Gov. Ron DeSantis’ newest target in his ongoing clashes with public health experts is one of the bedrocks of their profession: contact tracing.
It “has just not worked,” DeSantis flatly told reporters last week in Palm Harbor.
A day later, DeSantis convened a panel of his go-to scientists, who took turns picking apart the disease control tool.
Despite these criticisms, DeSantis’ administration continues to pay a hefty sum for a New York company to supply the state with a contact tracing mobile application. The developer of the app, Twenty Labs, has received $4 million from Florida so far, according to the state’s online contracts database. The latest installment of $200,000 was paid on March 12 — a few days before DeSantis said contact tracing was an ineffective strategy.
Florida hired Twenty Labs last summer with a no-bid emergency contract. The company had little track record in the arena of epidemiology before 2020, but its coronavirus app, Healthy Together, had received a plug on national TV from Vice President Mike Pence. The startup’s co-founder is the son of a Palm Beach billionaire and a donor to former President Donald Trump, a close ally of DeSantis.
The contract with Twenty Labs is one of many the DeSantis administration signed over the past year in response to the coronavirus pandemic. The fast-changing nature of the crisis meant the state needed to move quickly to slow the outbreak’s spread. To do so, DeSantis and his agencies used emergency powers to forgo state laws that require competitive bids for state contracts.
But a year into the pandemic, there has been little oversight or accounting of how DeSantis spent the money and even fewer answers as to why certain companies were tapped for state work. Department of Health spokesman Jason Mahon did not respond to questions about how Twenty Labs was chosen to build Healthy Together and why it was picked over other companies.
“The state continually evaluates strategies that have worked to contain COVID-19,” Mahon said in a statement, “and we will continue to use our experience from this pandemic to guide future efforts to control diseases in Florida.”
There are two apps for that
At the time Healthy Together first appeared in the Google and Apple app stores, the Florida Department of Health already had a basic contact tracing mobile application, Stronger Than C-19, that was a few months old. It was built by a different company, World Wide Technology of St. Louis, at a price tag of nearly $450,000.
In a March press conference, DeSantis said he personally green-lit the creation of the Stronger Than C-19 application. Its April launch was announced with a press release from the Florida Department of Health. Like the deal with Twenty Labs, this was also an emergency purchase. The most recent payment of $68,000 was delivered on Dec. 2.
Mahon declined to say why Florida needed a second contact tracing application. He said Healthy Together was “an innovative solution” for local contact tracing and delivering test results. He added that all of Florida’s contact tracing expenses will be paid for with grants or federal funds, and that the state uses data from both its coronavirus apps “to inform our response to COVID-19.”
The state paid both app developers throughout 2020 even as DeSantis was beginning to sour on contact tracing.
In July of last year, a month after reaching a deal with Twenty Labs, DeSantis downplayed the strategy when faced with questions over the state’s commitment to local contact tracing efforts.
“When you have a lot of these asymptomatic 20-year-olds, there’s not a lot of contact tracing that’s being effective with them, because they haven’t been as cooperative with doing it,” DeSantis said.
Contact tracing is one of the oldest methods of disease control. It involves interviewing a person to determine the source of their illness and building a list of people they may have infected. It can be a critical tool for spotting emerging hot spots so public health officials know where to direct their time and attention.
At the onset of the pandemic, Florida enlisted hundreds of public health students to assist in its statewide contact tracing effort. Local county health departments used CARES Act dollars to hire more people to interview infected residents about their recent histories. But critics said the effort was disorganized and underfunded, and within months, the staff, many of them temporary hires, could hardly keep up with the volume of new cases as the outbreak reached every corner of Florida.
Lately, DeSantis has suggested that the coronavirus posed too great of a challenge for contact tracing to work. At an event last week, DeSantis and a group of hand-picked scientists held a one-sided debate on the efficacy of contact tracing and they reached the same conclusion, calling it “counterproductive,” and “the wrong strategy.”
