New York City and cloud communications platform Twilio are partnering to “power the communications” of the city’s new contact tracing initiative. The city, which has the most COVID-19 cases and deaths in the United States, is rolling out the program as part of official efforts to open things back up before the end of the summer. Now that case numbers are falling steeply, city health officials are working to kickstart an ambitious effort to do what they wish they could have at the beginning: Contain the virus.

In a statement, Twilio described the partnership with New York City’s Department of Information Technology & Telecommunications in detail, saying the city will “deploy a cloud-based contact center on Twilio Flex and leverage Twilio SMS and Voice as key parts of the City’s COVID-19 tracing program.”

“Throughout this pandemic, the ability for businesses and government agencies to quickly spin up and iterate ways to engage customers and constituents has never been more important,” said George Hu, chief operating officer at Twilio.

“New York City’s contact tracing solution makes it possible for the city to connect with and support residents with COVID-19 and keep their known contacts safe and informed. Twilio is proud to work with innovative leaders like New York City’s CIO, Jessica Tisch, as they invest in the health, safety and future of their constituents.”

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During testimony last week at the New York City Council’s Health + Hospitals Committee hearing, Ted Long, M.D., vice president of ambulatory care for New York City Health + Hospitals, said the city had already hired 500 contact tracers with another 500 slated for onboarding in the coming days. The contact tracers will work with people who test positive for COVID-19 to figure out who they may have touched or passed the virus onto so the spread can be contained as much as possible.

In a press conference on May 8, Mayor Bill de Blasio said: “By later this month, we’ll be at a thousand contact tracers and folks working on the phone bank operation related to it. As I said, by early June we’re preparing to get to a number of tracers and folks in the phone bank operation, so a corps that will reach between 5,000 and 10,000 individuals.”

“This is a huge operational undertaking to literally test–we’re talking about initially, as I said, 20,000 people a day and then ultimately move up to 50,000 people a day, to bring together all the information from the other testing, to trace people, to make sure that people are isolated, get isolated, to make sure they get the medical care they need, the hotel room, the food, everything,” he said.

Contact tracing is critical to the city’s plan to slowly reopen even as other major cities have allowed a number of businesses to open their doors. The city originally planned to spearhead a big contact tracing effort at the beginning of the pandemic but quickly realized it was too late and that the virus had already spread across most of the city.

Even so, contact tracing efforts, both done by people and through digital applications, have been criticized heavily by those with tough questions about privacy and security concerns.

Part of New York Gov. Andrew Cuomo’s reopening plan involves hiring 30 contact tracers per 100,000 people, meaning the city would need about 3,000 tracers for the nearly nine million inhabitants. The state has enlisted Johns Hopkins University and a foundation run by the former New York City Mayor Mike Bloomberg to help with the contact tracing effort. Contact tracing is also listed by the CDC as vital in the fight against the virus.

In a statement, Twilio said the company’s platform is “well-suited to support the fundamentals of contact tracing, including connecting securely with COVID-19 patients and known contacts, and monitoring the spread of the virus.” It is also partnering with other government agencies and health departments on contact tracing efforts.

“Twilio’s platform is Twilio offers an omnichannel contact center built using Twilio Flex to call, message or email COVID-19 patients, educate them on the virus, and identify their close contacts through self-reporting. The platform also provides messaging based alerts using Twilio Voice, SMS, email or Whatsapp that prompt patients to fill out secure surveys on their symptoms,” a company representative wrote in a release.

“Twilio’s platform provides cloud contact center and notifications solutions for remote contact tracers to interview patients, notify contacts and send symptom survey reminders.”

Devang Sachdev, senior director of product marketing at Twilio, explained the nuts and bolts of the deal, saying the company would be working with the Department of Information Technology and Telecommunications as well as a CRM system created by Salesforce.

Twilio Flex will be embedded into the Salesforce CRM that will be populated with patient data. Sachdev could not confirm how exactly New York City would run their specific contact tracing program and city officials declined to explain the process when reached for comment. But Sachdev said typically, trained public health officials working as contact tracers will click on patient records and make outbound calls to connect them to COVID-19 positive patients.

The tracer will go through a number of questions related to people the patient may have been exposed to and the system will provide a way to set follow-up tasks. Sachdev said tracers will call everyone but make sure to not reveal the identity of the initial patient.

The platform will also give contact tracers a way to set up automated messages for two weeks that will send daily reminders via text to click through to a symptom survey where they report on how they are doing.

The contact tracing effort in New York City has been beset with controversy and infighting due to a few decisions from de Blasio and wide-ranging concerns about contact tracing in general. Multiple countries that quickly rolled out contact tracing programs or smartphone apps suffered hacks or distrust from local populations.

Apple and Google recently announced a contact tracing solution that would use Bluetooth technology while dozens of countries and states are releasing apps designed to track locations or symptoms.

Brendan O’Connor, co-founder and CEO of AppOmni, said companies must be diligent to ensure the security of the data processed and stored in these solutions.

“Unlike traditional data many organizations are accustomed to, these new services may need to handle sensitive details such as employee’s health information, results of health surveys, contact tracing information, and business continuity plans,” he said.

Sachdev noted that Twilio Flex “can be deployed in a HIPAA compliant manner” and that the company is working with the city to ensure that any and all sensitive personal information on the platform has appropriate safeguards at every stage of the contact tracing process.

“As Twilio works closely with governments, cities, and states to support their efforts, protecting the patient identity is a top priority. Twilio’s data is hosted in a private cloud,” Sachdev said.

“Our security framework is based on the ISO 27001 Information Security Standard, and we apply GDPR level privacy standards across our entire platform because we believe data privacy is critical. Twilio helps protect patient and constituent privacy with workflows and integration with other secure databases and survey platforms.”

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