Bill Kerr: Welcome to the Managing the Future of Work podcast from Harvard Business School. I’m your host, Bill Kerr. This episode is one of a series of special dispatches on the sweeping effect that Covid-19 is having on society, the economy, and the future of work. In addition to our regular podcast episodes, we’ll be bringing you shorter and more frequent interviews with business leaders, policy makers, and leading scholars on the coronavirus. My guest today is Derek Thompson, a widely followed journalist at The Atlantic magazine. Derek’s also author of the bestseller, Hit Makers, and host of the podcast, Crazy/Genius. Derek writes about economics, technology, and society, and he’s turned his full attention to Covid in recent weeks. Derek recently investigated contact tracing, which could become a big part of all of our lives due the pandemic. Welcome, Derek.

Derek Thompson: Great to be here, thank you.

Kerr: Derek, experts recommend that we combine three things: testing, social distancing, and contact tracing. The first two, testing and social distancing, I think are pretty well known at this point, but contact tracing remains a bit more obscure. Tell us about it.

Thompson: Right. In its most basic form, contact tracing means essentially once you diagnose somebody as sick, say, with Covid-19, you trace their recent contacts—you identify all of the people that may have had recent interactions with them in order to determine where the disease might’ve spread. So essentially, if all you do is just testing, you’re not fully besieging the virus, you’re not surrounding it, because you aren’t catching all those people that might have caught the disease from this person that you have just tested positive. What you want to do is quickly trace that person’s contacts, starve the disease of new bodies, find those contacts, isolate them as well, and that way you really draw a circle around the spread of the disease. Historically, contact tracing has worked through a really simple technology called “interviews.” You just ask people who they’ve recently come into contact with. This is a really common strategy for limiting the spread of viral diseases. For example, to trace the spread of Ebola, the CDC essentially identified people who were sick with the disease, and they asked them to list recent contacts—family, friends, businesses. Then that interview would produce a list of contacts, and then the CDC would reach out to those contacts and say either, “You should get tested,” “You should isolate,” “You should quarantine,” “You should tell us the contacts that you’ve recently had.” That’s really how you map the spread of a disease. Because if you imagine how a disease might spread—from the first individual to, say, the thousandth individual—you can imagine looking like a cascade, like a map of infection spreading from one to two and two to four and four to eight. What test and trace really is trying to do is draw a circle around that entire map and say, “We’re isolating all these people so that the cascade stops cascading.” The question now, I think, for a lot of people in the US is, “All right, can we rely on interviews to do this job? Can we rely on this old technology?” Some people that I talked to said, “No, Covid and coronavirus has spread too far, too fast. It’s already accelerated, and we need to find some more-sophisticated technology for tracing contacts.” That technology is your phone. There are basically two big technologies that you could potentially use that are already embedded in our phone in order to hunt down the spread of the virus. One is GPS. GPS obviously tells us where we are in the world. If I tested positive for Covid, potentially I could upload my location trail to some central authority that could say, “Okay, Derek went to this Starbucks, he went to this Sweetgreen, he went to this Equinox.” We can produce a map for other people who are on this Covid-tracing app that says, “Okay, we know that someone was just identified as Covid-positive. They’ve been to these places. Maybe avoid them for the near term.” The other technology, which is a little bit less invasive, is Bluetooth, which is a near-distance pinging technology. With Bluetooth, what could happen is essentially, if I have a Bluetooth-tracing app, along with everybody else in Washington, DC, where I live, if I’m diagnosed with Covid, I could upload my data to a central authority, and that authority would get a list of all of the contacts that I had pinged with my Bluetooth technology. If I came within six feet of my fiancée, which is very likely, then she would be on that list. If I came within six feet of my boss, then he would’ve been pinged through the Bluetooth technology, and he would be on this list. The agency could see this full list of people that my phone had come within a few feet of over the last few days and say, “Okay, this is the list of 13 people that we have to contact.” That’s a little bit more respectful of privacy, because it’s not a full map of location trails, it’s actually not a map at all. It has nothing to do with location, it just has to do with proximity. Basically, to summarize, the two technologies that you can use with our phones—GPS and Bluetooth—the first gives you location, the second really gives you proximity.

Kerr: Yeah, and your research has spanned the experiences of Korea, China, Singapore, Germany, and other places. Where has the contact tracing been successful? Is it using one of these technologies? Is it also how universal it’s adopted versus some opt-in strategy? What’s been the characteristics of those successful places?

