How tech companies can help combat the pandemic and reshape public health

Whitney Pennington Rodgers:
Before we really dive in

to talking specifically about
Google's work

in the contact tracing space,

let's first set up, sort of,

the relationship between
public health and tech.

You know, I think a lot of people,

they hear Google and they think of
this big tech company.

The think of a search engine.

And there may be questions
about why does Google

have a chief health officer?

So could you talk a little bit
about your work

and the work your team does?

Karen DeSalvo: Yeah. Well,
maybe I am the embodiment

of public health in tech.

Coming together, my background
is I practiced medicine for 20 years,

though a part of my work
has always been in public health.

In fact, my first job,
putting myself through college,

was working at the state laboratory

in Massachusetts.

As the story will go, with joy,
wherever you connect it again,

a Massachusetts theme.

And I, across the journey
of the work that I was doing

for my patients

to provide them information

and the right care and meet them
where they were medically,

translated into the work

that I did when I was
the Health Commissioner in New Orleans

and later when I had other roles
in public health practice,

that really is about thinking
of people and community

in the context in which they live
and how we provide the best information,

the best resources,

the best services that are
culturally and linguistically appropriate,

meet them where they are.

And when the opportunity arose
to join the team at Google,

I was really thrilled,

because one of the things
that I have learned across my journey

is that having the right
information at the right time

can make all the difference in the world.
It can literally save lives.

And billions of people
come to Google every day

asking for information,

and so it is a tremendous opportunity
to have that right information

and those resources to people

so that they can make good choices,

so that they can have
the right information,

so that they can participate
in their own health,

but also, in the context
of this historic pandemic,

be a part of the broader health
of the community,

whether it's to flatten the curve
or keep the curve flat as we go forward.

WPR: And so it sounds like
that there is this connection, then,

between public health
and what Google's work is

in thinking about public education
and providing information.

And so could you talk
a little bit about that link

between public health
and public education, and Google.

KD: Definitely.

You know, the essential
public health services

include communication and data,
and these are two areas

where tech in general,
but certainly Google,

has the opportunity to partner
with the public health system

and with the public
for their help more broadly.

You know, going back
to the earlier days of this pandemic,

towards the end of January,

Google first leaned in

to start to put information
out to the public

about how to find resources
in their local community,

from the CDC or from other
authoritative resources.

So on the search page,
we put up knowledge panels,

is the way that we describe it,

and we did develop an SLS alert,

which is something
we've done for other crises,

and in this particular historic crisis,

we wanted to be certain

that when people went on to search,

that there was authoritative information,

which is always there but certainly
very prominently displayed,

and do that in partnership
with public health authorities.

So we began our journey
really very much in an information way

of making certain that people
knew how to get the right information

at the right time to save lives.

I think the journey for us
over the course of the last few months

has been to continue to lean in

on how we provide information and
partnership with public health authorities

in local areas,

directing people in a certain state
to their state's health department,

helping people get
information about testing.

There's also been, though,

a suite of resources that we wanted
to provide to the health care community,

whether that was for health care providers
that may not have access to PPE.

For example, we did a partnership
with the CDC Foundation.

Though the scale of the company,

and the opportunity for us
to partner with public health

around things like helping public health
understand if their blunt policies

around social distancing
to flatten the curve

were actually having an impact
on behavior in the community.

That's our community mobility reports.

We were asked by public health agencies
all across the world,

including some of
my colleagues here in the US,

could we help them have a better
evidence-based way to understand

the policies around social distancing
or shelter in place?

Which I think we'll talk about more later.

In addition to that sort of work,
also been working to support public health

in this really essential work
they're doing for contact tracing,

which is very human resource intensive,

very complex,

incredibly important
to keep the curve flat

and prevent future outbreaks,

and give time and space for health care
and importantly science

to do the work they need to do
to create treatments

and, very importantly, a vaccine.

So that work around providing
an additional set of digital tools,

exposure notification
for the contact tracing community,

is one of the other areas where we've
been supporting the public health.

So we think, as we've thought
about this pandemic,

it's support the users,

which is the consumer.

There's also a health care system
and a scientific community

where we've been partnering.

And then, of course, public health.

And for me, I mean, Whitney,

this is just a wonderful opporutnity

for Big Tech to come together
with the public health infrastructure.

Public health, as Joy was
sort of articulating before,

is often an unsung hero.

It saves your life every day,
but you didn't know it.

And it is also a pretty under-resourced
part of our health infrastructure

globally but especially in the US.

It's something I worked on a lot
before I came to Google.

And so the opportunity to partner

and do everything
that we can as a company,

and in this case with contact tracing
in partnership with Apple

to create a very privacy-promoting,
useful, helpful product

that is going to be a part
of the bigger contact tracing

is something that we feel really proud of

and look forward to continuing
to work with public health.

In fact, we were on the phone this morning
with a suite of public health groups

from across the country,

listening again to what would be helpful,
questions that they have.