“To think that it can be used for a pandemic is naive to the max,” said Martin Kulldorff, a professor at Harvard Medical School and a leading skeptic of the coronavirus response advocated by most scientists.
Thomas Hladish, a research scientist at the University of Florida’s Emerging Pathogens Institute, said Florida never implemented a comprehensive or cohesive contact tracing strategy. That’s why it failed, not because contact tracing doesn’t work, he said.
“It’s like showing up to a house on fire with a squirt gun and saying water doesn’t put out fires,” Hladish said. “You didn’t do it right in the first place.”
Ties to Trump donor
Twenty Labs is a startup that created Twenty, a social meet-up app. It didn’t have a background in disease prevention when the company launched Healthy Together in Utah, but it swiftly generated national buzz with spotlights on the Today show and on the popular technology website TechCrunch.
It received another boost in April during a nationally televised White House coronavirus task force briefing when Pence highlighted Healthy Together as a key element of Utah’s pandemic response.
Jared Allgood, the chief strategy officer for Twenty Labs, told the Tampa Bay Times that a representative from Florida approached the company after the launch of Healthy Together in Utah. The company initially helped the state with “scaling up their contact tracing operation,” Allgood said. Twenty Labs created a case management system that could handle all the data input from the thousands of local workers hired to interview new coronavirus cases.
The original contract was signed in June by Shamarial Roberson, the state’s Deputy Secretary for Health, and Darren Peltz, the company’s CEO and co-founder. Peltz is the son of Nelson Peltz, a hedge-fund billionaire who has helped run some of the largest companies in the world. Last year, Nelson Peltz threw a fundraiser for Trump’s reelection bid at his palatial Palm Beach estate that cost $580,000 per couple to attend.
Twenty Labs shares a Manhattan address with Trian Partners, the hedge fund company started by Nelson Peltz. Darren Peltz used an email address for Trian Partners on the contract he signed with the state. The news website Florida Bulldog first reported in December on the contract with Twenty Labs and its ties to Trian Partners.
Asked if anyone at the state had a conversation with the White House before hiring Twenty Labs, Mahon said: “Any suggestion that any vendor was selected based on political connections is patently false.”
The governor’s office entered into a second pact with Twenty Labs later in 2020 and Healthy Together launched in Florida in November. Three states now use Twenty Labs’ contact tracing app — Utah, Florida and Oklahoma.
After someone takes a coronavirus test, they receive a text message encouraging them to view the result through the app — sometimes duplicating results sent directly by the local county health department or the testing site. If they tested positive, they’re encouraged to complete a contact tracing assessment through the app. Allgood told the Times that Healthy Together has 1.6 million Florida users and has delivered 5 million test results.
Allgood said Healthy Together has helped cut down the time it takes to learn about someone’s positive infection. About 40 percent of app users who test positive conduct their contact tracing interview through the app, usually within 2.5 hours, he said. It can sometimes take days for a county health department to reach out to someone who tested positive.
“If you’re making the phone call three weeks late, then you’re not actually doing contact tracing,” Allgood said. “So, in that sense, I think we agree with Gov. Desantis.”
Michael Wiese, chief epidemiologist at the Florida Department of Health in Hillsborough County, said contact tracing remains a critical tool, especially as case volume decreases and variants appear. Healthy Together has helped capture some of that data, he said.
Other local health department officials told the Times that the data from Healthy Together is often incomplete or subjective, and still requires an in-person follow-up call. Others, like the Hernando County branch of the state health department, don’t use data sent from the app, a spokeswoman said.
“Even after receiving data in our system from the app, our investigators still call subjects to gather information,” said Maggie Hall, spokeswoman for the Florida Department of Health in Pinellas County, “which is how contact tracing really works — and has worked — to protect the public.”
Unlike the rollout of the Stronger Than C-19 app, the state did not publicize its partnership with Twenty Labs or the launch of Healthy Together. There’s little acknowledgment of the app on the website for the Florida Department of Health.
Hladish told the Times: “I’m a software developer and an epidemiologist who works for the state of Florida, and I had no idea (Healthy Together) existed.”