Table 3.

Overview of technology implemented in response to Covid-19 in France, Belgium and Canada.

Health Technology (Announcement or use of Health Technology)	Contact Tracing	France	The Stop-Covid mobile app was released on June 1st after heated debates about data privacy. The app uses Bluetooth technology and its use is completely voluntary. Users will be warned if they have crossed paths with someone who has tested positive for Covid-19 in the two previous weeks. One week after its launch, 1.4 million people had downloaded it, representing only 2% of the population[51].
		Belgium	Belgium started its contact tracing trials on the 4th of May as part of their exit strategy, but refused to commit to an app-based approach until an announcement in early June that they would work to develop such an app by September. In the meantime, 2000 contact tracers were hired to perform manual contact tracing from call centers, which are operated by regional governments. The government in Brussels set aside €10m for contact tracing, with these measures expected to remain in place for one full year [52].
		Canada	In an effort to implement nationwide contact tracing, the federal government created the Canadian Digital Service, which developed an app based on Bluetooth technology provided by Apple and Google. The government has emphasized that the app is voluntary but recommended as many people download it to improve effectiveness. The app was first piloted in Ontario on July 2 before being released nationwide. Complicating matters, some provinces had already launched their own apps, such as ABTrace in Alberta, which was activated on May 1st. This created concern for a fragmentation of contact tracing networks across the country that could damage their effectiveness [53].
	Healthcare Delivery and Prevention of Covid-19 infections	France	Healthcare delivery: Some existing 3D printers were re-purposed to create masks and non-invasive ventilators [54]. Healthcare delivery: The government relaxed the conditions for carrying out telemedicine acts until April 30th. Doctolib, the largest provider of telemedicine services, delivered over 100 000 teleconsultations per day while confinement measures were active, 100 times more than before the pandemic [26]. Prevention: The Pasteur Institute has set up a “covid-score” website where individuals can calculate their risk of getting severe complications or dying from Covid-19, based on statistics around risk factors such as age, size, weight, and sex. This website was launched on the 11th of May to support phase one of deconfinement [55]. Healthcare delivery: The telepresence robot “Pepper” was used in a Paris ICU in an attempt to keep patients connected to their social networks and prevent mental health issues [56].
		Belgium	Healthcare delivery: On April 1st, Belgium started reimbursement for teleconsultations related to COVID-19. Under this measure, physicians were allowed to give out medical advice over the phone to help patients who were potentially infected with Covid-19 and to ensure continuity of care for patients with chronic diseases who faced increased risks in leaving their homes [20].
		Canada	Prevention: The federal government released the “Canada COVID-19 App and Daily Symptom Tracker” alongside an online self-assessment tool in an attempt to provide official information to citizens regarding pandemic policy measures and healthcare options. Prevention: The ArriveCAN app was developed to pre-screen arriving travellers and create a more contactless border security process [30]. Healthcare Delivery: Prior to the pandemic, telemedicine represented just 0.15% of all medical services delivered in Canada, due to billing models that paid more for physical visits. B.C. responded by making digital health services billable at the same rate as physical appointments, but in other provinces there has been little support for a shift to telemedicine [35], [36], [37].
	Covid-19 Treatment	France	The state recommended to suspected Covid-19 patients to use video-call consultations to get diagnosed and monitored at home in order to avoid risks of transmission and burdening of healthcare service. Patients with other pathologies were also encouraged to get treated remotely [26]. Remote monitoring also involved patients with confirmed or suspected Covid-19 receiving a secure link to a self-assessment questionnaire every day through the Covidom app, with follow-up calls from physicians if their state of health worsened [57].
		Belgium	A consortium of 7 Belgian medtech companies developed the “Covid-19 smart patch” to remotely monitor respiration, heart rate, and temperature of Covid-19 patients [58].
		Canada	Health Canada approved over 43 clinical trials for Covid-19 treatments (as of 10/06), including multiple for the controversial drug hydroxychloroquine. Novel chest x-ray technology that bypasses radiologist assessment requirements was also sped through the approval process for new medical devices in the hopes of obtaining faster Covid-19 diagnoses. A “DNA testing cube” the size of a coffee cup was developed by Canadian startups and can process Covid-19 tests in under an hour, and the federal government agreed to a procurement contract of 14000 per month [30].