Despite being months in development, leaders heading up the development of the UK's contact tracing app are no longer willing to commit to a launch date for citizens. Ministers and government leaders had touted the app as "world beating" early on in the nationwide lockdown, but have since had to make a number of development U-turns and push the launch date back a number of times.
Contact tracing is seen as a key system in breaking the chains of transmission in the fight against COVID-19. Manual systems rely on contacting people that have tested positive for the novel Coronavirus and then contacting the people they have been in close contact with in recent days, asking everyone involved to isolate for a period of time. A smartphone app hopes to carry out some of this work digitally, through the use of Bluetooth technology.
The NHS's digital arm - NHSX - was originally focused on creating a contact tracing app that relied on centralised data collection, which in theory would have allowed for more data analysis to help with enforcing local lockdowns where necessary. This approach, however, faced widespread criticism from privacy experts given the scale of data collected.
Alongside this, an API framework to create a decentralised app has been in development by Google and Apple, which are responsible for the world's two leading smartphone operating systems. The decentralised version keeps data stored on a user's phone, keeps a central data repository out of the hands of health authorities and doesn't rely on location-based data.
Following a pilot on the Isle of Wight, the government has since ditched its centralised app and is now focusing all its efforts on the Google/Apple decentralised framework.
However, giving evidence this week to the House of Lords Science and Technology Committee, the leaders overseeing the entire contact tracing system - including the app - still feel that the technology isn't yet sufficient to roll-out to citizens in full confidence.
Health Secretary Matt Hancock had previously suggested the app would be ready in mid-May. It is now July.
Baroness Harding of Winscombe, Chair of NHS Improvement, and previously CEO of TalkTalk, told the Committee that whilst the app is critical to supporting the efforts of contact tracing, she doesn't yet feel that the technology is ready. Baroness Harding also said that the teams don't feel that any country around the world has yet got an app functionally right- despite a number of countries with apps in place for months already. She said:
I think there's no doubt that if you can make the contact tracing apps and the Bluetooth technology work accurately enough, that that will be a significant benefit and free us all up a bit more. But it's not something that we think that anybody in the world has got working to a high enough standard yet to give us the confidence that if we just receive an electronic message telling us to isolate that we would trust it.
The most powerful tool that we all have in our hands as society opens up and gets back to normal more is following social distancing rules. The more that we do that, the more that we will limit the number of close contacts that we have whilst still getting back to a more normal way of life. Other than that I don't think there is a silver bullet.
‘We were right'
Speaking alongside Baroness Harding was Simon Thompson, managing director of the NHS COVID-19 App within the Department of Health and Social Care, who also wouldn't be drawn on the launch date of the app. In fact, it appeared that Thompson had been given a line, which he read from a sheet of paper, to repeat again and again when pushed on the timelines. He said:
It's a question that I get asked on a frequent basis and I can totally understand why I get that asked that - but I'm sorry for repeating myself that we really recognise that the introduction of the app is urgent and important, but it must be a product that the user can trust. It really must work.
Thompson said that the NHS and government has learnt a lot from working with Apple and Google and other countries around the world and that the teams building the app are increasing the confidence that they will release something that "citizens can trust".
He added that NHSX was right to work on the centralised version of the app, but that new information has come to light regarding functionality.
When we started the development of the original app, it's worth bearing in mind that there was no Google/Apple API framework. I'm pleased to say that the team made absolutely the right decision to start the parallel development of our original approach and the Google/Apple API at the same time.
But when we really reflected on it there were three elements that the functionality needed to work to a really good standard. One of them is around contact reliability. The second one is around distance. And the third is around time measurement. Those are the elements required to create a reliable risk score.
Thompson revealed that in the Isle of Wight pilot, the app was downloaded 56,000 times. This is about 40% of the population of the Isle of Wight and about 60% of the population with a compatible smartphone. He added that when compared to statistics around the world, no other country - except for Singapore - gets close to this level of uptake. He said:
We are leaving no stone unturned to make sure that we can accelerate, at pace, to make sure that we do have a product that works to give them the maximum freedom and the minimum risk.
Baroness Harding backed Thompson up on not wanting to be drawn on the timelines of the app and said:
Technology development paths do not run in a smooth and linear way. We are keen not to commit to a certain date as the technology development work is ongoing.
It's important to remember that a contact tracing app is just one element of a wide-ranging contact tracing system that needs to be in place to effectively minimise transmission of COVID-19, until there is a working vaccine. I don't think it's too much of a problem that an app hasn't yet been released if one isn't working effectively - but I do think expectations have been poorly managed and that the UK government started this development journey with a dogged view that centralised data collection was imperative. It appears that that view has changed quite substantially. I also believe that if the manual tracing system was working effectively and that there was trust in that system, there would be less of a focus on the app to support this. However, I get the sense that given the UK's relatively poor track record in limiting the impact of COVID-19 has eroded trust in the public in all areas. As ever, there remains a long road ahead...