Can the app make a comeback?
A weapon to battle Omicron is stuck in the Whitehall weeds
Remember the NHS Covid-19 app that annoyed everyone back in the summer when it was behind the “pingdemic” sending thousands into isolation? I certainly do - there’s a whole chapter of Always On devoted to the story of its troubled birth in 2020 which I tracked closely.
After that was written and just when anger was at its height over its disruptive effects, I changed my mind about the app. It struck me that much of the rage was misguided - after all, it was finally doing exactly what it was designed for, sending people who might have been in contact with the virus into isolation and thus saving quite a few lives. (Note the “might have been” - contact tracing, whether of the old-fashioned variety or via an app, is an imprecise art which is bound to sweep up many people who are not infected).
Much of the criticism was also related to the way many people - and too many journalists - lumped the app in with the wider Test and Trace operation, assuming it cost an eye-watering £37 billion rather than £76 million. Full Fact explained just how misleading that was.
But now the app could be set for a comeback in the battle against the Omicron variant of concern. I had assumed that most people had deleted it but a glance at the weekly stats on its performance put out by the NHS shows that isn’t the case. The figures for the week ending November 24th reveal that over 77,000 positive Covid tests were entered into phones in England and Wales, resulting in around 212,000 contact tracing alerts being sent to app users seen to have been in close contact with a person who later tested positive.
While that’s far short of the nearly 700, 000 weekly alerts sent at the height of the pingdemic, it’s the highest number since late August and the trend has headed up in recent weeks.
But before we see the NHS Covid-19 app in a new role fighting Omicron there is a problem which needs sorting out. Since mid-August the app has stopped sending people into isolation if they’ve been in contact with someone who has tested positive as long as they have been fully vaccinated. That has been a common policy across Test and Trace, with those phoned by contact tracers advised to look out for symptoms but not ordered to stay at home if they’ve had two jabs.
Until now, that is. With the arrival of the new variant, anyone who gets a call saying they’ve been in contact with an Omicron case must self-isolate for 10 days, regardless of their age or vaccination status.
The trouble is, as someone who has been closely involved with the development of the app told me, it has no way right now of telling whether a positive result relates to the Omicron or the Delta variant. So people who may have unknowingly stood next to an Omicron case on a crowded bus or train will still be told they can carry on as normal as long as they are vaccinated.
The person who got in touch with me told me the app team had recognised months ago that this kind of issue with a variant of concern could arise. It was far from insoluble - a tweak to the app would enable it to differentiate between positive Delta and Omicron tests. (This very useful Twitter thread from an epidemiologist explains why something known as S gene target failure means the two variants look different in tests.)
My caller sounded exasperated, explaining that a change which would give differentiated advice, bringing the app into line with the rest of Test and Trace, was simple enough but stuck in a Whitehall logjam: “It’s kind of frustrating because it's something that should have been implemented three months ago.”
Of course, the simplest thing would be to change the alerts so that everyone was sent into isolation, whether they were a Delta or an Omicron contact. But at this stage that would probably mean there would be mass deletion of the app.
There is an opportunity now to give the app a new lease of life and prove that the money spent on it has been worthwhile. Will the Department of Health seize it? When I contacted the Health Security agency, which is now in charge of the app, to ask whether there were any plans to change it so that it could send targeted alerts to Omicron case contacts I got this response:
“The NHS COVID-19 app is currently working as expected and it has been effective at reducing transmission of the virus. The more people that use it, the more it can reduce the spread of the virus, irrespective of the dominant variant.”
Hmmm - not exactly what I asked. Maybe there is frantic work going on behind the scenes to make the app a key weapon in the battle against the new Covid variant - or maybe ministers have just lost interest in the whole project.
Note:
I am planning a major makeover of this newsletter some time in the next month, with a new focus on tech and healthcare. I will define that pretty widely, everything from the use of technology such as contact tracing apps in the battle against the pandemic, the hope that artificial intelligence can play a growing role in healthcare, the use of smartphones to monitor various conditions, to the debates over how we share health data while preserving privacy. I also hope to raise awareness of Parkinson’s - I was diagnosed with the condition three years ago - and to explore whether tech can help me as I attempt to carry on living as normally as possible.
With that in mind, here’s an appeal. If you are involved in the healthtech sector, as a company, an NGO or an individual I want to be on your radar and on your mailing list. My friends in PR will laugh at this but I really do want to see your press releases.
The best way to contact me initially is to DM my Twitter account @ruskin147. I look forward to hearing from you.