Do contact tracing apps have a future?

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It may seem like a long time ago, but the UK has only been in the grips of the ‘pingdemic’ for nine months. In the summer of 2021, the lifting of COVID restrictions saw the country’s contact tracing apps – the NHS COVID-19 app in England and Wales, the StopCOVID NI app in Northern Ireland and the Protect Scotland – informing hundreds of thousands of people of their need to self-isolate, causing widespread disruption.

Fast forward to the spring of 2022, and these apps are getting little attention today. In England in particular, now that living with COVID is the goal and isolation rules have been scrapped, the NHS COVID-19 app faces an uncertain future. The rates could also indicate what’s to come for Scottish and Northern Irish apps, as well as others around the world.

A central part of the test and trace strategy in England and Wales, the NHS COVID-19 app was launched in September 2020 to monitor and manage the spread of COVID. Like many contact tracing apps, it works using the Bluetooth wireless signal – if someone using the app registers a positive COVID test result, other app users who have been nearby long enough to risk to be infected are asked to self-isolate as a precaution. Hopefully this then breaks potential chains of transmission, limiting the spread of the virus.

Did it work?

To some extent, yes. Analysis of the performance of the NHS COVID-19 app from its launch to December 2020 found that it helped control the spread of the virus in those early days. During that time, the app was used regularly by about 28% of the population, preventing about 600,000 cases of COVID at a time when vaccines were unavailable and treatments limited.

However, the app was not enough to completely stop the transmission. Cases spiked through autumn 2020, pushing Britain into lockdown in November and again in early 2021. Limited uptake in turn limited the impact of the app.

Researchers estimated before its launch that it would only be effective in containing the virus if 60% of the total population (80% of smartphone users) used the app and followed the self-isolation advice it gave. . At best, the absorption was only about half of what it should be.

And since this analysis was conducted, the nature of the pandemic has evolved. The app was launched before the most transmissible alpha variant emerged in the winter of 2020, and since then delta and omicron have made COVID even more transmissible. Patterns of people’s face-to-face interactions have changed as restrictions have been lifted and vaccines have reduced the threat of COVID.

When transmission was high, the demands of the app quickly became incompatible with the workings of the country.
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As we saw in the summer of 2021, changes to the virus and to people’s behavior have seen so many people exposed and asked to self-isolate by the app that many have started to question the practicality of its use. The app’s sensitivity was withheld in an attempt to reduce the number of people asked to self-isolate, but that will inevitably have diminished its ability to prevent the virus from spreading.

As 2021 progressed, the notifications sent by the app steadily decreased. Cases, however, plateaued at a relatively high level, possibly indicating that fewer people had activated the app and many had given up using it. That said, notifications spiked again before last Christmas, indicating that many still had it turned on.

After that ?

Existing research does not give a clear indication of the impact a contact tracing app might have during a future outbreak. But what we know from the early stages of this pandemic is that this technology can help limit the spread of the virus. It is therefore plausible that these applications could be reused if the reduction of cases of COVID (or perhaps even another disease) were necessary.

But what is also clear is that a tool like this cannot substitute for other efforts. It must be used alongside other key measures – such as face masks, social distancing and widespread and effective testing – to work well. If these apps return to widespread use, they should be part of a set of controls.

And if the apps were ever to be used again, several issues would require attention. First, there is the issue of personal data. Public concern about how personal data is used is high. People want to know who has access to their data, have more control over how organizations use their data, and know where their data is stored.

Surveys show that concerns about the use of personal data were lower in the context of the fight against COVID. And previous research in the UK found that people generally argued that their personal data was used by others if it was in the public interest. But if it’s not clear that resuming use of these apps is beneficial, it can be difficult to maintain support and drive adoption.

A retiree using a smartphone
There is still a long way to go to get certain demographics to use the app.
WittayaP/Shutterstock

Another problem to solve is the inequality of use of these applications. With the NHS COVID-19 app, uptake was significantly lower among older people, people from ethnic minorities and those from deprived areas, even though people in these groups are most at risk from coronavirus.

If there were a pressing need to use these applications again, it would be important to adopt strategies to increase usage among these groups. It would also be important to find alternatives to involve those who do not have a smartphone – or who, due to age, disability or lack of digital literacy, are otherwise excluded.

But of course it’s hard to predict whether the UK will reach a point where it has to try to contain cases through heavy use of these apps. Certainly in England, for now the government’s plan appears to be to refrain from trying to control viral transmission. He hasn’t completely abandoned the NHS COVID-19 app, however. NHS Test and Trace has signed an agreement for continued development and support of the app until at least the end of 2022.

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