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When there’s an app that can save lives, there will be no need to download it out of a sense of duty

<span>Photograph: Department of Health & Social Care/PA</span>
Photograph: Department of Health & Social Care/PA

The NHS Covid-19 alert app will be available nationwide in June. It’s voluntary, so those of us with smartphones must decide: should we download the app?

The health secretary, Matt Hancock, thinks we should, claiming that we would be “doing our duty and helping to save lives”.

If only it were that simple. Even if 80% of smartphone users (60% of the UK population) download the app, which is the adoption rate epidemiologists say is needed to make it work, the app won’t save lives.

Our first problem is that the UK’s testing capability is too slow stop the spread of the virus. Once you’re infected, you’re contagious for two days before the onset of Covid-19 symptoms and most contagious on the first day of symptoms.

To break the chain of transmission, you must alert your contacts within that narrow window of opportunity, so that they can quarantine for the 14-day incubation period and report if they too show symptoms and need testing. Yet many people struggle or are unable to get tested, and the average return time for a test result is five days – with the longest taking 13 days.

If we could improve our testing capacity to meet the tight turnaround needed to alert people within the “window of opportunity”, and if we built an app that sent alerts based on a positive test result, then we might have something useful.

However, the app we are being invited to download doesn’t rely on a positive test result. Instead, it asks us to self-report symptoms. This introduces several pathways to failure.

The app only asks if you have two out of 14 Covid-19 symptoms recognised by the World Health Organization: fever and continuous cough. This means it may fail to account for infected people who show the other symptoms – and thus will not alert their contacts.

The app may not flag up people who don’t have a fever, who account for about a third of positive cases. No self-reporting app will work for people who are infected but never show symptoms, which the US Centers for Disease Control estimates could amount to as many as 30% of cases. Only a test will detect those cases.

Still, it can’t do any harm to download the app, right? Actually, no. Unless the government compels employers to pay people to quarantine for 14 days every time they receive an alert, people may feel pressured to ignore the alerts and keep working, even if that risks their health and that of their contacts. Also, not every worker is entitled to sick pay. Those are policy problems, not an app problem, but if we don’t solve them, the app won’t work and the virus will continue to spread.

The app also puts our data and privacy at greater risk of an accidental breach or a cyberattack because it is based on a centralised model, which stores our data on a central server. A decentralised model, which keeps our data on our devices, minimises this risk. Most other countries have opted for a decentralised model for their app. There’s still time for the UK to change course.

Most worrying of all, the government has so far denied parliament the opportunity to pass primary legislation to protect and limit the use of our data relating to using the app.

Without such legislation, we risk creating a new set of problems. For instance, do we want the police to have access to our data to enforce quarantine? Do we want our employers to be able to know our Covid-19 status, or to be able to pressure us to download this “voluntary” app as a condition of returning to work?

Do we want the police to have access to our data to enforce quarantine, or employers to pressure us to download the app?

Do we want private companies to access this data, the way they already access so much else? Can we request that our data be deleted after the pandemic or will the government retain it indefinitely, and use it however it wants? Will this app exist only for the duration of the pandemic, or could the government require it to be used as a permanent health tracker, as is already being planned in the Chinese city of Hangzhou?

The answers to these questions could change our lives and the balance of power between individuals, employers and the state. Parliament must therefore scrutinise all of this and, where necessary, legislate and specify oversight and enforcement mechanisms.

A contact tracing app could play a useful role in our pandemic response, but only if we set it up to succeed, not fail. If we create an app that really could help save lives, and which we could use with confidence, there will be no need to ask us to download it out of a sense of duty.

We’ll want it.

Stephanie Hare is an independent researcher and broadcaster