Thirumala-Devi Kanneganti led Team Develops Potential Strategy to Deal with COVID-19 Symptoms

A team led by Thirumala-Devi Kanneganti, vice chair of the St. Jude Department of Immunology, identified a previously unknown interaction between two messenger proteins that can unleash a cascade of inflammatory cell death, leading to tissue damage and multiple organ failure. The team also reported that two existing drugs based on neutralizing antibodies appear to disrupt this deadly process.

The study, published online in the journal Cell, comes as researchers around the globe race to develop therapies and vaccines to staunch a pandemic that, in less than one year, has killed some 1.2 million people and sickened millions more. With effective treatment options currently limited, doctors often rely on supportive care, including supplemental oxygen and mechanical breathing assistance, in their efforts to save patients.

“Understanding the pathways and mechanism driving this inflammation is critical to develop effective treatment strategies,” said Kanneganti, who was corresponding author of the study. “This research provides that understanding.”

The scientists, led by Thirumala-Devi Kanneganti, vice chair of immunology at St. Jude Children’s Research Hospital in Memphis, Tennessee, identified the drugs after discovering that the hyperinflammatory immune response associated with Covid-19 leads to tissue damage and multi-organ failure in mice by triggering inflammatory cell death pathways, the report said.

“Understanding the pathways and mechanism driving this inflammation is critical to develop effective treatment strategies,” Kanneganti, who was born in Telangana and earned her undergraduate degree at Kakatiya University in Warangal, said in the report.

“This research provides that understanding. We also identified the specific cytokines that activate inflammatory cell death pathways and have considerable potential for treatment of Covid-19 and other highly fatal diseases, including sepsis,” she said in the report.

Kanneganti worked with Bhesh Raj Sharma, Rajendra Karki and others at her lab for the research that helps increase understanding of the pathways and mechanism that drives COVID-19 inflammation so researchers can develop effective treatment strategies, it said.

The infection is marked by increased blood levels of multiple cytokines. These small proteins are secreted primarily by immune cells to ensure a rapid response to restrict the virus. Some cytokines also trigger inflammation, the release notes.

Kanneganti’s team focused on a select set of the most elevated cytokines in COVID-19 patients. The scientists showed that no single cytokine induced cell death in innate immune cells, it said.

The investigators showed that blocking individual cell death pathways was ineffective in stopping cell death caused by TNF-alpha and IFN-gamma, according to the report.

“The findings link inflammatory cell death induced by TNF-alpha and IFN-gamma to COVID-19,” said Kanneganti. “The results also suggest that therapies that target this cytokine combination are candidates for rapid clinical trials for treatment of not only Covid-19, but several other often fatal disorders associated with cytokine storm,” she said.

The work by Kanneganti’s team focused on cytokines, tiny proteins secreted primarily by immune cells. Infections involving SARS-CoV-2 — the virus that causes COVID-19 — can lead to increased blood levels of cytokines.

These proteins sometimes cause inflammation, and when they flood the bloodstream in dramatically increased levels, lead to what researchers call a “cytokine storm.” Other life-threatening disorders such as sepsis and hemophagocytic lymphohistiocytosis (HLH) can lead to the same immune system overreaction. But the exact pathways initiating the cytokine storms and subsequent inflammation have remained a mystery.

To find them, Kanneganti and her team examined the cytokines most often present in elevated levels in COVID-19 patients. After finding that no single cytokine caused cell death, the scientists tested 28 combinations of the proteins and discovered that just one pair, working together, did induce inflammation and tissue damage mirroring the symptoms of COVID-19.

Researchers further concluded that existing drugs, Remicade and Gamifant, which are used to treat such inflammatory diseases as Crohn’s disease and colitis prevented COVID-19 complications in laboratory models.

“The results also suggest that therapies that target this cytokine combination are candidates for rapid clinical trials for treatment of not only COVID-19, but several other often fatal disorders associated with cytokine storm,” Kanneganti said.

