On May 5, the UK began managing a contact tracing mobile application on the Isle of Wight. After over a month, the mobile app has everything but faded from the public talk about the strategy of the government to fight the coronavirus pandemic. As the broader contact tracing system comes into action, we still are unaware of what happened in the pilot – and how it was planned to shape the UK’s contact-tracing strategy.

Health Secretary Matt Hancock’s first declared the app would be rolled out nationwide on the first of June finally that did not materialize. On May 28, England started its system, powered by 25,000 call centre workers emailing and phoning the contacts of individuals who tested positive for Covid-19; the app wasn’t included in the system.

Asked when the app is going to be launched, Hancock reported to The Daily Telegraph, “we will launch it if it is right.” September appears as an official launch date.

 

credit: https://www.bbc.co.uk/

 

The lack of focus on the app is strange. Until the Isle of Wight introduction, the app, developed by the NHS’s innovation branch NHSx, was touted as a critical tool to prevent the virus. The launch was also widely broadcasted by the government, which declared that 60,000 people — from a total population of 140,000 — had downloaded the app on the Isle of Wight.

In actuality, that figure could have included people who had downloaded the app more than once or were able to download it even if they weren’t on the island. Those users would have the ability to report through the app if they had developed symptoms, which would at once let them get tested for Covid-19, and automatically notify all the people they’d crossed paths with for over 15 minutes in the past two weeks. If the test returned positive, human contact-tracers would follow up with each of the patient’s contacts on the phone.

 

 

Questions began to emerge soon after the launch, the most pressing of them was the app working? An analysis from The Times has extrapolated from the difference between the increase of cases on the Isle of Wight and people on the mainland that the app has managed to first identify and then flatten the virus — but there are too many factors involved to take that case as convincing.

The government has not published any figure concerning the number of tests or those which have begun to self-isolate due to the app.  Local news site On the Wight has been posing precisely these questions, which amounted to a broader question: what exactly is being tested on the Isle of Wight?

The question was asked and randomly replied, in the House of Lords, on May 19. A life peer for the Green Party, Jane Jones, questioned James Bethell, junior health minister, what “the goals and purposes of the trial” were. Local Green representative Vix Lowthian had stated that the Isle of Wight’s residents were confused.

Bethell’s response was light on detail: this pilot’s purpose was learning from it. But one of the things learned, he said, was, “It is most likely a mistake to start an app before you’ve gotten the public used to the concept of tracing.” But such remarks have done little to clean up what the trial is currently attempting to attain.

“When it is about launching the test and tracing program, we’ll start with the tracing, not using the app,” which the authorities would do some weeks afterwards, Mr Bethell added.  A spokesperson for NHSX explained that the organization was “hoping to issue an evaluation shortly with discoveries.”

 

 

Common sense is that the pilot’s purpose was about measuring the app’s acceptance among the general public, rather than its efficacy at containing the virus. “We have never had an app like this before. [You need to know, can this work in reality? Is it accepted by people, which phones could or couldn’t download it? ,” Bryant says. “How would you use something like this? If you do not carry your phone around all of the time?”

Even if the first reports saying that contact-tracing apps would only be capable of an adoption rate of 60 percent have since been rectified, you still want more people rather than fewer to download the app. Short of making its download a compulsion, that means people have to be willing to download it.

“For the app to function, folks will need to believe in it,” says Martin McKee, a member of the Independent Sage, a group of scientists publishing information about the coronavirus crisis.  If trust — quantified in downloads — is precisely what was estimated in the Isle of Wight pilot, that will justify the lack of any release of figures from the government except for, indeed, the number of downloads.

It would explain the selection of an isle as the testing ground for an app whose usefulness would shine through in the hustle-and-bustle of a metropolis.  “For me personally, the Isle of Wight has been an odd choice, particularly during lockdown since it is a relatively closed community with plenty of physical distancing among strangers,” says David McCoy, professor of international public health at Queen Mary University. “The app is useful for identifying contacts that aren’t known. Its value will be useful for scenarios where a Covid situation has been in close and prolonged contact with a lot of strangers, like in public transportation.”

Why has the app’s wider launch repeatedly postponed? The discovery of technical constraints has probably something to do with it. Even since the app analyzed on the Isle of Wight is about to undergo its first upgrade, reports have surfaced showing worries within NHSX about Bluetooth’s ability to correctly calculate the distance between two users.

The same report says that the unit is thinking about backtracking on its decision to rely on a centralized approach that provides the NHS access to app data, over the decentralized system of alerts developed by smartphone manufacturers Apple and Google, which underpin contact-tracing apps in countries such as Switzerland, Latvia, Italy, and Poland.

Even in other nations, contact-tracing apps have faced challenges. The administration of Iceland, where about 40 percent of the populace has downloaded the official contact-tracing mobile app, has indicated the app was far from a “game-changer”; in Singapore, worries about information privacy and an overall distrust of the government resulted in a nearly low adoption rate: only approximately 25 percent of the populace.

In Italy — which started its own contact-tracing app in four areas before a national-rollout on June 15 — the app has quickly been captured as a political football, with rightwing leader Matteo Salvini vowing to not download it.

Britain’s delay will be less significant, had the authorities — and notably, Hancock, who started his very own Matt Hancock app in 2018 — not touted the app so powerfully, before making it fail in development limbo. Apps did not go to be anything more than a part of the broader contact-tracing effort. “It is just another tool in our armoury,” Bryant, the public health director, says.

 

 

England’s contact-tracing system itself was criticized from the get-go when contact-tracers working for call-centre companies whined of non-existent training and lack of guidance. On the Isle of Wight — in which the contact-tracing service was launched concurrently with the app — local politicians and reporters, such as the Green Party’s Lowthian, have shown confusion regarding the fact that contact-tracers are dependent on the mainland and have no awareness of the island’s topography.

The Independent Sage advocates for a more localized approach on the Isle of Wight, and throughout the UK.  This should not have been achieved through call centres.

It is not wise to do it like that, McKee says. Testing and contact- tracing has to be fostered very much in the local surroundings, there ought to be local ownership over it.  Finally, it’s going to be done best if it’s done by people who know the local area and the community. And that’s not happening.