Dig­i­tal war­fare

Can the NHS Covid-19 app get the mil­lions of down­loads it needs to pre­vent a sec­ond wave?

The Daily Telegraph - Business - - Front Page - Matthew Field

‘Here we are, try­ing to do our bit and it fails,” read an irate re­view on Google’s ver­sion of the NHS Covid-19 app. “My 79-year-old mother tried to down­load the test and trace app onto her iPhone 6. But she can’t. Her phone is too old … how stupid is that?,” wrote another user on Twit­ter.

It wasn’t the best start to the app’s roll out in Eng­land and Wales yes­ter­day. Just hours af­ter its launch, NHS Covid-19 had a lowly one and a half stars out of five on the Google Play Store, and just three out of five on Ap­ple’s App Store.

With grow­ing frus­tra­tion over a lack of tests and the fail­ure in hu­man con­tact trac­ing, con­fi­dence in the Govern­ment’s abil­ity to cre­ate an ef­fec­tive test and trace sys­tem has dropped to an all-time low.

The app is meant to change that. Based on Ap­ple and Google’s pri­vacy-cen­tric soft­ware, it is the sec­ond at­tempt by the Depart­ment of Health and So­cial Care (DHSC) to de­velop a soft­ware for con­tact trac­ing.

A first ver­sion, that stored some in­for­ma­tion cen­trally and was sup­posed to launch in May, was ditched af­ter months of de­lays, mil­lion of pounds and an un­suc­cess­ful trial on the Isle of Wight.

The new ver­sion has been tri­alled again on the Isle of Wight and in the Lon­don bor­ough of Ne­wham. While it has over­come some tech­ni­cal hur­dles that plagued the ini­tial de­sign, it still faces ma­jor chal­lenges. Chief among them: con­vinc­ing mil­lions to use it.

Early es­ti­mates sug­gested 50pc of all smart­phone users, or 30m peo­ple, will need to down­load the app for it to work ef­fec­tively. The Govern­ment and sci­en­tists have since trimmed those fig­ures. Christophe Fraser, the Ox­ford sci­en­tist be­hind the orig­i­nal re­search into dig­i­tal con­tact-trac­ing, says at least about 15pc of the pop­u­la­tion need to have the app to make an im­pact, claim­ing that sort of up­take could help cut Covid deaths by 6pc.

How­ever, a study con­ducted in May by re­search firm Ogury found only two fifths of the UK pop­u­la­tion were will­ing to share such data with the Govern­ment, while an es­ti­mated 20pc of UK adults do not own a smart­phone at all, ac­cord­ing to the Of­fice for Na­tional Statis­tics.

Scot­land and North­ern Ire­land al­ready have their own apps, but up­take in Scot­land has been fairly mod­est. Around 1m peo­ple have down­loaded the app out of a pop­u­la­tion of 5.5m. More than 300,000 have down­loaded North­ern Ire­land’s app, from a pop­u­la­tion of 1.8m.

Will the NHS app be any dif­fer­ent? Wolf­gang Em­merich, the CEO of a lit­tle known An­glo-Swiss start-up called Züh­lke En­gi­neer­ing, who helped de­sign the app as part of a £3.8m con­tract, claims it is the “most fea­turerich app in the world.”

“I can’t tell you that we could have done it any faster,” Em­merich says. “We don’t build med­i­cal de­vices in a mat­ter of weeks. It nor­mally takes years, and we did not want to launch a buggy app. We have the ben­e­fit of learn­ing from what other coun­tries ex­pe­ri­enced [with the app].” This in­cludes what he calls “me fea­tures” to get ex­tra down­loads.

These fea­tures, the Govern­ment’s sci­en­tists be­lieve, will be key for keep­ing peo­ple en­gaged. Its cen­tral fea­ture is Blue­tooth con­tact trac­ing, which can alert users when they come into close con­tact with some­one who also has the app and re­ports a coro­n­avirus in­fec­tion.