The study’s co-first authors are Rajendra Karki, PhD, and Bhesh Raj Sharman, PhD, of the Kanneganti laboratory. The other authors are Shraddha Tuladhar, Parimal Samir, Min Zheng, Balamurugan Sundaram, Balaji Banoth, R. K. Subbarao Malireddi, Patrick Schreiner, Geoffrey Neale, Peter Vogel and Richard Webby, of St. Jude; and Evan Peter Williams, Lillian Zalduondo and Colleen Beth Jonsson, of the University of Tennessee Health Science Center.

The research was supported in part by a grant from the National Institutes of Health (NIH); and ALSAC, the fundraising and awareness organization for St. Jude.

Beyond Covid-19, A Book By Dr. Chalil & Ambassador Kapur Is Now On “Amazon Best Sellers List”

(New York, NY: November 29th, 2020) Beyond the COVID-19 Pandemic: Envisioning a Better World by Transforming the Future of Healthcare, authored by Ambassador Pradeep Kapur, a practitioner of Public Policy, and Dr. Joseph Chalil, an expert in healthcare policy, is now on Amazon’s Best Sellers List.

Around the world, providing quality and affordable healthcare remains a challenge. As the COVID-19 pandemic began, it quickly became apparent that public policy and current healthcare systems were ill-prepared to deal with the challenges. Ambassador Kapur and Dr. Chalil discuss the lessons learned and the way ahead in the book, Beyond the COVID-19 Pandemic: Envisioning a Better World by Transforming the Future of Healthcare.

The authors offer sustainable and revolutionary solutions to change healthcare delivery in the United States and a model for other countries. With a combination of a public SafetyNet and free-market competition, they offer their “Grand Plan.” The advances and adoption of current and new technology will revolutionize the field of healthcare. They offer critical strategies that countries can adopt during natural disasters, wars, or a pandemic.

The authors focus on breaking the chain of employer-based health insurance, where your health insurance is not tied to your employment. Too often, the benefits of providing healthcare for all is lost in discussions about health insurance. Yet, this book does not allow these issues to control the analysis of healthcare delivery.

This book offers practical solutions, addressing citizens’ needs now and into the future while empowering them to be more responsible for their health. As envisioned by the authors, the emerging global scenarios address healthcare needs, education, and sustainable lifestyle choices, reducing the need for more intensive and costly interventions to improve the overall quality of life. There is a roadmap for U.N. and WHO, which are not living up to their initial promise, beyond just reform. They challenge the world to have the political consensus to create meaningful change for all, both in the United States, the United Nations, and around the globe.

The COVID-19 pandemic has made it clear that ensuring affordable and timely access to health care is a priority for all. It has shown us the limitations of each country in combating a healthcare crisis like the one we are experiencing today. As the pandemic began, it quickly became apparent that public policy and current healthcare systems were ill-prepared to deal with a pandemic’s challenges. Providing quality and affordable healthcare remains a challenge.

Esteemed personalities worldwide have much acclaimed the timely and insightful edition of the book released in October this year. Gurudev Sri Sri Ravi Shankar, a globally revered spiritual and humanitarian leader, wrote: “Ambassador Pradeep Kapur and Dr. Joseph Chalil discuss the lessons learned in the book, Beyond the COVID-19 Pandemic: Envisioning a Better World by Transforming the Future of Healthcare. The authors offer sustainable and revolutionary solutions to change healthcare delivery in the United States and a model for other countries. With a combination of a public SafetyNet and free-market competition, they offer their “Grand Plan.” The advances and adoption of current and new technology will revolutionize the field of healthcare. They offer critical strategies that countries can adopt during natural disasters, wars, or a pandemic.”

The authors are will donating the profits from the sale of their book to AAPI Charitable Foundation and WHEELS!

