UK government redesigns contact-tracing app and begins new trial phase

The UK government has dashed hopes that its Covid-19 contact-tracing app may at last be introduced into general availability, announcing a new test phase for the redesigned app in the Isle of Wight and the London borough of Newham.

Before revealing details of the new trials, the government released statistics showing that in the tenth week of the NHS Test and Trace operation, the service has reached more than 250,000 people since its launch, claiming to have reached almost 80% of all those who test positive, and 83.4% of their contacts, where contact details were provided.

The government stressed that these results were in line with the recognised metrics of success for contact-tracing services across the world. Claiming a rise of 12% in the number of people getting tested compared to the previous week, it said the data showed that the public health campaign run by NHS Test and Trace to encourage greater uptake of testing for those with possible symptoms of the virus, was working.

However, data from the UK Department of Health and Social Care showed that only 61% of 12,731 contacts had been identified by staff at Test and Trace national call centres.

The revised app has a number of key features: alerts based on postcode, QR check-in at venues, symptom checker and test booking. It is designed to work in conjunction with the government’s official Test and Trace programme and its initial trial phase will aim to help minimise the spread of coronavirus alongside national and local contact-tracing for residents on the Isle of Wight, for NHS volunteer responders across England, and in the multicultural, densely populated London borough of Newham.

Trails of the new app have already started on the Isle of Wight and with NHS volunteer responders, with the Newham trial to follow shortly. The updated app is using a decentralised data collection app model based on Google and Apple application programming interface (API) technology, rather than the previous, much-criticised, centralised database structure that was used in the trial of the first app on the Isle of Wight.

Despite that first major test attracting criticism for a number of mishaps and technical issues, at a recent Westminster Health Forum policy conference looking at the development and roll-out of Test and Trace and the future of the contact-tracing app, Christophe Fraser, senior group leader in pathogen dynamics at the Big Data Institute and a professor in the Nuffield Department of Medicine at the University of Oxford, said the results of the trial had been encouraging.

As a co-lead in the app’s development, Fraser said one of the findings of the Isle of Wight trial was that simulations had shown that by combining manual contact tracing with social distancing, the app could contribute to stopping the epidemic. He concluded that the tests showed evidence that stopping infection was possible by using the app together with other measures, including ongoing social distancing.

However, he stressed that the Isle of Wight results represented causal proof, and that a randomised control trial was also necessary. But he said the work had resulted in a very encouraging analysis.

The UK government said that in addition to Google and Apple, it had worked with other major tech companies in developing the enhanced version of the app, as well as scientists at the Alan Turing Institute, medical experts, privacy groups, at-risk communities and teams in countries across the world, such as Germany, that were using similar apps, to develop a state-of-the-art app that is safe, simple and secure. 

Germany provided a great example. As of 24 July 2020, barely a month after initial introduction, the app developed by Deutsche Telekom and SAP had been downloaded 15.8 million times.

The enhanced UK app is designed to log the time and distance a user has spent near anyone with the app on their phone, generating a random ID for an individual’s device, which can be exchanged between devices to monitor the spread of the virus, while rotating frequently to prevent tracking. If necessary, it can alert people if an app user they have been within two metres of for 15 minutes or more later tests positive for Covid-19, and helps them book a free test, and quickly get their results.

The app will also be able to alert users about the level of coronavirus risk in their postcode district and a QR check-in feature can alert users if they have recently visited a venue where they may have come into contact with someone who later tests positive with Covid-19.

As well as allowing users to check whether they have coronavirus symptoms and see if they need to order a free test, a timer feature will help a user who is told to self-isolate count down that period and provide access to relevant advice.

Starting this week, residents on the Isle of Wight and NHS volunteers will receive unique codes via email and post to give them early access to download the app, with residents in Newham receiving theirs soon after.

Given that the Isle of Wight is a controlled geographical area, it is seen as particularly suitable to test features such as the QR code check-in and the alert and contact-tracing reliability. Newham has a diverse population that might be more at risk from the virus, so trialling the app there will ensure that it meets the needs of a range of different communities, said the government. The NHS volunteer responders will help to test that the app is ready to scale ahead of national launch.

The government says it will also work with local partners to ensure users are supported by a wide range of marketing and communication activity. They will be part of a trial period as the NHS Test and Trace programme evaluates the app in real-world settings to monitor performance and identify improvements, ready for national launch, for which no date has been given.

Dido Harding, executive chair of the NHS Test and Trace programme, described the app as a great step forward, even though she repeated previous disclaimers about there being no silver bullet when it comes to tackling coronavirus. “It’s really important that we make it as easy as possible for everyone to engage with NHS Test and Trace,” she said.

“By launching an app that supports our integrated, localised approach to NHS Test and Trace, anyone with a smartphone will be able to find out if they are at risk of having caught the virus, quickly and easily order a test, and access the right guidance and advice. The new app will complement all the work we are doing with local areas across the country to reach more people in their communities and work towards our vision of helping more people get back to the most normal life possible at the lowest risk.”

Simon Thompson, managing director of the NHS Test and Trace app programme, added: “NHS Test and Trace is vital to controlling the spread of coronavirus and this app is designed to give people maximum freedom at minimum risk. We have worked with some of the most innovative organisations in the world to come up with a state-of-the-art product that works to protect people every day. It’s like NHS Test and Trace in your pocket.

“By giving access to the Isle of Wight, Newham and NHS volunteers first, we can make this app even better before rolling it out nationwide so the rest of the nation can benefit.”