Societal Effects Are a Major Factor for the Uptake of the Coronavirus Disease 2019 (COVID-19) Digital Contact Tracing App in The Netherlands

Highlights

• Digital contact-tracing (DCT) apps can contribute to significantly reducing coronavirus disease 2019 (COVID-19) transmission rates. The main determinant of the effectiveness of a DCT app is the level of adoption among potential users.

• The prevention of deaths and financial problems of households had a very strong influence on the uptake of the app. Predicted app uptake rates ranged from 24% to 78% for the worst and best possible app for these societal effects. The uptake levels in our study are much more volatile than the uptake levels predicted in comparable studies that did not include societal effects in their discrete choice experiments.

• Our study provides decision makers with information concerning the extent to which the uptake of the COVID-19 DCT app can be affected by its configurations and government policies toward such an app.

Abstract

Objectives

Our study investigates the extent to which uptake of a COVID-19 digital contact-tracing (DCT) app among the Dutch population is affected by its configurations, its societal effects, and government policies toward such an app.

Methods

We performed a discrete choice experiment among Dutch adults including 7 attributes, that is, who gets a notification, waiting time for testing, possibility for shops to refuse customers who have not installed the app, stopping condition for contact tracing, number of people unjustifiably quarantined, number of deaths prevented, and number of households with financial problems prevented. The data were analyzed by means of panel mixed logit models.

Results

The prevention of deaths and financial problems of households had a very strong influence on the uptake of the app. Predicted app uptake rates ranged from 24% to 78% for the worst and best possible app for these societal effects. We found a strong positive relationship between people’s trust in government and people’s propensity to install the DCT app.

Conclusions

The uptake levels we find are much more volatile than the uptake levels predicted in comparable studies that did not include societal effects in their discrete choice experiments. Our finding that the societal effects are a major factor in the uptake of the DCT app results in a chicken-or-the-egg causality dilemma. That is, the societal effects of the app are severely influenced by the uptake of the app, but the uptake of the app is severely influenced by its societal effects.