Thompson: I think it’s fair to say from a broad level that countries that had previously experienced outbreaks of SARS have been more successful, at least here in the short term, at limiting the spread of the disease, either because the populations have a certain familiarity with or a muscle memory with social distancing or because the governments, having learned from previous outbreaks, acted faster. Let’s go through some of these countries one by one. I’ll start with China. China has taken the most draconian measures to basically map the spread of their population, take a bunch of information in order to code individuals as being either high risk or low risk. It’s been, I think, extraordinarily invasive. And the data coming out of China is pretty meager. It’s kind of difficult to figure out exactly how bad the outbreak is right now in China because, by a lot of sources, they’re essentially saying no one’s getting sick in the entire country anymore, which seems really unlikely. Second, we can look at a place like South Korea, a democracy, unlike China. South Korea uses a lot of different sources of information in order to do tracing. They look at cell phone location data, CCTV, credit card records. And when somebody tests positive, the local governments essentially send out an alert to the local population, the same way you’d receive a local flood warning, for example. And that local alert will give the newly Covid-positive individual’s last name, their sex, their age, their district of residence, maybe their credit card history, a minute-to-minute record of everywhere they’ve been recently, including detail as specific as what rooms of a building they’ve been in. I mean extremely, extremely specific stuff, and you could argue extremely invasive. Indeed, there’s people who are concerned about human rights and privacy in South Korea who say, “Not only does this violate human dignity, but also it might violate public health, because the more information you give up about people that test positive, the more they’re likely to be identified, condemned online. That might make them less likely to get tested in the first place.” Then you look at a place like Singapore. I think Singapore really offers the most potentially influential model for Western democracies. Singapore uses an app called “Trace Together,” which uses Bluetooth technology that, as I said, keeps a log of nearby devices, nearby contacts. Again, if I get sick, I would upload my Bluetooth data to the equivalent of the Singaporean Ministry of Health. Or if I live in Singapore, I’d upload it to the Ministry of Health. And the Ministry of Health would essentially say, “Okay, the names that have been pinged by Derek’s device include his fiancée, his boss, four of his friends, the barista at the local Starbucks. We’re going to contact, isolate, these 13 people to make sure that they don’t spread the virus.” I do think that from my conversations with people, both in the US and in Germany—which is leading the efforts in the EU to develop tracing technology that is phone-based—a lot of them are looking to the Singaporean model, because it’s more respectful of privacy, it’s more likely to get buy-in from users, and this Bluetooth data is probably the most accurate in terms of telling people who I actually came into close contact with.

Kerr: Turning to the US—and thanks for taking us around the world and showing us what the frontier looks like—we’re clearly lagging in contact tracing, and I’d love to get your impressions of both why and, then, if we were to adopt this widespread, what do you think that would look like? Maybe you can give a sense of how do you think our lives would feel with contact tracing.

Thompson: Right. The big-picture answer about why the US is so far behind in terms of its response—or why it was a for a long time so far behind the rest of the world in terms of its response to the virus—there’s a lot of different reasons you can give. Maybe it’s the federalist structure of our society—that we necessarily or naturally outsource our response to the state and local level. It might have to do with the fact that, I would argue, that the Trump administration and, in many ways, Republican governance over the last few years and decades has questioned and pushed against science and expertise, not only in global warming, but also with the president’s firing or downgrading of the pandemic response team, including in this administration. Then also, I think, for a variety of reasons, we’ve just been behind on testing. We’ve been behind on social distancing recommendations, even from Democrats, like the New York City mayor. And we’ve been behind on masks and personal protective equipment. There’s a variety of reasons of why the US has lagged so far. But given that Silicon Valley is very obviously in the United States—and so is MIT and Caltech and a lot of other really wonderful universities with really, really strong tech grounding—my hope is that we can get a little bit faster in terms of our technological response to the tracing problem. In terms of what it might look like to live in a world of widespread tracing, let’s start with the most low-tech possibility, which is that we don’t get any sort of phone app because Americans are too freaked out by it. We just have the old-fashioned CDC Ebola response, which is interviews. We just interview people. If I am diagnosed, I can expect to get a call from the Washington, DC, Health Department that says, “Hey, Derek, sorry to hear about your positive diagnosis. Hope you’re doing all right and you’re self-isolating and self-quarantining. Can you tell me—give me a list—of everyone and everything that you’ve done in the last seven days and everyone that you’ve potentially come into contact with?” That simply is an interview. I could also imagine, however, that because this is a country where Apple and Google are based, that maybe some kind of tracing app could be built into the Apple or Android OS update. Maybe something like the Singaporean Bluetooth pinging model could be built into the Apple or Android OS update, so that what could happen, for example, is that people are getting tested regularly as tests ramp up, and maybe one day I want to go out to have dinner with some friends, and I get a bottle of wine, and I’m sliding into the front seat of my car, and I feel my phone vibrate. I take out the phone and I can see in the log screen that says, “Please be advised.” It’s a message from the DC Health Department. And I go, “Oh, god, I know what this is.” And I open it, and I read that I’ve been diagnosed with Covid. And they’re asking me to just press a button on my phone that will automatically upload all of my recent Bluetooth pings to some central authority that will look over those pings and reach out to those people. Then, obviously, they’ll be asking me to get out of the car, not go have dinner with my friends, and quarantine for at least the next week. It is possible that something like that could be our future, that we all are living with the possibility that, at any given moment, we could get that message from a local agency on our phone that says, “Sorry to tell you this, you’ve been diagnosed. We need your data, and we need you to participate in more severe-isolation and quarantine.”