Ambassador Pradeep Kapur is an acknowledged “luminary diplomat,” with a distinguished career working with leaders and policymakers in different continents of the world: Asia, Africa, Europe, North America, and South America. He was the author and editor of many books. Kapur was Ambassador of India to Chile and Cambodia and Secretary at the Indian Ministry of External Affairs before joining as an academic in reputed universities in the USA and India. A graduate of the globally acclaimed Indian Institute of Technology, Delhi (IIT-D), he is Executive Director of Smart Village Development Fund (SVDF); International Economic Strategic Advisor, Intellect Design Arena; and Chairman, Advisory Council, DiplomacyIndia.com. His healthcare contributions include setting up of BP Koirala Institute of Health Sciences in Eastern Nepal, which is acclaimed as an exemplary bilateral India Nepal initiative.

Dr. Joseph Chalil, an author of several scientific and research papers in international publications, is the Chairman of the Complex Health Systems Advisory Board, H. Wayne Huizenga College of Business and Entrepreneurship at Nova Southeastern University in Florida and a member of Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD) Executive Leadership Council. A veteran of the U.S. Navy Medical Corps, he is board certified in healthcare management. He has been awarded a Fellowship by the American College of Healthcare Executives, an international professional society of more than 40,000 healthcare executives who lead hospitals, healthcare systems, and other healthcare organizations. Dr. Chalil is the Chairman of the Indo American Press Club (IAPC). He is an expert in U.S. healthcare policy and a strong advocate for patient-centered care. With years of experience working in the U.S. healthcare system, he discusses healthcare delivery challenges, including providing quality, affordable patient care to all and alternate templates for health insurance.

The authors challenge the world to have the political consensus to create meaningful change for all, both in the United States, the United Nations, and around the globe. For more information, please visit https://beyondcovidbook.com.

Study Finds, Essence Of Person Remains Same Throughout One’s Life

In a unique study, researchers have now shown that the essence of on individual remains largely stable over the years. “In our study, we tried to answer the question of whether we are the same person throughout our lives,” said study author Miguel Rubianes from the Complutense University of Madrid (UCM) in Spain. “In conjunction with the previous literature, our results indicate that there is a component that remains stable while another part is more susceptible to change over time,” Rubianes added.

The ‘continuity of the self’ — the capacity for self-awareness and self-recognition– remains stable whereas other components such as physical aspects, physiological processes and even attitudes, beliefs and values are more liable to change.

Even components such as personality traits tend to change slightly over the years, but “the sense of being oneself is preserved, improving our understanding of human nature,” Rubianes said.

The study, published in Psychophysiology, also determined how long it takes the brain to recognize our own personal identity as distinctive compared to others: around 250 milliseconds. To carry out this study, the brain activity and event-related brain potentials of twenty participants were recorded by electroencephalography (EEG) when presented with stimuli and performing identity and age recognition tasks.

The research has revealed that the essence of our being remains largely stable over the years. “This study demonstrates the importance of basic and clinical research alike in the study of the role of personal identity, and may play a fundamental role in psychological assessment and intervention processes,” Rubianes noted. (IANS)

Fauci Warns, US May See ‘Surge Upon Surge’ Of Virus In Weeks Ahead

The nation’s top infectious disease expert said Sunday that the U.S. may see “surge upon a surge” of the coronavirus in the weeks after Thanksgiving, and he does not expect current recommendations around social distancing to be relaxed before Christmas.

Meanwhile, in a major reversal, New York City Mayor Bill DeBlasio said the nation’s largest school system will reopen to in-person learning and increase the number of days a week many children attend class. The announcement came just 11 days after the Democratic mayor said schools would shut down because of rising COVID-19 cases.

“We feel confident that we can keep schools safe,” he said.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told ABC’s “This Week” that the level of infection in the U.S. would not “all of a sudden turn around.”

“So clearly in the next few weeks, we’re going to have the same sort of thing. And perhaps even two or three weeks down the line … we may see a surge upon a surge,” he said.

Fauci addressed the school issue, saying that spread “among children and from children is not really very big at all, not like one would have suspected. So let’s try to get the kids back, but let’s try to mitigate the things that maintain and just push the kind of community spread that we’re trying to avoid,” he said.

