Subtitles section Play video Print subtitles 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 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. They 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'm the embodiment of public health and 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 Joia [Mukherjee] we're reconnected 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 an opportunity to partner with the public health system and with the public for their health 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 SOS 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 in 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 opportunity for Big Tech to come together with the public health infrastructure. Public health, as Joia 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 they can help navigate their health journey, but also especially in this pandemic because it's going to save lives. WPR: That's great. Thank you. So, 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's some opportunity 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 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." There's some amount of recall bias in that for all us, like 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 also 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 -- keep the 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 risk scoring. 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 got to do on the front lines every day, been doing, frankly, but needs to be able to step up.