Users up­load their test re­sult, the app then warns any­one else us­ing the tech­nol­ogy that they came within two me­tres for a set amount of time. This is anony­mous, so strangers can be warned with­out ever know­ing the name of the per­son who trig­gered the warn­ing.

But it also has fea­tures to en­cour­age more down­loads. One is QR code scan­ning. QR codes are bar­codes that can be scanned to ac­cess an in­ter­net link. The app will be able to scan Govern­ment QR codes that are now manda­tory in restau­rants and pubs. Peo­ple will use this fea­ture to “check-in”.

But rather than en­cour­age users, the use of QR codes risks alien­at­ing the el­derly who may strug­gle to un­der­stand how it works. One ONS study found just 4pc of UK mo­bile users had scanned a QR code for mo­bile bank­ing or pay­ments, one of their most com­mon uses.

An added com­pli­ca­tion is that the app will not work on iPhones older than the iPhone 6, which was launched in 2015.

The app needs phones run­ning iOS 13.5 or later, with one es­ti­mate from Glob­alS­tats sug­gest­ing as many as 20pc of UK iPhones run on older op­er­at­ing sys­tems. An­droid phones older than 2017 may also strug­gle to down­load the app. An es­ti­mated 40pc of over 65s also do not own a smart­phone at all.

Even for those who have a phone that is com­pat­i­ble and know how to use QR codes, the ef­fec­tive­ness of the tech­nol­ogy and pri­vacy con­cerns re­main a stick­ing point to peo­ple down­load­ing it in the first place.

Ap­ple and Google said ear­lier this week that they be­lieve their Blue­tooth tech­nol­ogy is able to cor­rectly iden­tify around 80pc of close con­tacts.

And Matt Han­cock, the Health Sec­re­tary, yes­ter­day de­nied a re­port that Blue­tooth’s abil­ity to be in­ter­fered with by nearby ob­jects meant one in three peo­ple told to self-iso­late will have been given a “false pos­i­tive”.

“No, no­body who gets an alert say­ing they should self-iso­late will have not been in close con­tact with some­one else who has the app,” he said.

Take-up on the Isle of Wight was re­port­edly around 30pc, still some way off the 50pc con­sid­ered ideal. In Ne­wham, one of Bri­tain’s most di­verse bor­oughs which also has a high rate of Covid in­fec­tion, it was just 10pc.

Em­merich says, how­ever, that un­der­stand­ing of the app was high. “The find­ings were it was easy and in­tu­itive to use,” he says. “We have run fo­cus feed­back ses­sions and we have ev­i­dence that it is rea­son­able to use.”

Em­merich adds that Ger­many’s app, which has around 15m down­loads, has suc­cess­fully bro­ken 5,000 chains of trans­mis­sion. The prob­lem is, since the data is com­pletely anonymised, it is hard to know if these con­tacts self-iso­lated. De­spite ini­tial scep­ti­cism af­ter the fail­ure of the first app, the new con­tact-trac­ing app ar­rives at a mo­ment when Bri­tain is des­per­ate for some good news. It has also en­joyed a boost of good­will from the sci­en­tific com­mu­nity.

Celebrity physi­cist Brian Cox wrote on Twit­ter yes­ter­day: “For those who have pri­vacy con­cerns about the NHS Covid app, it uses Ap­ple and Google’s API [soft­ware], not govern­ment’s. If you are a con­spir­acy the­o­rist and don’t trust Ap­ple and Google, re­mem­ber you have in­stalled their OS any­way so it makes no dif­fer­ence!”

Michael Veale, a re­searcher at UCL who was crit­i­cal of the UK’s first app at­tempt, said on the so­cial net­work: “I un­der­stand mis­trust that may linger – but please do try this new one.”

The app will also only truly be ef­fec­tive if the Govern­ment’s test­ing pro­gramme gets back on track. It will also re­quire peo­ple to abide by self-iso­la­tion, trust­ing the app’s judg­ment.

The app will not be a sil­ver bullet for the rise in cases. But at this stage, even mar­ginal gains to avoid a full lock­down are likely to be wel­comed by the pub­lic.

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