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30 March 2021updated 12 Sep 2021 2:47pm

The mixed success of contact-tracing apps

Governments across the globe have developed mobile software to trace cases of Covid-19. But how effective have they been? 

By Jonny Ball

The UK’s NHS Covid-19 app has been downloaded to 21 million phones. Its main function uses Bluetooth to automatically detect proximity to those with confirmed cases of the virus. Users check in to shops, restaurants and pubs with a QR code. If someone who later tests positive checks into the same venue, other visitors may be notified to isolate. The app has sent 1.7 million exposure notifications to users since its September 2020 launch.

Measured by the proportion of the population that has the app installed on their phones, NHSX – the health service’s digital transformation unit – has developed the seventh most popular coronavirus app in the world, just behind Australia and the top five nations listed on the map below.

 

Despite this apparent success, however, Britain has suffered 125,000 coronavirus deaths – 1,859 deaths per million inhabitants, the fourth-highest per capita mortality rate in the world. Last week, parliament’s Public Accounts Committee reported that, despite the £37bn allocated to the UK’s test and trace system over the next two years, there was “no clear impact” on reducing transmission. The system, administered by the National Institute for Health Protection, uses the app as a tool for thousands of volunteers and employees to manually trace the contacts of those who have tested positive.

The launch of the app itself was beset with difficulties as the government attempted to opt for a “centralised” platform, in which user data is stored on a central server. This raised privacy concerns, and Google and Apple both warned that this type of software would not be compatible with their systems. In one of several U-turns, in June 2020 – the tail end of the pandemic’s first wave – the government switched to a “decentralised” model in which data is instead kept in individuals’ phones. Apple had refused to waive its restrictions on the use of background Bluetooth until governments around the world adopted the firm’s preferred decentralised approach.

Read more: Will people continue to share their health data post-pandemic?

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Some of the countries shown in our graphic have been fortunate enough to keep their coronavirus death rates comparatively low. But contact tracing apps are no panacea. Vietnam and New Zealand’s apps have lower penetration than that of the UK, but each has recorded among the world’s lowest Covid-19 deaths per head. Japan’s app has been downloaded by only 6 per cent of the population, but the country has a lower death rate than any European country.

Apps aid manual, human contact tracing rather than replacing it. Mobile phone software is no substitute for strong, local public health infrastructures and adherence to social distancing, isolation and hygiene measures in high-trust societies. Once the pandemic has receded, apps will play a part in test, trace and isolate regimes that could help prevent a resurgence. No matter how high our faith in technology, however, they can only play one part in a necessary panoply of responses.

Read more: One year on: What do front-line staff think of telehealth?

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This article originally appeared in our latest Spotlight policy report on healthcare. To read the full edition click here.