Kerr: Yeah, I’m curious, given that our cell phones have also gotten into the health aspect—Apple Health and other kinds of things—have there been any instances where they’ve tried to integrate some health functionality of the phone with the tracing?

Thompson: Yeah, that’s a great question. Actually, I, as you said, am an economic and culture reporter who now has shifted my attention full time to Covid. So I’m not an expert on the full health-tracking capacities of our devices, specifically our Apple devices. I know, for example, my fiancée has an Apple Watch, and when she is working out, she’s constantly looking at it to see, “All right, what’s my beats per minute? What does it say about my breathing? And what does it say about how far I’ve run?” I’m an old-school workout guy. I go to the gym, or at least did go to the gym when gyms were legal in this country. I work out at home still, but I use no technology—no Fitbit or no Apple Watch—in order to monitor my behavior. So I don’t know a whole lot about exactly what tech is available. But I will say this: It was absolutely a point of almost cliché that health tech was the next frontier for Silicon Valley as of 18 months ago—way, way before we were all locked in our houses because of a pandemic. So I can imagine absolutely a future—not just the next two months, but in the next two decades—where we’re living with a kind of a new awareness of the possibility of a pandemic. And as a result, there’s an increased demand in the health functionality of all of our devices. That we want to know, maybe from our headbands, “Do I have a fever?” From our watches, “Can you tell me something about my breathing or my health or my physical activity?” That you might see, for example, when I’ve talked to people in New York City who have said, “The best way to get people to go back to restaurants is to give them the peace of mind that everyone in the restaurant is healthy.” Wouldn’t you prefer to go into a restaurant where you knew that there was no one with a temperature over 100 in that restaurant versus a restaurant where there are a lot of people bumping into each other and rubbing elbows and clasping hands? You have absolutely no idea whether any of them were running some kind of fever. I do think that you’re going to see how technology is integrated into a lot of parts of American society, but I don’t know a lot about the specifics of it.

Kerr: That’s a very powerful example with the restaurants and that you would want to know about others as well as also your own. Your work has talked about this tension between privacy. If we could possibly rewind the tape to two or three months ago, even at that point, there was a big question about data privacy and Big Tech and so forth. But we also have now this big public health concern. Do you think the pandemic will shift our attitudes here? If you go to some of the other countries that you’ve looked at, have you noticed any shift toward greater acceptance that we’re going to all need to share this type of information more?

