In March 2020, Uruguay reported its first Covid-19 case. Software engineer Laura Aguiar immediately called Gastón Milano, CTO of the Montevideo-based software development firm GeneXus. Aguiar offered to help in creating a digital solution to combat the virus, but Milano was already one step ahead of her. In the days prior, he had coordinated hundreds of the country’s technologists around the production of a Covid-19 app, which was developed and released through Uruguay’s digital governance agency, AGESIC, in a record-setting seven days.
Developing and expanding the app, known as CoronavirusUY, over the following months took its toll on the volunteer technologists, many of whom experienced fatigue-induced weight loss and exhaustion. Still, Aguiar says it was worth it. “We all had the feeling that we were doing something important.”
Between March and October of 2020, as countries across the Americas and Europe racked up cases by the thousands, Uruguay stood out globally by emerging relatively unscathed. The CEOs of Google and Apple wrote public letters to the Uruguayan government, praising its “innovative approach to harnessing technology for the social good.” Ever since, the app’s reception on the international stage has been a mix of gushing praise and complete obliviousness.
However, circumstances on the ground have changed, and the pandemic is now deadlier than ever. From mid-March to late October 2020, there were only 2,807 cases with 53 deaths from Covid-19 in Uruguay. By early February 2021, that total had ballooned to 42,667 cases with 453 dead, a rate of 133 deceased per million. This still places Uruguay far below its neighbors’ death rates, but has decidedly moved the country’s performance from world beating toward world average.
Though initially heralded as a “miracle,” Fabián Baptista, a technologist involved in the app’s creation, now calls certain aspects “almost useless.” He told Rest of World that months of work and thousands of developer hours had resulted in “a huge effort to end up with an app that has only been partially adopted.”
The Covid-19 application’s initial success at first seemed easy to explain. For decades, Uruguay’s government has worked to make the 3.4 million-person country a digital pioneer, placing it in the company of hyped-up techno states like Singapore and Estonia. Popular public programs to provide laptops and tablets to large swathes of the population — from toddlers to the elderly — have enjoyed broad support across the political spectrum. By 2019, these clear-cut digital successes led the government to invest $800 million in the country’s broadband internet infrastructure — 1.4% of GDP — which, in turn, facilitated the rise of a tech community that recently saw the creation of the country’s first unicorn.
Digitally enthusiastic public policy made Uruguay’s private and public tech sectors more deeply intertwined than in other countries across the world, particularly since the 2007 establishment of AGESIC. When the government decided to work on a coronavirus app, there were no public tenders, but also no controversies over the cost of blue chip consultants.
In November 2020, as the coronavirus began to spread rapidly, Uruguayans — average citizens and technologists alike — began wondering why cases were rising, given the trust they had invested in their technological approach. The disconnect between technologist optimism and user skepticism of the app widened. Aguiar lamented that they had been caught off guard by the schism: “We are tech people; we thought that what we are doing was important and that it would be accepted and used by everybody.”
Deeper soul searching was required when the CoronavirusUY app failed to live up to its initial hype. Its creation required the input of technologists, public health experts, and government officials — diverse stakeholders with needs and interests that diverged more than initially expected. There was also the lack of a comprehensive public communications strategy and the misplaced belief that citizens would simply trust and use the app.
Technologists and government officials presented their joint Covid-19 digital strategy in March 2020. It featured the CoronavirusUY app as its centerpiece, consisting of two main elements: communications and contact tracing. The communications portion of the app was designed to alleviate the burden that thousands of telephone calls and unwarranted doctors’ visits would have had on public resources. Through this communications initiative, developers introduced a telemedicine system and automated processes, like test booking.
The contact tracing feature is both the most crucial and most controversial feature of the app, since it relies on users’ willingness to notify those whom they may have infected. Yet, a national newspaper reported that notification rates stood as low as 3.3% of the third of Uruguayans who had downloaded CoronavirusUY and tested positive. As one user described to Rest of World, many opt to not disclose their condition because they have “doubts about how the app handles private data and security.” This is because it relies on a protocol developed by Google and Apple — two of the most enthusiastic cheerleaders of Uruguay’s digital coronavirus strategy.
Uruguayan technology researcher Fabrizio Scrollini and others echoed these concerns, highlighting the extent to which the country’s public sector relies on private sector solutions. Scrollini revealed to Rest of World that Apple and Google made decisions about the app’s design, such as what counted as “close” contact and aspects of data governance, which, he said, “the Uruguayan government had no say in, and then it eventually just decided to go with.” The government acquiesced, Scrollini said, because “data from Apple and Google was very useful in the context of the pandemic.”
While many technologists in the region share Scrollini’s worries about the influence of Big Tech — particularly in light of its spotty track record dealing with Covid-related misinformation and conspiracy theories — the concern isn’t universal. CoronavirusUY co-developer Baptista says these worries are “irrational,” arguing that “big companies like Google, Apple, and Facebook know almost everything about us already.” To Scrollini, this rebuttal was tantamount to “assuming that the government and citizens have no role to play … in conversations about the use of data as a public service.”
Google and Apple’s involvement has become more transparent as it has come under scrutiny from AGESIC and university researchers. However, the exact nature of the data-sharing agreement reached between government officials and the tech giants remains opaque. This is due to technologists’ feeling that expediency trumped most other concerns: “This is a war effort, and we will deal with the details later on,” was the general consensus, according to Scrollini. Precedent in other countries suggests otherwise, as governments around the world have used Covid-19 to pursue undemocratic practices under the guise of emergency measures.
Compounding skepticism around CoronavirusUY is the fact that user experience has hardly matched expectation, as Rest of World found after interviewing 30 Uruguayans who downloaded the app. Most report consulting the app to view statistics; “I use it to stay informed about daily cases.” Some said that they find it a useful tool “to report symptoms and ask for assistance,” while others complained that their test results were never synced: “I used it twice when I had symptoms, and it never helped get in contact with the health system,” one user told Rest of World. Some reported that early versions of the app did not function on the iPhone 6 or on older Android devices, which still have a significant number of users.
As the pandemic raged on into a new calendar year, public health experts began to publicly voice less enthusiastic opinions. Late last year, the poor execution of the contact tracing feature led Monica Castro, director of epidemiological surveillance at Uruguay’s Ministry of Public Health, to publicly assert that Covid apps overall had been less successful than technologists claimed.
On the other side of this widening government-technologist divide, Baptista pinned blame on officials, speculating that they had downplayed promoting the app wholeheartedly because, “when it comes to sensitive aspects like security and surveillance, the administration didn’t want to screw things up.” Technologists Milano and Aguiar also expressed frustration with the government’s communications strategy. “The government instructed citizens to wash their hands and social distance,” Aguiar said, “but they didn’t sufficiently emphasize the importance of downloading the app.”
In Uruguay and around the world, apps have been sold as a “miracle,” “a great milestone,” and “an enormous qualitative leap,” rather than just another tool in the government’s Covid-fighting arsenal. For Uruguay’s technologists, the creation of the CoronavirusUY app is a success — even if not an unmitigated one. They believe they’ve created a “big system,” a “monster” (a positive remark in Uruguay), something that can be used for future pandemics. Overall, technologists are proud of the work they did under budget and in record time: “good outcomes at almost no cost,” in the words of Joaquín Bazzano, an Uruguayan doctor and public health expert. But if — as some citizens, academics, and officials worry — the privacy and surveillance precedents that the app creates become more significant than its ability to mitigate the virus, could the placebo not end up being worse than the disease?