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Contact-tracing app could allow release from Covid-19 lockdown

Image credit: University of Oxford

University of Oxford researchers have proposed the deployment of an app which logs all other app users a person has recently been close to and notifies them if any of these people have tested positive for Covid-19.

It is hoped that an app like this could significantly slow the rate at which the novel coronavirus responsible for the Covid-19 pandemic is transmitted with minimal human work, eventually allowing countries to emerge from lockdowns safely.

Manually tracking down every other person that a Covid-19 patient has recently been in close proximity to and warning them to go into temporary self-isolation – as has been done in Taiwan, where infections are currently lower than in many other parts of Asia – is an extremely time-consuming and complicated process.

A Science paper written by researchers from Oxford’s Big Data Institute and Nuffield Department of Population Health concludes that the virus spread is “too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient, and happened at scale”.

The report suggests that this process could be scaled using an app which uses Bluetooth to keep a log of other app users a person has been in close proximity with. When an app user tests positive for Covid-19, the app would then notify everyone they have been near to in the past few days, and advise them to self-isolate to minimise further transmission.

“We need a mobile contact-tracing app to urgently support health services to control coronavirus transmission, target interventions, and keep people safe,” said Professor Christophe Fraser, from Oxford’s Big Data Institute. “Our analysis suggests that about half of transmissions occur in the early phase of the infection, before you show any symptoms.”

An app like this could potentially allow for the Covid-19 pandemic to be contained without the need for mass quarantines, the researchers concluded. They added that the app would need to be opt-in and provide secure data storage and privacy protection in order for people to feel comfortable using it. It should also be used alongside social distancing, scaled-up testing, and enhanced decontamination and hygiene measures.

Dr David Bonsall, a senior researcher at the Nuffield Department and a clinician at John Radcliffe Hospital who co-led the study, said: “If the mobile app is widely adopted in any country, and combined with other critical interventions such as physical distancing and widespread testing, our models suggest the epidemic could be brought under control. This app is a tool for each and every person affected to contribute towards protecting their health services, supporting vulnerable people and simultaneously gradually releasing communities out of extended quarantine.”

NHSX, which has been tasked with leading the digital transformation of the NHS, has said that it is considering “whether app-based solutions might be helpful in tracking and managing coronavirus”. It says that it has assembled experts from within and outside the organisation to do this as quickly as possible.

The Singaporean government has been using TraceTogether – an app which works in precisely the way the Science paper describes – in an effort to minimise coronavirus transmission. The Irish government is considering similar technology, and the German government hopes to have a similar app ready within weeks (with privacy kept a priority).

“A contact-tracing app can foster good citizenship by alerting people at risk, it can also help ease us out of confinement,” Fraser continued. “If we know we’ve not been in contact with anyone infected we can leave home safely, while still protecting our loved ones and avoiding a broader resurgence of coronavirus in our community.”

Professor Keith Neal, an infectious diseases epidemiologist at the University of Nottingham, said: “This is a theoretical modelling paper. It does not provide any direct evidence as such that mobile apps could control epidemics without the need for quarantines. But it is important in getting the UK to debate what has already been done elsewhere.

“Apps are already in use globally and are probably contributing to management of the epidemic. One concern is that geotracking is a key part in the methodology. If too few people sign up it can only have minimal benefit. Uptake would need to be high and too many people may complain about the Big Brother aspect of the methods and opt out.”

Meanwhile, experts from the University of Oxford and the Francis Crick Institute have claimed that public health officials have ignored their offers to help boost the UK’s coronavirus testing rate. The UK is testing far fewer of its citizens than other European countries like Germany, with the likely result that some coronavirus carriers are not entering strict self-isolation.

According to a Daily Telegraph report, Public Health England has ignored offers to provide trained staff and hundreds of specialised machines from among the UK’s most respected scientific institutions. For instance, Professor Matthew Freeman – head of Oxford’s Dunn School of Pathology – said that his repeated offers to provide dozens of PCR machines (which are used to identify signs of the novel coronavirus) had resulted in just one machine being accepted.

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