The saga of the development of a contact-tracing app to aid the UK’s fight against Covid-19 has taken another step with the news that just as senior members of the UK government concede that the official launch date of 1 June 2020 will not be met, health officials in Northern Ireland and Scotland look to be moving away from the official national strategy.
The UK’s track and trace programme is due to begin, as assured by prime minister Boris Johnson, on 1 June, but a key element of this – the contact-tracing app – is still only in test phase.
A trial of the contract-tracing app developed by NHSX, the digital innovation unit of the National Health Service, began in the Isle of Wight on 4 May. The app uses Bluetooth Low Energy technology to alert people who may have been exposed to the coronavirus.
Once installed, the app logs the distance between a user’s smartphone and other phones nearby that also have the app installed. The anonymous log of how close users are to others will be stored securely on the user’s phone. If a user becomes unwell with symptoms of Covid-19, they can use the app to inform the NHS, which, subject to risk analysis, will trigger an anonymous alert to other app users with whom the user has come into significant contact over the previous few days.
Yet even before it became available, the app had been surrounded by criticism, with critics weighing in with concerns over what it could achieve and whether the public could, or would, make representative use of it. Particular concerns were held over whether the app’s centralised nature would lead to privacy breaches and whether it would be any use at all if there was a lack of user uptake.
Less than a week since the app became available to residents of the Isle of Wight, UK communities secretary Robert Jenrick revealed that it had already been downloaded by more than 50,000 people – a third of the island’s population – and confirmed reports, highlighted by Computer Weekly on 8 May, that a radical change in the nature of the app was a possibility.
Timely launch unlikely
Only days ago, more experts piled into the debate as to whether the app would be launched by its scheduled time slot, releasing research casting doubt on what the trial could achieve. According to a survey by BCS, The Chartered Institute for IT, less than a quarter of IT professionals think the planned NHSX contact-tracing app will be effective in containing Covid-19, while a study on behalf of cyber security solutions provider Anomali revealed that a significant proportion of the population was not prepared to download the app.
After members of the House of Lords cast doubt on the 1 June target being met for a working app to support the contact-tracing and tracking personnel that have been employed, James Brokenshire, minister of state for security, toured leading media outlets in the UK attempting to assure that all was on track.
After junior health minister Lord Bethell indicated that the emphasis of the government was no longer on the app itself, but on the human elements of testing and tracking – an assertion not denied by government spokespeople – Brokenshire told BBC TV and radio news that he had every confidence the target would be met for the app’s launch and noted that the Isle of Wight trial was proceeding as planned. This was despite widespread reports of problems with the app regarding false negatives, lack of uptake and it draining phone batteries.
Divergent developments in Scotland
As the debate was raging, NHS Highland, in charge of healthcare in the Scottish region, was revealed to have signed a deal with Highland Health Ventures Ltd (HHVL) in association with Wyld Networks to test and deploy mobile mesh technology in care homes in Scotland to help protect residents, staff and visitors by preventing the spread of Covid-19 or other viruses.
Statistics from the National Records of Scotland (NRS) show that more than half of the recorded coronavirus deaths in Scotland over recent weeks were in care homes. Data from the Office of National Statistics (ONS) also shows that 12,526 care home residents died due to coronavirus in England and Wales during the four months to May.
“Supporting innovation across the healthcare system is more important than ever and will be central to securing transformation and improved care,” commented Frances Hines, research, development and innovation manager at NHS Highland. “Creating the conditions for more collaborative approaches to innovation and enabling the adoption of cost-effective new technologies will be key, and we are pleased to be working together with Wyld and HHVL to deliver innovative potential solutions for care homes.”
The Wyld technology will be used to provide digital access and anonymised social distance monitoring and alerting through a mobile app and a mesh wireless network of connected smartphones and internet of things (IoT) devices. The Wyld system is able to create virtual geozones around the care home and particularly sensitive or quarantined areas to control access, as well as dynamic personal two-metre geozones around everyone with the app.
Wyld and HHVL have already started the first project for implementation in a care home in Scotland. This came just as NHS Scotland launched a two-week pilot to test Covid-19 contact-tracing technology before it is deployed nationally. Three Scottish health boards – NHS Fife, NHS Lanarkshire and NHS Highland – have begun testing software, separate to the UK app, as part of the Scottish government’s Coronavirus: test, trace, isolate and support strategy, which aims to keep transmission of the virus as low as possible as the lockdown restrictions ease.
Northern Ireland’s decentralised route
NHS Scotland’s departure from the UK government’s contact-tracing plan reflects previously stated concerns in Northern Ireland. On 4 May, Northern Ireland Assembly health minister Robin Swann MLA urged the creation of an app that could work across the island. After acknowledging the data privacy concerns regarding the NHSX app, he added that the Northern Ireland authority would examine developing a separate app that could interact with an app in use in the Republic of Ireland which is based on a decentralised structure.
“Ideally, I would like to see one app used across these islands, because it means no matter where an individual is travelling, once we come out of lockdown, whether east-west or north-south, that same platform, that same app, can be utilised,” he remarked.
At the heart of the decentralised app will be an application processing interface (API) developed by Google and Apple. The Silicon Valley giants have just released a Covid-19 Exposure Notification API that will enable apps created by public health agencies to work more accurately, reliably and effectively across Android smartphones and Apple iPhones.
First revealed in April 2020, the technology is designed to enhance public health agencies’ apps by allowing smartphone users to decide whether or not to opt-in to Exposure Notification. Unlike the centralised NHSX approach, Google and Apple’s API-based system does not collect or use location data from a device, and if a person is diagnosed with Covid-19, it is up to them whether or not to report that in the health app.
As it released the API, Google said: “User adoption is key to success and we believe that these strong privacy protections are also the best way to encourage use of these apps.”