Fauci also appeared on NBC’s “Meet the Press,” where he made similar remarks, adding that it’s “not too late” for people traveling home after Thanksgiving to help curb the virus by wearing masks, staying distant from others and avoiding large groups of people.

The number of new COVID-19 cases reported in the United States topped 200,000 for the first time Friday, according to data from Johns Hopkins University. Since January, when the first infections were reported in the U.S., the nation’s total number of cases has surpassed 13 million. More than 265,000 people have died.

Fauci said the arrival of vaccines offers a “light at the end of the tunnel.” This coming week, the Advisory Committee on Immunization Practices will meet with the Centers for Disease Control and Prevention to discuss a rollout of the vaccine, he said.

He added that President-elect Joe Biden should focus on distributing vaccines in an “efficient and equitable way.” Fauci also said he planned to push the new administration for a rigorous testing program.

Health care workers will likely be among the first to get the vaccine, with the first vaccinations happening before the end of December, followed by many more in January, February and March, he said.

“So if we can hang together as a country and do these kinds of things to blunt these surges until we get a substantial proportion of the population vaccinated, we can get through this,” Fauci said.

Other experts agreed that the coming weeks would be difficult, especially since so many traveled over the holiday and held in-person dinners indoors.

Dr. Deborah Birx, the White House coronavirus response coordinator, said Sunday on CBS’ “Face the Nation” that Americans who traveled this past week should try to avoid people over 65. She said that those who were around others for Thanksgiving “have to assume that you were exposed and you became infected and you really need to get tested in the next week.”

Meanwhile, a busy travel weekend continued, despite warnings for Americans to stay close to home and limit their holiday gatherings.

Aside from the Thanksgiving holiday itself, anywhere from 800,000 to more than 1 million travelers made their way through U.S. airport checkpoints on any day during the past week, according to Transportation Security Administration statistics. That’s a far cry from the 2.3 to 2.6 million seen daily last year. But it far surpasses the number of travelers early in the pandemic, when daily totals fell below 100,000 on some spring days.

More COVID-19 restrictions were in store for California starting Monday. Los Angeles County will impose a lockdown calling for its 10 million residents to stay home. Santa Clara County, which includes San Jose, is banning all high school, collegiate and professional sports and imposing a quarantine for anyone traveling into the region from more than 150 miles away.

Back in New York, some elementary schools and pre-kindergarten programs will resume classes Dec. 7, a week from Monday, the mayor said. Others will take longer to reopen.

The plan for reopening middle and high schools is still being developed, de Blasio said.

About 190,000 students will be eligible to return to classrooms in the first round of reopening, just a fraction of the more than 1 million total pupils in the system. The great majority of parents have opted to have their kids learn remotely by computer.

De Blasio said that many of those returning in person will be able to attend five days of class a week, up from one to three days previously.

Elementary school students attending in person will be required to undergo frequent testing for the virus. Previously, the city set a target of testing 20% of teachers and students in each school building once a month. Now the testing will be weekly.

The mayor said the city was doing away with its previous trigger for closing schools, which was when 3% or more of the virus tests conducted in the city over a seven-day period came back positive.

New York exceeded that threshold early in November, and infections have slightly worsened since then. More than 9,300 residents have tested positive for the virus over the past seven days.

(By TAMARA LUSH)

Cyber Vulnerability Grows Along With COVID-19 Pandemic Stresses

As the COVID-19 pandemic rages, demand for telehealth services has also grown, increasing the vulnerability that medical operations have to cyberattacks and hacks, according to Laura Hoffman, AMA assistant director of federal affairs.

Hospitals and medical practices must always take steps to protect their networks from cyberattacks on patient records and other data, but as hospitals and physician practices have adjusted to provide more care virtually, while also devoting significant resources to treating patients with COVID-19 and managing the increased number of cyberattacks on health care providers, security can become stressed, she said during a recent episode of the “AMA COVID-19 Update.”

