During the coronavirus pandemic, the UK’s world-leading research and development has been at the forefront of the nation’s response, from the Oxford and AstraZeneca vaccine partnership to the new low-cost ventilator developed at the University of Glasgow. Yet, unlike other countries, our contact tracing system is still without an app.
The NHS centralised app has been abandoned. The trial carried out on the Isle of Wight was remarkably unsuccessful. Using Bluetooth, the app was planned to use an exposure notification system to establish the risk of each contact, based on the time of exposure and proximity to individuals who self-reported symptoms. One of the central issues with the app was the centralised data collection. An open letter signed by 177 computer and privacy experts voiced their concerns over the susceptibility of the data being hacked, combined with the fact that it’s possible to re-identify individuals from this data. The anxiety regarding data collection may have been a factor as to why only 40% of individuals downloaded the NHS app.
The fundamental issue, however, was that it functionally did not work. It was established that only 4% of IOS contacts and 75% of Android contacts were detected, compared with 99% from the Application Program Interface (API) created by Apple and Google. This significant failure was due to the operating system not allowing Bluetooth to run seamlessly in the background. The decision to create the app independently resulted in an estimated £11.8m being squandered, critical time lost, and an affirmation in the belief of British exceptionalism at the heart of government.
At Prime Minister’s Questions on 24 June, Boris Johnson claimed that no country in the world has a functioning contact tracing app, to which Keir Starmer cited Germany. This is an interesting exchange in the current context. The NHS website currently states: “the next phase of development in building an app … will bring together the work done so far on the NHS COVID-19 app and the new Google/Apple framework.” Turnitin would undoubtedly conclude a high level of plagiarism from the German app.
The German Corona Warn app uses a jointly developed API designed by Apple and Google, which broadcasts a random identifier powered by Bluetooth Low Energy that changes every 20 minutes. When an individual tests positive, their identifiers are then notified. A key benefit of this decentralised model is that data is not stored centrally and health information is limited to the device. Although functionally the app is an improvement, uptake is still an issue. The German app, at the end of July, had 16.4 million users, which works out at around 20% of the population. A recent analysis of downloads of the equivalent app in Singapore, where uptake is at the same level as Germany, shows that the likelihood of two randomly chosen individuals coming into contact both with the app downloaded is 4%. However, the decision from the UK government to go down the same path as Germany is due to a lack of other options as opposed to its effectiveness.
Evidence of the effectiveness of any contact tracing app in the world is scarce. South Korea is often touted as the pinnacle for technological surveillance in this field. However, their system is built on a comprehensive testing programme backed up by an extensive network of human tracers that send through phone alerts – a system not comparable to the Bluetooth technology considered essential in Europe. Although highly successful, the system can’t be replicated in Europe due to the extensive data gathering of personal information by the government (including credit card transactions), which would break EU regulations. The favoured approach in Europe is not without its privacy issues as, even though health data is not stored, they have the right to collect wider metadata, which is why both the UK and German governments opted to design their own app initially.
Privacy concerns are currently a key flaw to any contact tracing system. However, there are also contradictions between the design of an app and the nature of COVID-19. Firstly, the virus disproportionately affects the elderly. According to the National Records of Scotland, 77% of deaths from COVID-19 have been people aged over 75. This is a central concern for an app as this age group is the least likely to have a smartphone, which will break the chains of transmission the app records. Another paradox is that asymptomatic transmission is not reduced by an app that relies on symptoms, either to report or get a test. The World Health Organisation has suggested that around 16% of transmission is asymptomatic, and it could be as high as 40%. These two groups are of utmost importance to reducing cases in the UK yet the app will help with neither.
The lack of an app has been a huge political football overblowing the possible impact of an app that is within the realms of possibility from a technological and privacy standpoint. Although theoretically, an app seems like a magic bullet but simply it is not.