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Podcast: COVID-19 Exposure Notification in Colorado with Sarah Tuneberg

Posted on September 29, 2020


Sarah Tuneberg

Sarah Tuneberg
Innovation Response Team Lead
State of Colorado
Bio | LinkedIn | Twitter


Technology and emergency response. Sarah Tuneberg, the Innovation Response Team Lead for the State of Colorado, joined the podcast to talk about a new COVID-19 exposure notification app that uses bluetooth to alert people if they have exposed to someone who has tested positive for COVID-19. She described how the technology works and how it helps as another tool in the State’s response to the coronavirus. Sarah also shared how she ended up working on the Innovation Response Team and what else the group is working on.

Host: Alyssa Dinberg

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Episode Transcript

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ELGL Oktoberfest is coming. Instead of gathering in person this year for a few days of learning and fun, we’re going all digital. So for the whole month of October ELGL members from across the country will be gathering together virtually, to talk all about local government. We have three tracks to choose from plus summits on Creative Placemaking and Innovation and Strategy. It’s going to be a great time. To get you even more excited, here’s a couple of our amazing speakers. Brian Platt from the City of Jersey City, New Jersey is joining us. Dr. Farris Muhammad from the City of Peoria, Illinois, and Tina Walha from the City of Seattle, Washington is going to speak at the conference as well. You can learn more at the ELGL website and register for the best conference of the year. Go to ELGL20.org. That’s ELGL20.org to learn more.

Alyssa Dinberg

Coming to you from Denver, Colorado, this is GovLove, a podcast about local government. GovLove is produced by ELGL, the Engaging Local Government Leaders network. We engage the brightest minds in local government. I’m Alyssa Dinberg, and today I’m joined by Sarah Tuneberg, Governor Jared Polis’s Coronavirus Innovation Response Team Lead. Sarah is going to walk us through how Colorado became the first state to deploy a phone app for COVID-19 tracing. Welcome to GovLove, Sarah.

Sarah Tuneberg

Thanks so much for having me. I’m super excited to be here.

Alyssa Dinberg

Yeah, I really appreciate you taking the time to do this. I know that things are really crazy for everyone right now. And so we’re super excited to have you on.

Sarah Tuneberg

Yes, crazy indeed, but important that that we all have good conversations about the important things in the midst of the crazy. Yeah.

Alyssa Dinberg

Okay, so as we do with every podcast episode, we start off with a lightning round. And if you’re unfamiliar with our podcast, the lightning round is just a fun way for our listeners to get to know you and to break the ice and to just start off in a fun way. So if you’re ready to get started, I’m going to start with my first question.

Sarah Tuneberg

Let’s do it.

Alyssa Dinberg

Alright, so if you could have an unlimited supply of one thing for the rest of your life, what would it be?

Sarah Tuneberg

Empathy.

Alyssa Dinberg

Ooh, that is not the answer. I was like, I don’t know what I was expecting. But that’s not what I was expecting. That’s really good.

Sarah Tuneberg

I think that’s where you start with everything. If you have an unlimited supply of empathy, you can sort of tackle any problem and communicate it with any hard situation or challenge. Like it’s the key to me.

Alyssa Dinberg

You’re definitely in the right field. I have to say that. [Laughter] Okay, so I ask this question in every episode. If you could be a vegetable, what would what would you be and why?

Sarah Tuneberg

Ooh, a carrot without question. It is the perfect vegetable because it can be sweet on its own, has lots of nutrition. It’s also, it like walks that fine line of sweet and savory, like equally delicious in a cake with cream cheese icing, as it is dipped in Ranch, or just by itself on the road, the perfect vegetable.

Alyssa Dinberg

Wow, I never really thought about that. Carrots are really, really diverse. They can cover a lot of bases.

Sarah Tuneberg

Adaptable.

Alyssa Dinberg

Very adaptable. Okay, so let’s switch gears to talk about everything that’s happening in Colorado right now with the app. It’s super exciting. Um, so if you could briefly tell the listeners who you are and what you do. So I think if you could talk just briefly about what you did pre COVID. And what you do now, that’d be great.

