During the COVID-19 pandemic, governments worldwide turned to digital tools to strengthen health-system surveillance, contact tracing, and vaccination management. In Canada, COVID alert was launched in 2020 as a Digital Contact Tracing (DCT) mobile application promoted as a voluntary, privacy-preserving complement to manual contact tracing. Built on the Bluetooth-based Exposure Notification (EN) framework jointly developed and embedded by Apple and Google, COVID alert relied on a decentralized architecture that aligned with rapid implementation needs but limited centralized epidemiological monitoring and performance evaluation. Despite early promise, adoption remained modest, and the app was discontinued in June 2022. This commentary uses the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework to examine the socio-technical and socio-political factors shaping COVID alert ’s trajectory across domains including technology integration, value proposition, adopters, organization, the wider system and embedding over time. Building on these insights, the commentary argues that digital health innovation in crisis contexts requires more than technical feasibility; it demands anticipatory governance, reflexivity, inclusion, and responsiveness. Integrating the NASSS framework with Responsible Innovation principles provides guidance for aligning technological design with public values, institutional capacity, and long-term sustainability. As AI-enhanced public-health tools emerge, strengthening responsible digital governance will be essential to balancing privacy, effectiveness, and democratic legitimacy. • COVID Alert reveals limits of crisis-driven digital contact tracing • Adoption is shaped by socio-technical and governance factors • NASSS reveals misalignment across design, institutions, and context • Findings highlight need for a responsible innovation approach
Racha Soubra (Wed,) studied this question.