And as we think about
rolling out the system,

this is the way that we've been
for the last many months at Google,

and I'm just really,

I landed at a place

just a few months ago --
I just started at Google --

where we can have an impact
on what people know

all across the world,

and I"ll tell you, as a public
health professional, and as a doc,

that is one of the most critical things.

People need to have the right information

so that they can help
navigate their health journey,

but also especially in this pandemic
because it's going to save lives.

WPR: It's great. Thank you.

I guess, to talk more
about this contact tracing system

and the exposure notification app,

we've read so much about this.

Could you describe this,
a little bit about how the app works,

what exactly are users seeing,

what information is being collected?

Just give us sort of a broad sense
of what this app does.

KD: Yeah.

Let me just start
by explaining what it is,

and it's actually not even an app,

it's just an API.

It's a system that allows
a public health agency

to create an app,

and only the API,

this doorway to the phone system,
is available to public health.

So it's not designed for any other purpose

than to support public health
and the work that they're doing

in COVID-19 in contact tracing.

The second piece of this
is that we wanted to build a system

that was privacy-promoting,

that really put the user first,

gave them the opportunity
to opt into the system

and opt out whenever
they wanted to do that,

so they also have some control
over how they're engaging

and using their phone, basically,

as a part of keeping the curve
flat around the world.

The system was developed in response
to requests that we were getting

about how could technology,

particularly smartphones,

be useful in contact tracing?

And as we thought this through
and talked with public health experts

and academics and privacy experts,

it was pretty clear that obviously
contract tracing is a complex endeavor

that does require human resources,

because there's a lot of
very particular things

that you need to do
in having conversations with people

as part of contact tracing.

On the other hand,

there are some opportunities

to better inform the contact investigators

with things like, particularly,
an exposure log.

So one of the things that happens
when the contact tracer calls you

or visits you is they ask,

"Hey, in the last certain number of days,"

and in the case of COVID, it would be
a couple days before symptoms developed,

"hey, tell us the story of what
you've been involved in doing

and so that we can begin to think through
where you might have been,

to the grocery, or to church,
or what other activities

and with whom you might
have been into contact with.

There's some amount of recall bias
in that for all us.

We forget where we might have been,

and there's also an amount
of anonymous contact.

So there are times when
we're out in the world,

on a bus or in a store,

and we may have come into prolonged
and close contact with someone

and wouldn't know who they were.

And so the augmentation

that the exposure
notification system provides

is designed to fill in those gaps

and to expedite the
notification to public health

of who has a positive test,

because the person would have notified,

they trigger something
that notifies public health,

and then to fill in some of those gaps
in the prior exposure.

What it does not do is it does not use
GPS or location to track people.

So the system actually uses
something different

called Bluetooth Low Energy,

which is privacy-preserving,

it doesn't drain the battery,

and it makes it more interoperable

between both Apple and the Android system

so it's more useful,
not only in the US context,

but globally.

So we built this system
in response to some requests

to help augment
the contact-tracing systems.

We wanted to do it in a way
that was user-controlled

and privacy-preserving

and had technological features

that would allow public health
to augment the exposure log

in a way that would accelerate
the work that they needed to get done

to interrupt transmission
to an R naught less than one,

and do that in a way that we would also
be able to partner with public health

to think about ??.

We could talk more about
any of these areas that you want,

but I think maybe

one of the most important things
that I want to say, Whitney,

is how grateful Apple and Google are --

I'll take a moment to speak
for my colleagues at Apple --

to the great partnership
from public health across the world

and to academics and to others

who have helped us think through

how this can be,

how the exposure notification system

fits into the broader
contact tracing portfolio,

and how it does it in a way
that really respects and protects privacy

and also is useful to public health.

We're still on this journey with them,

and I really believe that
we're going to be able to help,

and I'm looking forward
to being a part of the great work

that public health's gotta do
on the front lines every day,

been doing, frankly,

but needs to be able to step up.

WPR: That's great, and thank you
for that really detailed explanation.

And you know, we actually have Chris here
with some questions from our community,

so why don't we turn there really quickly.

Chris Anderson: Yep.

Questions pouring in, Karen.

Here's one from Vishal Gurbuxani.

I pronounced that horribly wrong,
but make up your own mind.

Vishal, we'll connect later and you
can tell me how to say that.

KD: Fabulous last name. I love that.

That's a Scrabble word.

CA: "Given where we are today,

how should employees think
about returning to work,

with so many conflicting messages?"

KD: This has been an important part
of my work for the last few months.

I joined Google in December,
when all this started happening,

the pandemic in the world
first began in November

but it got very hot
in many parts of the world

in the last few months,

and we've been thinking a lot
about how to protect Googlers

but also protect the community.

I've been talking a lot about
what we've done externally.

You know, internally,
Google made a decision

to go to work-from-home pretty early.

We believed that we could.

We believed that in all the places
across the world where we have offices,

that the more we could not only model

but frankly just be
a part of flattening the curve,

that we would be good citizens.

So we have been fairly,

I don't know if the right word
is conservative or assertive, about it,

because we really wanted to make sure
that we were doing everything we could

just to get people to shelter in place
and socially distance.