Thompson: Yeah, I guess I have two answers to that question. The first answer is that, when I think about how are American attitudes toward privacy or government power shifting, I mean, just turn inward. Look at yourself. We are all under house arrest. We are all allowing our local and state governments to put us under house arrest. And most of us aren’t complaining. If you look at governor approval ratings across the country, they’re basically soaring, unless you’re Governor DeSantis in Florida. I mean, all over the country, people are talking about Gavin Newsom in California and Cuomo in New York as being potential presidential candidates, not in 2024, in 2020! People are so proud of leadership, even though that leadership is resulting directly in their loss of employment, their loss of livelihood, and their loss of literal freedom. They can’t leave their friggin’ houses. So that tells me that Americans are absolutely renegotiating their relationship with values that might’ve seemed previously non-negotiable. How that translates to privacy is interesting. I do think that, in many ways, the privacy concerns that were being raised in the last few years were being led by the media, that The New York Times and The Atlantic and people like me were saying, “Are we sure we want these big-tech companies like Amazon and Google and Facebook to have this much power over our lives and our behavior? Do we want them listening in to our lives and manipulating our behavior?” We kept asking these questions, but what happened in the public? They kept using Instagram, they kept buying Amazon Echos, they kept using Google. They seemed to understand that there was this sort of social contract with these tech companies that was like, “Yeah, I use you. You’re free. And the cost of my participation is that you spy on me a little bit, and I’m okay with that.” It’s possible that you take that, and you amplify it with the new renegotiated social contract to the pandemic. And you could imagine, a lot of the Americans would be like, “Fine. If you’re telling me that downloading a Bluetooth app on my phone means that life can go back to normal six months earlier, and I can be rehired, and my kids come back to school, et cetera, I am definitely going to take that.” That seems to be a possibility. But I also think that, because the media is influential, and there are a lot of people who are duly concerned with the US taking maybe what should be a temporary public surveillance program during the pandemic and extending it, Patriot Act-style, into a permanent surveillance program, that the fear of that could lead tracing in the US or public health policy in the US to leave the phone stuff on the side for a while and say, “Okay, what can we do in the short term? We can do masks, we can do fever checks in buildings, we can do a 10X increase in tests, maybe, if we increase the availability of swabs and testing kits. Maybe let’s start there, and then we’ll think about turning our phones into espionage devices.”

Kerr: All right, thank you. That is a great segue to maybe our last question here, which is, while you’ve been under house arrest in your apartment and in-between you’re exercising, you’ve also been at a front-row seat for policy responses to the pandemic. Any key takeaways you’re emphasizing at this point?

Thompson: Yeah, my big take here is that we’ve already done way more than I expected at the federal level. And it’s also not enough. The economic rescue plan was massive. I mean, you can criticize it 100 different ways. You could say there’s not enough money for small businesses, which I think is true. You could say the checks are too small or too delayed, which is true. You could say our unemployment insurance offices across the country weren’t ready for this deluge of jobless claims, which is obviously true. But the economic rescue package was $2 trillion. I mean, we committed in a matter of weeks to spend 10 percent of the US economy to be concentrated in a matter of like three months. That was a huge response, and that was a response that was appropriate given the level of the crisis. So we need more. This is an absolutely bizarre and horrible economic shock that, in many ways, as I’ve written, has turned economic policy on its head. I mean, you have economists saying that able-bodied people should stop working. You have economists saying that fantastic companies should stop operating. You have economists essentially rooting in the very short term for a recession. They are saying we should put the economy into a kind of coma for the next few months and hope that we can take the economy out of the coma, thaw the deep freeze once the pandemic is over. Given that economics has been turned on its head in the short term, I think the response has been really, really strong. But I also think more needs to be done. In particular, I think more needs to be done on the small business front. There are 6 million small businesses in the US. That is a lot of phone calls to the SBA and to local banks—6 million, to be specific. We need more money to be available to these small businesses, because what we don’t want to happen is that when we wake up from this induced coma, we wake up to 35 percent unemployment and 1 million declared bankruptcies. What we want to do as much as possible, I think, is freeze the economy in place. Say, “Everyone to the extent that you can, just stay where you are. Hold on. Hold your breath. We know you can’t hold your breath forever. We’re going to help you. But we’re going to find a way to transition to a more normal economy.” It’s not going to go 1 percent normal to 100 percent normal. I would consider us right now at 1 percent normal, but 1 percent normal to 20, 20 to 50, 50 to 60, and eventually, back to the fully normal economy that we can hopefully have if you have widespread, effective antiviral medication or a vaccine.

Kerr: Derek, thanks so much for joining us. We appreciate you introducing us to contact tracing as well as also these broader perspectives.

Thompson: Thank you.

Kerr: Derek

Thompson: is a writer for The Atlantic as well as also his own podcast series. He’s producing an article, it seems, about every five days related to the Covid crisis. I recommend you look it up and keep in touch with the work he’s conducting. Thanks, Derek.

Thompson: Thank you.

Kerr: Thank you for listening to this special episode of the Managing the Future of Work podcast. To find out more about our project on the future of work and for more information on the coronavirus’s impact, visit our website at hbs.edu/managing-the-future-of-work and sign up for our newsletter.