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How will the NHS coronavirus app work and should I be worried?

The health secretary is launching the government’s latest weapon in the fight against Covid-19 today — a smartphone app.

Matt Hancock will urge Britons to download the app within weeks in an effort to harness technology to slow the spread of the disease. But what does it look like, how does it work and what are the concerns, privacy and otherwise, around its use?

What is the NHS Covid-19 app?
At its most basic the app is a piece of software that you download onto your phone either through Apple’s App Store or Google Play. You then need to open it up and give it permission to start working. After that you can close the app and forget about it — unless you start to develop coronavirus symptoms or it alerts you that you may have come into contact with someone who has.

So what is happening behind the scenes?
The app uses Bluetooth to log and store anonymous details of everyone with whom you come into close contact who also has it installed on their phone.

Nothing is done with this information and it remains stored on your phone unless you notify the app that you have developed symptoms associated with the coronavirus. In this event the data is uploaded onto a central server, where an algorithm determines who needs to be alerted to the risk that they may also have caught the virus, and that they need to be tested and possibly self-isolate — this is based on how close their phones have been to yours and for how long.

The World Health Organisation advises that only people who have been within two metres of a suspected coronavirus case for more than 15 minutes should be screened for the illness. But the app will eventually combine this measure with others that assess an individual’s risk of infection and infectiousness based on key epidemiological considerations, such as the number of repeat interactions an app user has, their age and their symptoms.

The idea is to keep the number of people in quarantine as low as possible while enabling as many people to move about safely again.

What happens if I report coronavirus symptoms?
As well as warning people with whom you have come into contact the app will also help you to quickly get tested. This could be by giving you a phone number to call or a reference code that you take along to a specified testing centre. Ultimately the hope is that you will be able to book a test directly through the app.

When you have been tested you will be informed of the result and given further advice on what to do. If you test negative, the people with whom you have come into contact may also be informed that they are no longer at risk.

What happens if I get an alert saying I’ve come into contact with someone who has suspected coronavirus?
Again, you will be given advice on what to do. This is likely to involve getting tested. However, you will also be advised to be on the lookout for symptoms even if you test negative, as testing is not 100 per cent reliable at present.

Does the app work on all phones?
It works only on smartphones that allow you to download apps.

When will it be available?
The app will be available from this week but is not scheduled to start working nationwide until a trial starting in the Isle of Wight this week has been completed. There is no exact date for a national rollout but it is expected to be in two to three weeks, coinciding with the first moves to ease the lockdown measures.

Will Google and Apple have access to my location data?
No — at least no more than they do already. The app has been made by the NHS and is not part of any formal collaboration with the two tech companies.

Will the government have access to my location data?
No — the app records only which phones you came into contact with, not where you or they were. The app may ask you to give rough details of where you live to help epidemiologists track the spread of the disease but this will not be enough to identify you.

How will the app work with conventional track and tracing?
Alongside the app, the government is recruiting about 15,000 people to phone anyone who has a confirmed case of Covid-19, regardless of whether they have the app installed. They will run through your movements over the previous two weeks to try to find out who you have been within two metres of for at least 15 minutes. These people will also be contacted and asked to get tested.

Even if you have the app installed you are still likely to be called, because it will detect only people who also have the app installed.

If you have been in contact with large numbers of people or vulnerable individuals, it is likely that you would speak to one of 3,000 medically qualified call handlers.

Why does the government think the app is better than conventional contact tracing?
Epidemiologists calculate that nearly half of all coronavirus transmissions have been occurring before an infected person shows any symptoms. This means that traditional contact tracing will struggle to keep up with the epidemic.

The app, on the other hand, can identify people at risk and get them tested before they show symptoms, potentially slowing the spread of the illness substantially.

How many people need to get the app installed for it to be effective?
Scientists who devised and modelled the app have calculated that for it to be most effective 80 per cent of people with smartphones need to download it. This would give coverage to about 50 per cent of the population, as by and large younger children and older people are less likely to have smartphones or carry them around.

However, they stress that even if this uptake is not achieved it will still be a useful additional tool, albeit less effective.

What about privacy concerns?
Ministers are acutely aware that people will be concerned about sharing personal information with the government, thus they are emphasising how little information is being collected. Future versions of the app may try to collect more information, such as location data to help to map the spread of the disease and make manual contact-tracing more effective, but those behind the project insist that this will only be done with individual consent. They also point out that the app can be deleted at any stage and all information collected on it is automatically wiped.

Are there any other concerns?
Yes. Although it is better than it used to be, the government and the NHS do not have a good track record with big IT projects, let alone one built so fast and under so much pressure. The app has not been tested in the real world and there could be unforeseen glitches that delay it — or, even worse, that compromise the data being generated. False positives risk gumming up the testing system, while false negatives could give people a false sense of security.

(Source:  The Times 5/5)