immuni” app). Let’s see what it’s all about.

We should begin by saying that the idea of the app was formed in the East and has already been adopted in China, Hong Kong, South Korea and Singapore — in more or less restrictive forms. Europe (and also the United States) is adopting a similar solution that adapts to the needs of the various cultures and laws of the different countries. “AppImmuni” is a technological solution, selected by Italy, that’s based on an application that must be installed on smartphones.

The “Immuni” app’s main characteristics

The main features of “AppImmuni” are based on a very simple concept — which we can sum up as follows:

  • The application aids in notifying the user of the risk of infection at a very early stage
  • The user, in case he or she has been in contact with infected people, can isolate him-or-herself, in order to avoid infecting other people
  • If the user is notified that he or she has come into contact with infected individuals, then he or she will be able to consult his or her attending physician at an early stage, in order to reduce the risk of continued exposure

In order to respect users’ privacy, “AppImmuni” is based on Bluetooth Low Energy (BLE) technology and saves the user’s data on their own device, assigning them a temporary ID, which will change frequently and will be shared via Bluetooth with nearby devices. Its function is therefore to track contacts that the user has had in the last 14 days, and if, among his or her saved contacts, someone has tested positive for SARS-CoV-2, they are to be notified (in order to take their own isolation measures independently and to seek advice from a Physician) if the symptoms are serious. Finally, please note that downloading the app is not mandatory for all Italians.

However, several questions still have yet been answered.

The 3Ts and privacy

How can the success of the new 3T concept (Testing, Tracing, and Treating) be guaranteed?

The 3 Ts mean Testing, Tracing, and Treating. Starting with the testing (i.e. test), it’s clear that only those who will have symptoms that lead them to require the intervention of a Physician, can be reported by the app. However, how can we avoid false positives? That is, those who have flu-like symptoms that can be mistaken for COVID-19? The answer is only found by taking a swab. This assumes that hospitals are prepared to accommodate an unspecified number of people and receive swabs (and especially SARS-CoV-2 detection kits), and these kits are currently a limiting factor.

As far as tracing is concerned, the “Immuni” app should take care of this, while respecting Italians’ privacy. Also, in this case, it’s not clear whether the technology based on Bluetooth is actually precise enough to ensure the traceability of contacts, the duration of contact, and how often contact occurred (or will occur) between the same devices.

But perhaps the most painful point is the treating (i.e. treatment). Once the user has been notified by the app that he or she has had fairly close contact with a person who turned out to be positive, the user receives only recommendations (i.e. it is at his or her discretion, whether to isolate him-or-herself and consult his or her Doctor). Self-isolate for 14 days… but where? In his or her home, where s/he probably lives with other people who should isolate themselves, regardless of whether they’ve downloaded the application (remember that downloading it is only voluntary). Therefore, it will take a considerable amount of civic responsibility and respect for the health of others for this application to be of real help.

The success of traceability applications in East Asian countries is derived from the fact that in some cases, its adoption had been mandatory and that generally; the respect of the rules is very strong, thus facilitating the effectiveness of the technological tool that would otherwise remain an end in itself.

Experts agree that the effectiveness of this app would be tangible only if at least 60% of Italians would download and use it continuously; in fact, it’s not enough just to download it, but you must also keep your smartphone and its Bluetooth “On”.

The greatest doubts are related to the fact that such an application could lead to a limitation of individual freedoms, in favor of the good of the community — which not everyone perceives as a priority, especially with the quick approach of summer. I am studying incentives; for example, a lottery that would encourage people to download the “Immuni” app.

The challenge is therefore not only technological, in order to guarantee a useful, effective and privacy-friendly application, but above all, in terms of communication and image; so as to persuade people to make an effort for the good of all, even at the cost of giving up their holidays, in order to isolate themselves.

This post is also available in: Italiano

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