“In the pandemic, we rightfully have a lot of resources focused on caring for patients with COVID. So, you’ve got a lot of additional personnel maybe working in different areas of the hospital that they aren’t accustomed to, maybe their access controls have had to change in terms of who’s allowed out into what portions of the electronic health records, and that can contribute to insider threats,” Hoffman said.

“We’ve got people continuing to work from home and continuing to receive treatment from home. So, the landscape of the vulnerabilities and entry points during the pandemic are increased as compared to a regular health care system where a lot of the care is delivered inside your secure clinic or hospital.”

Telehealth creates vulnerabilities

Hoffman also pointed to a growing reliance on telehealth and how more patients are receiving care from home using different telehealth platforms. The use of the technology has been “a wonderful way for us to promote social distancing and preserve” personal protective equipment (PPE), she said.

“But at the same time, what is good for the health care system and patients presents an opportunity, unfortunately, for cyber criminals. So, they see this now as an opportunity to perhaps exploit these increased use of telehealth systems and the fact that people are working in an environment that they may be less familiar with, and they are going to town in terms of trying to infiltrate different systems,” Hoffman said.

Ransomware, a long-standing problem for individual internet users, is also on the rise for institutions. “In the beginning [of the pandemic] we saw a lot of attacks via phishing and ransomware. Having people click on links for additional PPE that they might be trying to find … actually would then infect computers and systems,” she said.

Ransomware criminals then demand money from affected institutions to release infected software and locked up data. “It’s not just something that happens in a back room where the IT staff then gets busy to work and trying to fix the ransomware that has infected the system,” Hoffman noted. “It really is a system-wide impact when your systems are shut down. You can’t pull up distinct patient records to learn what medications they’re on or even what their diagnoses are.”

Beware of insider threats

One of the newest and biggest threats is called “Ryuk ransomware,” she explained, which has been released into the open internet for use by any malicious criminal.

The ransomware has created an opportunity for insider attacks by individuals who recognize an opportunity to exploit weaknesses in an institution’s technology.

“We’re seeing a lot of insider threats, unfortunately, where folks may recognize that their systems aren’t patched as strongly as they should be or completely as they should be, and they’re able to just insert this software right into some unsecured systems. One of the biggest examples we’ve actually seen recently is with the UHS [Universal Health Services Inc.] health care system where computers were infected, and many practices had to shut down. Hospital systems were without their EHR for some time,” Hoffman said.

It’s not just hospitals and large institutions that are affected. Small practices or individual physicians working from home may be storing less data, “but they may not have the same kinds of robust cybersecurity protections in place, and so it’s easier to infiltrate that network and maybe link it to a larger network,” she said.

Keep software up to date

Hoffman recommends IT staff check that software is up to date and make sure software patches for all technology are completed regularly—even personal computer operating systems and internet browsers that link to bigger data management systems.

“One thing to consider is giving all of your employees a really serious refresher about the kinds of links they should be clicking on when they review their emails inside the hospital system. Maybe have everybody change their passwords more frequently, make the requirements more complex.

“I know it just adds one more thing for everybody to remember, but you can use password managers to help with that and come up with complex passwords that you don’t need to actually remember every time,” she said

(By Len Strazewski, a Contributing News Writer at AMA)

Moderna Seeking US, European Regulators To Approve Covid-19 Vaccination

Moderna Inc, which has reported its Covid-19 vaccine is 94 per cent effective, on Monday announced it is filing with US and European regulators for emergency use authorization. Moderna follows barely a week after Pfizer and its German partner BioNTech filed for US regulatory approval. By the end of 2020, Moderna expects to have approximately 20 million doses of its mRNA-1273 vaccine available in the U.S and is “on track to manufacture 500 million to 1 billion doses globally in 2021.

Moderna created its shots in collaboration with the U.S. National Institutes of Health and got a final batch of results over the weekend which show the vaccine is more than 94% effective. Moderna’s efficacy results are based on 196 Covid-19 cases in its huge U.S. study with more than 30,000 participants. Of the 196 cases, 185 were in participants who received the dummy shot and 11 who got the vaccine. Severe cases and one death were reported in participants who got the dummy shot.

