Goodbye to the app...for now

No more pings

Still pinging….for now

On Monday Boris Johnson announced the end of all Covid legal restrictions in England and effectively began the winding down of the vastly expensive Test and Trace programme. On Wednesday I got a ping from the NHS Covid-19 app, telling me I had been near someone who had tested positive for the virus - a reminder that this part of Test and Trace was working.

But today an update to the app has been released reflecting the changes in the rules - which is slightly bizarre because there are now no rules, and that means there really is no longer any point to the app. After all, if people aren’t getting tests and aren’t entering test results in the app, then no contact tracing alerts will be sent out.

So - is the app over, and if so how should we rate its contribution to the battle against Covid-19? The app team is being wound down and the contract of Zuhlke, the software company behind it, only runs until the end of March. In what felt like a valedictory statement Zuhlke’s CEO Wolfgang Emmerich summed up what he felt had been achieved:

“I believe that the app has made a noteworthy contribution to controlling the pandemic in England. The app has warned about more than 13 million exposures to infection and recommended users to self-isolate or perform daily tests.”

But when I contacted Professor Christophe Fraser, the epidemiologist who was the driving force behind the development of the contact tracing app, he cautioned me against assuming this was the end.

He conceded that if people stopped entering test results then the app wouldn’t be much use but he said commentators had consistently underestimated the public’s caution about Covid, and there was still a high number using it. But why would anyone still want it, I asked?

“You'd want it because you want as much information as possible about your personal risk,” he said.

We moved on to his assessment of the app’s contribution. Professor Fraser accepted that it had had a rocky start but insisted it had done a good job. He pointed to the paper in Nature in March 2021, authored by him and other scientists involved in the app, which suggested it had led to a major reduction in both cases and deaths.

Its major impact, he said, came at a time when the vaccine programme was only just starting: “It really was a major contributor to delaying the epidemic and preventing those infections and deaths at a time when an infection was much more dangerous than it is now.”

Then in the summer of 2021 the “pingdemic” sent thousands of people into isolation and reminded the public of the app’s existence - though not necessarily in a good way: “The pingdemic probably didn't do much for the app’s popularity,” he said, “but it was very effective.” Professor Fraser’s claim is that a new surge in infections caused by people getting together to watch the Euros was damped down by all those pings.

Since last August, however, the message of those contact tracing pings has been changed - they advise their vaccinated recipients to get a test rather than go into isolation. Today saw the weekly release of the stats about the app and while the number of contact tracing alerts was the lowest this year, nearly 300,000 people still got a ping in the week from the 10th to the 16th February. That number will now surely plummet - if the Department of Health even bothers to go on releasing the statistics.

But even if this is the end of the road Christophe Fraser, who stresses he is speaking as an independent epidemiologist rather than on behalf of the Department of Health, hopes that the app will be kept in reserve in case a new variant arrives:

“It’s now firmly established as one of the tools in our arsenal to help protect us against future variants and future threats,” he says. “We understand how it works technically, we understand how it works behaviourally. And we understand how to integrate it into health systems.

While it is obvious that it was vaccinations which played the major role in controlling Covid-19, my judgment is that this app - which, remember, was an experiment with unproven technology - did play some part in nudging behaviour in a more cautious direction. That in turn slowed the spread of the virus on some occasions and may be one of the reasons why the worst case scenarios from some epidemiologists did not come to pass.

Throughout its somewhat tortuous history I have been impressed by the software developers, data scientists and public health experts who have talked to me about their work on this project.

What has been less impressive has been the communications strategy, surely a vital part of any public health initiative. When the app came out I and other journalists found that it was up to us to explain its rather complex workings to the public because neither the government nor NHS England would put anyone up to do the job.

And right until the end there seems to be a reluctance to come out and talk about the app or perhaps celebrate its achievements. I asked the Department of Health about its status given the scaling down of Test and Trace, what the message to the public about the app was, and whether the government was still encouraging people to use it.

Some hours later came a reply “on background” that the app continued to be a useful tool and remained voluntary for people to use. Hardly a ringing endorsement so I think I will now delete it and I imagine many others will do the same.