Sarah Tuneberg

Sure, absolutely. So I have kind of a, as all good people mid career might have or late career, I have sort of a circuitous varied background. So I’m an emergency manager with a background in public health. I did a bunch of work related to refugees in the early part of my career, and then was living in New Orleans when Hurricane Katrina happened. And that really drove me to shift my focus. And so since Hurricane Katrina, I’ve been working, sort of at the intersections of public health, emergency management and crisis. And that looks a lot like climate change lately. So I went from a government role, a consulting capacity, really being in service in a public service capacity to co founding a tech startup in Denver in 2018. It’s called Geospiza. I was the CEO of Geospiza, where we do large scale data analytics, to support decision making in crisis, particularly around climate change. And another thing about my career is that I’ve spent all of my career deeply engaged in issues related to equity, and justice in disaster and crisis. So people with disabilities for example, people of color, are disproportionately affected by disaster. And I am deeply passionate about that and how we use technology to reduce that disproportionate effect and better meet the needs of the whole community in disaster. So that’s my background. And I was in my CEO role working in the tech and startup space in Denver when Hurricane Katrina, I mean, sorry, when COVID happened, and a great investor and a great person within the startup space, Brad Feld, reached out to me. He’s known Governor Polis forever and ever. They had a business together a million years ago. And he said that there was this idea brewing called the innovation response team, within the governor’s office to bring the ideas of entrepreneurship, entrepreneurial thinking, startup mentality, and the power and the speed of the private sector, to the COVID response, not to replace any of the work that the amazing people were doing. It just was such a huge and new and emerging problem that the governor had an idea as a tech CEO, a former startup person, this idea that we could add something to the mix by bringing entrepreneurial thinking and startup mentality and problem solving to the mix. So in March, mid March, I was tasked by Governor Polis to lead the Innovation Response Team. So that’s how he came to this work. And part of my big part of my portfolio is tech. It’s how can we bring new and emerging technologies, data analytics visualization, to the response to better inform the policy decisions we’re making to help be in communication with all Coloradans to help all of the aspects of the response.

Alyssa Dinberg

That’s amazing. So I am a Colorado resident. And so I just feel very lucky to have both Governor Polis and you leading our COVID response. I feel like Governor Polis has done a really good job. And yeah, I just, it’s great to have you guys here.

Sarah Tuneberg

I absolutely agree. I feel incredibly lucky to live in Colorado, not just to have Governor Polis as our governor, but all of the leadership we have sort of up and down from city managers and county commissioners to our incredible local public health directors just like all around, it’s been this incredible experience of seeing people in a real time of struggle and crisis come together. And I also feel incredibly lucky to live in the state with all of Coloradans. We are health oriented, we’re innovative, where we have sort of a Western mentality. And that has given us an edge. I think we’ve we’ve responded so well to this, because of the amazingness that is Colorado, and as a Colorado native, I feel really lucky to be here.

Alyssa Dinberg

I echo all of those things. I am not a Colorado native Colorado native, I’m actually from a state that is not doing so well. So very happy to be here right now. Um, so let’s talk a little bit about the app. And just to give our listeners some back history. On April 10, Apple and Google announced plans to build a COVID-19 tracing into iPhone and Android operating systems. This move marked a major partnership between the two top mobile operating system competitors in an effort to limit the spread of COVID-19. How did the State of Colorado get involved in this? And what has the process looked like?

