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The NHS coronavirus enforcement advisory council is divided over whether it has the authority to tell the government to abandon its version and switch to a decentralized model proposed by Apple and Google.
After a meeting on Thursday, it emerged that members argued that their role on the board is limited to providing guidance on ethical issues, and not branching out into a broader discussion of whether the app is the right tool for the job.
The UK contact tracking app, which will alert people to the need to self-isolate if they have come in contact with a person who reported coronavirus symptoms, is controversial due to its centralized design.
Applications from other countries use a decentralized model. Under a centralized system, data is uploaded from phones to a central NHS server for analysis. Under a decentralized system, the data remains on the phones.
There is increasing recognition within No. 10 that the NHSX application is having difficulties and may not survive in its current form after testing on the Isle of Wight. The software for a centralized version of Apple and Google is expected to be released Tuesday.
While government enforcement raises questions of data ethics, which will collect data on the spread of the disease and centrally store it for analysis, some of the members’ concerns focus on more prosaic issues, such as absorption or effectiveness.
As a result, the board has publicly limited itself to raising concerns about the problems the current approach might cause, rather than suggesting alternative routes. In a letter to Matt Hancock of April 24, released Tuesday, the chairman of the board, Jonathan Montgomery, that the application must follow six basic principles, including the collection of “minimized” data and voluntary use.
It came when members told the Guardian about concerns that a lack of transparency and a rush to implement the technology without adequate evidence runs the risk of compromising the project.
Several members said they felt their work had been impeded because they had been given limited supervision.
On Thursday, the board met for its regular weekly meeting. The agenda was understood to include the merits of the centralized and decentralized models for a tracking application, as well as the preliminary results of the Isle of Wight trial.
Some members are particularly concerned that they were not informed of the development of a second parallel NHS application that was secretly built until the Financial Times revealed its existence last week.
Board members, who spoke on condition of anonymity, said they were only shown a draft of a key legal document evaluating the possible privacy impacts of the app, and did not see the final version of that document until it was released. public.
They also expressed frustration that a letter sent by the board last month to health secretary Matt Hancock, advising on ethical principles that should guide the app’s design, was withheld from the public for several weeks.
After repeated complaints from board members, the letter was finally posted on a government website on Wednesday, along with the government’s response.
A board source said there were “many communication and transparency failures” that they believed had prevented them from properly carrying out their oversight role.
They said the final version of the data protection impact assessment (DPIA) was “substantially different from the draft we were asked to comment on before it was released.” They added that they were “not impressed” by the government’s legal explanation for its data collection.
Another member of the supervisory board described the DPIA as “disappointing.”
Another member warned that the app was still incompatible with some devices.
A board member cautioned that while the Isle of Wight trial would provide useful data on how many people would be willing to download it, it would be of limited use in evaluating how effective the app would be in fighting the disease, because most residents use it would still be under lockdown.
The premise of a contact tracking application is that phones with installed software will record their contacts with each other via Bluetooth. If a user notifies the system that they have Covid-19 symptoms, other users who have been near them will be warned and asked to take appropriate action.
One of the supervisory board members expressed frustration that the first thing they learned about the government’s plans to commission a second version of the app, based on the principles of a decentralized model, was when they read it in the press.
Tracking contacts is one of the most basic tables of public health responses to a pandemic like coronavirus. It literally means tracking anyone with whom someone with an infection had contact in the days leading up to the illness. It was, and always will be, central in the fight against Ebola, for example. In West Africa in 2014/15, there were large teams of people tracking family members and knocking on doors of neighbors and friends to find anyone who might have become infected by touching the sick person.
Most people who receive Covid-19 will be infected by their friends, neighbors, family, or coworkers, making them first on the list. It is unlikely that someone will be infected by someone they do not know, passing through the street.
There is still supposed to be a reasonable exposure: Experts originally said that people would have to be together for 15 minutes, less than 2 meters away. Therefore, a contact tracker will want to know who the positive person met and spoke with for the two to three days before symptoms developed and became isolated.
South Korea has large teams of contact trackers and notably persecuted all contacts of a religious group, many of whose members became ill. That outbreak was efficiently removed by contact tracing and quarantine.
Singapore and Hong Kong have also advocated testing and contact tracing, as has Germany. All of these countries have had relatively low death rates so far. The World Health Organization says it should be the “backbone of the answer” in all countries.
Sarah Boseley Health editor
“I believe that if we are to fulfill our role in good faith by providing the government with ethical guidelines for its implementation, then we must monitor the plans,” the board member told the Guardian. “We should not expect us to read about an apparently parallel application that is being secretly developed until the FT has reported it. We did not know about that.”
The Financial Times reported that the second app being developed was a backup, and had been commissioned after pressure from within the government on technical and ethical issues with the first app currently undergoing testing on the Isle of Wight.
In their letter to the health secretary last month, members of the advisory board warned that the UK’s failure to significantly improve its testing infrastructure could prevent the app from working properly. They also warned against rushing app development.
In an email to The Guardian, the board’s chairman, Sir Jonathan Montgomery, said the government had accepted the six principles that the ethics board had suggested should inform the design of the app. “Given the magnitude of the pandemic threat, the NHS needs to act quickly to identify the best way to use technology to protect people,” he wrote.
“The board received documents at first glance and received periodic reports from those who participated in the creation of the application. This has allowed us to provide advice that has been positively received. “