Moderna expects to present its data to the US Food and Drug Administration on December 17. First up will be Pfizer and BioNTech, on December 10. Both Pfizer and Moderna are two-shot vaccines.

The US government’s vaccine management chief has said all systems are ready to deliver the vaccines to priority groups within 24 to 48 hours of FDA approval.  Government Model Suggests U.S. COVID-19 Cases Could Be Approaching 100 Million

The actual number of coronavirus infections in the U.S. reached nearly 53 million at the end of September and could be approaching 100 million now, according to a model developed by government researchers.

The model, created by scientists at the Centers for Disease Control and Prevention, calculated that the true number of infections is about eight times the reported number, which includes only the cases confirmed by a laboratory test.

Preliminary estimates using the model found that by the end of September, 52.9 million people had been infected, while the number of laboratory-confirmed infections was just 6.9 million, the team reported in the Nov. 25 issue of the journal Clinical Infectious Diseases.

“This indicates that approximately 84% of the U.S. population has not yet been infected and thus most of the country remains at risk,” the authors wrote.

Since then, the CDC’s tally of confirmed infections has increased to 12.5 million. So if the model’s ratio still holds, the estimated total would now be greater than 95 million, leaving about 71% of the population uninfected. The model attempts to account for the fact that most cases of COVID-19 are mild or asymptomatic and go unreported.

Scientists used studies looking for people who have antibodies to the coronavirus in their blood – an indication that they were infected at some time — to estimate how many infections went undetected. Some of these antibody studies have suggested that only about one in 10 coronavirus infections is reported.

The goal in creating the model was to “better quantify the impact of the COVID-19 pandemic on the healthcare system and society,” the authors wrote. The model also estimated that official counts do not include more than a third of the people hospitalized with COVID-19.

NPR (11/26, Hamilton) reported “the actual number of coronavirus infections in the U.S. reached nearly 53 million at the end of September and could be approaching 100 million now, according to a model developed by” Centers for Disease Control and Prevention researchers. The model “calculated that the true number of infections is about 8 times the reported number, which includes only the cases confirmed by a laboratory test.” NPR added, “Preliminary estimates using the model found that by the end of September, 52.9 million people had been infected, while the number of laboratory-confirmed infections was just 6.9 million, the team reported in…Clinical Infectious Diseases.”

Your Phone Can Send You An Alert If You Were Near Someone Who Has Coronavirus

As new coronavirus cases explode nationwide, health officials are turning to cell phones to help slow the spread of infections. Thanks to technology available on Apple and Google phones, you can now get pop-up notifications in some states if you were close to someone who later tested positive for Covid-19. The alerts come via state health department apps that use Bluetooth technology to detect when you (or more precisely, your phone) has been in close contact with an infected person’s phone.

While these apps can’t keep you safe — they only let you know after you’ve been exposed — they could prevent others from getting infected if you take precautions, such as self-quarantining, after receiving an alert.

Millions of people are signing up, although these apps aren’t yet available in many states. Health officials believe the alerts could be especially helpful in cases where an infected person has been in contact with strangers — for example in a bus, train or checkout line — who wouldn’t otherwise know they were exposed.

How the notifications work

iPhones and Android devices contain constantly changing anonymous codes that ping nearby phones via Bluetooth — a process that starts once the user opts to get the notifications.

For the exposure notifications to be effective, Android users must turn on Bluetooth and download their state’s Covid-19 notification app. On iPhones, the system is already baked into settings, although users must go to exposure notifications and make sure availability alerts are on.  A close-contact alert from the Covid-19 exposure notification app made by the Nevada Department of Health and Human Services.

When someone who uses the feature tests positive for coronavirus, he or she gets a PIN from a health official to enter into their phone. Any other phone that was nearby in the previous two weeks — usually within six feet or less, for at least 15 minutes — will get an alert telling the user to quarantine and notify a health provider.