Sarah Tuneberg

Yeah. So in the earliest days, I will say I think, even before Google and Apple announced their partnership, the innovation response team was watching technology, including exposure notification really closely. So we had seen South Korea and Singapore deploy exposure notification technology, Bluetooth enabled technology, really successfully. And in South Korea, especially it was an incredibly strong part of their response, and their ability to contain and suppress the disease. So we, in the innovation response team put together a team that were just monitoring and were having a lot of conversations, were exploring it, reaching out to contacts in other countries and just trying to get a sense of what was happening. And then, um, Google and Apple announced their partnership. And that was huge, such a big milestone, two big competitors who sue each other all the time and battle it out for market share really coming together for the good of people, of mobile phone users, which is nearly all of us. And as with any technology, there was iteration that needed to happen and there was a lot of work that needed to be done. So the first things they proposed weren’t great for Colorado. From our perspective, they didn’t, they didn’t have enough privacy protections, they didn’t have the right sort of, it just wasn’t right for Colorado. So we in Colorado and in the governor’s office and in the IRT took a very deliberate stance of waiting and watching, participating in discussions, incredible learning, watching what other countries did, and watching the development of the technology. And some things that were absolutely crucial to us were that it be Bluetooth only, and not be location services. So we didn’t want satellite pinging of the location. Because we thought that that could facilitate tracking. We didn’t want this to be an app that tracked anybody. And we also wanted to ensure that an individual’s personal health information and name or anything like that was fully disconnected from the exposure notification service. And it took a little while for that to come to be. Um, but it happened just recently. And that’s why we’re launching it now is we feel really confident that this is the right time and that the technology is advanced to the place that it meets all of our expectations.

Alyssa Dinberg

That’s really interesting. I didn’t realize that it was Bluetooth. That’s really cool.

Sarah Tuneberg

It is.

Alyssa Dinberg

Can you talk a little bit about how the app works, and how it’s going to help with contact tracing?

Sarah Tuneberg

Yes. So I will preface this by saying it’s a little bit um, it feels a little convoluted when you talk about it. Because of the incredible layers of privacy protection, it becomes like a little bit obtuse to talk about. So I’ll preface that with that. So the way it works is a little bit different, whether you’re on Android’s operating system or iOS, Apple’s operating system. So on Android, you’re going to have to download the exposure notification app onto your phone. So you will, if you are an Android user, sometime in the next couple of weeks, get a pop up on your phone that says, Do you want to know download exposure notification. You’ll go to the Google Play store and you can notify, you can download it and turn on the functionality. So that’s the way it’s gonna look on Android. The experience on iOS is a little bit smoother, maybe it’s the language is a little different. And the way it’s going to work on iOS might work for lots of people already, which is you will get a pop up on your phone that says Do you want to enable exposure notification, and you will then click through to your settings. And you will slide the little sidebar in your settings to enable exposure notification. And so just like you would turn on Bluetooth, turn on anything Wi Fi, it’s in that same menu, I think it’s in the same place as emergency notifications as you would turn on and off for weather notifications. So that’s the first step. And you will also if you’re in Colorado, we need a couple of more weeks to customize the experience for Coloradans. We’re working on it. What will happen is that you will enable the functionality and go about your business and nothing else. You don’t have to do anything else. Until one of two things happens. The first one is that you test positive for COVID. And when you test positive for COVID, you will it is currently the process that you will get a phone call either from the Colorado Department of Public Health and Environment or your local public health entity to do what’s called case investigation and contact tracing. So a trained public health professional is going to call you and they’re going to ask how you are and try to understand where you were exposed and who else you might have exposed. So we can then call them and ask those individuals to get tested and also maybe isolating quarantine, so we can limit the spread of covid. That’s our current process. During that process, once we have exposure notification turned on, your contact tracer case investigator will say hey, do you have exposure notification enabled on your phone? And if you say yes, they will give you a unique key that will turn on the functionality that’s been working in the background on your phone. And what that thing is, that’s been working in the background is that anytime your phone is in proximity to another phone that has the exposure notification functionality turned on, and if those phones are close enough to each other for 15 minutes or more, every 15 minutes, they’ll exchange a random string, which we call a token. And that string is a random set of letters and numbers, they exchange on back and forth every 15 minutes. And those are stored for 14 days. So when you test positive, and your contact tracer gives you the key, the key unlocks all of those tokens, those random strings, and any phone that exchanged those keys that are now associated with those 14 days, those tokens, and those 14 days, get a notification that that phone has been exposed to COVID. And so again, it’s a little bit funny, because we think about, we don’t think about phones as being susceptible to COVID or exposed to COVID. But what we’re really talking about is a phone because it’s not actually a person, there’s no personal data associated with it. No names, no IP addresses, no locations, it really is just this exchange of these random tokens every 15 minutes. And they build up over 14 days. After 14 days, they’re deleted. That sort of turns on the functionality. Again, a little obtuse, a little like, out there. Does that make sense, though?

Alyssa Dinberg

No, that makes complete sense. And I have to say that while you were talking, I pulled out my iPhone just to like, see if it was on here. And it totally is. And when I selected Colorado, it says exposure notifications are currently not available. So you are right.

Sarah Tuneberg

Yeah, we’re getting there. We’re very close.

Alyssa Dinberg

It’s awesome. I’m excited that it is already on my phone.

Sarah Tuneberg

And if you turn it on and leave it on, I believe it will work once we make our customization. So if I were you I would leave it on.

Alyssa Dinberg

Yeah. So do you have to have Bluetooth on the whole time?

Sarah Tuneberg

That’s a really good question. I don’t know the answer to that.

Alyssa Dinberg

I mean, I guess most people use Bluetooth these days. But yeah, yeah. Just wondering.

Sarah Tuneberg

I think so. I think you need to. And so then to answer your next question, which is how does that help. Um, so it doesn’t technically in and of itself, health contact tracing, because we don’t, it doesn’t collect any personal data, doesn’t collect names or locations. It doesn’t give contact tracers any more. Contact traces are sort of like a disease detectives, right. It doesn’t give them any more information. But what it does do is it allows for the seamless and privacy protected anonymous notification of individuals who might have been exposed to a person who now has COVID. So it helps all of us fight COVID because we know a lot of things. One is that asymptomatic or pre symptomatic infection is a huge part of the problem of COVID. People who have no idea they have it, are out spreading it. So we sit on a park bench or we sit on a ski lift, maybe someday with somebody, we end up getting stuck on that ski lift with them for longer than we intended. And it turns out, they had COVID, and they exposed us. You’d never be able to find that person again, if you had never met them before. But through this sort of random exchange of tokens on our phones, we can get notified and we can take protective actions like get tested, stay in isolation, quarantine, avoid being close to other people. It’s not a replacement for contact tracing, or testing or masking, or six feet of physical distance. It’s another tool in our tool chest. It’s just another one. And we like to think of it as getting your phone in the fight against COVID. And there’s no reason not to have your phone in the fight. Right? It doesn’t cost you anything. It doesn’t harm you. It doesn’t track you. It’s not big brother, and it might actually protect you.

Alyssa Dinberg

So I know that Colorado is participating. Are state’s able to opt in or opt out?

Sarah Tuneberg

Yes. So Google and Apple have been incredibly particular that they want states to be on board this and that they’ve required that states as a whole opt in, not all states as a whole, but like we couldn’t have half of Colorado opt in. The whole state of Colorado has to. And part of the reason is that we, it only works if enough people use it. And we believe based upon the data modeling, that that right amount is at least 10%. And so we need everyone in Colorado to do it for it to be its most effective.

Alyssa Dinberg

Ok, that makes sense.

Sarah Tuneberg

And the other reason why we need states to opt in is because you can only get that key, which releases the tokens from a public health professional, from an official because that then avoids problems of spoofing or disruption. We have to have, you can only get that key to notify to send the notifications from a public health person.

Alyssa Dinberg

Okay, that makes sense. Cool. Well, that’s awesome. I’m really excited about this. I’m excited to see how it makes an impact in our numbers, both in Colorado, but also nationwide, I hope, I hope all states opt in to participate because it could make a huge impact.

Sarah Tuneberg

Yeah. And we target it in Colorado, we aligned our participation with some Western state partners, Oregon, Washington, California. One of the reasons that we’re really excited about this is not just for Colorado, but recognizing that Colorado has incredible tourism. And we welcome lots of people from out of Colorado and they come and go from our state. And this is another tool to help us keep them safe and keep Coloradans safe as they interact with people from out of state right. It’s, as people come skiing, we want them to download this app, so that we can ensure that if they were exposed, they while they were here, they can find that out. And that if they came with COVID and expose people, we can find that out as well. So the more nationwide distribution we have, the more enabling we have, the better it works for all of us.