The apps assess your risk on the strength of the Bluetooth signal (how close you were to the other person) and the duration of your contact with them.

Where you can get them

At least 15 states are taking part in this Covid-19 exposure notification system.  They include Alabama, Colorado, Connecticut, Delaware, Michigan, Minnesota, Maryland, Nevada, New Jersey, New York, North Carolina, North Dakota, Pennsylvania, Virginia, Wyoming and the nation’s capital, Washington, DC.

Some states reported a flurry of sign-ups within weeks of launching the program. Maryland launched its notification system on November 10 and more than 1 million people have already signed up, said Charlie Gischlar, a spokesman for the state health department. He described the app as “a complement to traditional contact tracing and another tool in the toolbox” to combat coronavirus infections.

Colorado, where coronavirus cases and hospitalizations have surged in recent weeks, has also seen more than 1 million people sign up for alerts since the system launched on October 25. The state is one of several conducting massive campaigns to educate residents about their exposure notification service.

Some states have launched apps to alert residents when they may have been exposed to coronavirus.  “We are at a pivotal moment in this pandemic, and opting in to this service helps keep our families and communities safe and our economy running,” Colorado Gov. Jared Polis said in a statement.

Other states, including California and Oregon, have launched pilot programs but their notification systems are not yet available to everyone.

Questions about privacy

Is information from the apps anonymous? Experts say it is.  The apps don’t collect data on users or their locations, and there is no way to link Covid diagnoses and alerts to names and identities on phones, Gischlar said.

Unlike a previous notification system widely touted at the beginning of the pandemic that used GPS, which tracks a person’s location, the Bluetooth system helps maintain privacy and anonymity among users.

“The fact that they use Bluetooth to bounce signals off other phones close to you, as opposed to tracking your location, does make them less invasive, and people shouldn’t worry their location is being tracked — it isn’t,” said Steve Waters, founder of Contrace Public Health Corps, which provides guidance on Covid-19 contact tracing.

“The process is entirely anonymous and doesn’t collect any personally identifiable information, addressing the privacy concerns of earlier more invasive contact tracing apps.”

Earlier versions that sparked privacy concerns were created by third-party developers. This coronavirus notificiation alert technology is provided by Apple and Google, and users can opt out from using it at any time, Gischlar said.

The alerts can reduce Covid-19 infections

The more people who sign up for the alerts, the more effective they are. Right now only a small percentage of the roughly 100 million Americans who live in the 15 states use the apps.

But health officials say even these minimal numbers are making a difference. In Colorado, officials cited studies that show even a 15% use of exposure notification technologies leads to a significant decrease in coronavirus infections and deaths. The state says usage of their app is now at 17%.

Some states have grouped together to enable pop-up notifications across state lines, according to Tony Anscombe, a global expert for internet security company ESET. This is especially important in places near state borders where people work in one state and live in another.

The alert system only works on phones that are less than five years old. For example, New York, New Jersey, Pennsylvania and Delaware have formed a regional alliance that uses a similar system that allows their apps to work across state lines, Anscombe said.

States face some challenges in spreading them. The alert system is designed to complement traditional contact tracing, not work alone.  But technology brings its own set of challenges. For starters, the notification system only works on Google and Apple phones that are less than five years old, Anscombe said. Not everyone has a newer smartphone, and only a small percentage of those who do are using the notification system.

The software on iPhones and Android devices detects when people — or rather their phones — get close to one another.

In addition, not all states are using the notification system. Many state health departments are already overwhelmed by the virus’ resurgence, and some may not have the resources to develop and maintain an app, Anscombe said.

The earlier, GPS-based notification system caused an outcry among privacy advocates and has created skepticism about contact tracing in general, Waters said.

“States need additional funding, currently stuck in Congress, to help battle disinformation and increase adoption of this critical tool in the battle against Covid,” Waters said. The coronavirus pandemic also has become a political issue, with some Americans taking it less seriously than others. For that reason, Waters said, some are also reluctant to use Covid exposure apps.