Alyssa Dinberg

Awesome. So I have one last question. Is the Innovation Response Team working on anything else breaking like this, that you might or breaking news that you might be able to share or not?

Sarah Tuneberg

Sure. I think there are a couple of things that the Innovation Response Team and the teams at the Colorado Department of Public Health and Environment have made incredible progress on. So I have two that I think are really great. The first one is, we have procured a new case investigation and contact tracing software solution. It’s not public facing, it’s the sort of CRM or customer relationship management tool. If people are from a tech world that helps us do our work better. Case investigation and contact tracing historically in Colorado has largely been done on paper and pencil or in spreadsheets. And that doesn’t scale. And that is an incredibly difficult tool to operationalize an outbreaks where you’re talking about cases across jurisdictions, maybe a workplace that draws employees from three different counties and makes collaboration really hard. And one of the things we don’t have enough of in COVID is time. And so we’re really at the Innovation Response Team and at CDPHE at the direction of the governor really working on how do we optimize for more time? And how do we help our incredibly talented public health professionals be using their brains sort of at their highest best purpose to help battle COVID and, and that looks a lot like using great software tools rather than spreadsheets. So that’s something I’m super excited about. Also, that software is called Dr. Justina. And it’s named in honor of Dr. Justina Ford, our first African American female physician in Denver, who really was an early pioneer of health equity. She serviced anybody no matter what race, no matter your economic background. She often traded things like soap or eggs or flour for medical treatment. And so it’s really an homage to her and this idea of equity and health, especially in COVID that we named it for her. So we’re really excited about that. And then the other thing that we’re really excited about is innovation and testing. I think we are at a sea change. We’re approaching an incredibly new development hopefully, which is widespread availability of rapid low cost testing options. So we have the first one which is called an Abbott Binaxnow. Abbott’s says it’s gonna cost $5 and results come back in 40 minutes, has to be administered by a public health professional or a medical professional. But 40 minutes is a game changer. And $5 is a game changer. We’re currently paying $100 a sample on average, and it takes six to eight hours just to process it. This is a huge thing. And this is just the first of those. So I think we’ll be in a really different place on testing over the next 90 days. And we’re excited about it.

Alyssa Dinberg

Yeah, that is super exciting. I know that a lot of Public Health Directors around the, around the country are going to be very excited to hear about that.

Sarah Tuneberg

Yeah. And teachers and parents. Yeah. And folks who can then visit their grandparents and family members and loved ones in nursing homes. It’s just, it’s a really great thing. So…

Alyssa Dinberg

Yeah, that’s huge. All right. So I really appreciate you coming on and talking with me today. As we end every podcast episode, and I was wondering if you could be the GovLove DJ for this episode, what song would you pick as your exit music?

Sarah Tuneberg

Oh, Ain’t No Mountain High Enough, by Marvin Gaye and Tammi Terrell. It’s my walk on and walk off song, the thing we all should think.

Alyssa Dinberg

Yeah, that’s awesome. I’m really, really happy to have had you join me today. I think it’s really really amazing all the innovative things that you’re coming up with. And thank you to you. Thank you to your team.

Sarah Tuneberg

Thank you for having us and stay well, wear masks, wash your hands, stay six feet apart.

Alyssa Dinberg

Thank you. Well, that ends our episode for today. Thanks for coming on and talking with me. GovLove is produced by a rotating cast of awesome ELGL volunteers. ELGL is the Engaging Local Government Leaders network. Our vision is to amplify the good in local government and we do this by engaging the brightest minds. For our listeners, you can reach us at elgl.org/govlove or on Twitter at @govlovepodcast. If you have a story for GovLove, we want to hear it. Send us a message on Twitter or email [email protected] Thanks for listening. This has been GovLove, a podcast about local government.


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