An Island View: Test, track and trace

When I moved to the Isle of Wight almost two months ago, I hadn’t anticipated taking part in the ‘most important mass social experiment of our time’¹ but as of this Thursday, that’s exactly what’s happening.

‘Stay at home. Install the app. Protect the NHS. Save lives.’ became the new public health message to Isle of Wight residents, as of Monday afternoon. This addition came as Health Secretary Matt Hancock announced that the Island will pilot the NHS’s new contact tracing app, as Britain moves into the ‘test, track, trace and isolate’ phase of managing this pandemic. Whilst a poll on local radio indicated 80% of participating listeners would be keen to take part, will the government’s communication strategy be sufficient to engage enough residents to make sure the trial gains meaningful results?

‘Where the Isle of Wight goes, Britain follows.’ – Matt Hancock

The Health Secretary stated that the contact tracing app will be available to Isle of Wight NHS and council staff from Tuesday, and more widely to other residents on Thursday. It is estimated that at least half of the Isle of Wight’s 141,538 population will need to download the app for the pilot to work effectively, although parliamentary groups have stated that important learnings will still be gathered if fewer than that do so. It’s clear that what we learn here will be of vital importance for helping the rest of the UK to move into the next phase of the pandemic.

Two socially distanced fishermen, Ventnor.

An Island view:

For almost two months now, I have been living on the Isle of Wight with my mother and brother. My younger brother is a vulnerable adult on the autistic spectrum and has been in education on the Isle of Wight for over a decade. Highly concerned at the prospect of him potentially facing lockdown alone, my mother and I took the decision to move to the Island for the foreseeable future, taking every precaution to protect him and the local population in the process.

Whilst the Isle of Wight may be regarded as a microcosm of the UK, there are particular nuances that ought to be taken into account throughout the trial and in the analysis of its results.

Why the Isle of Wight?

Over the past couple of weeks, we’ve often speculated that the Island would make an ideal population to pilot a tracing app so, like many other people locally, we were pleased to hear that this was the plan. As an island with one central hospital and a relatively low number of confirmed Covid-19 cases at 143 (or 101 per 100K people), the Isle of Wight offers a largely contained population and an easily monitorable healthcare system.

However, there are significant aspects of the population demographics that should be taken into consideration. Whilst the single hospital should make data collection and contact tracing easier, it also means that the Island is regarded as a ‘hospital desert’ where demand for hospital beds could outstrip their availability if local coronavirus cases were to significantly increase.

With one in four residents 65 or older, many fall into the category of vulnerable people self-isolating for 12 weeks, whilst a significant number may not have smart phones, making it difficult for them to take part in the trial. It should also be noted that the population of the Isle of Wight is 97.3% white – 17.3% higher than the rest of the UK. With evidence that Covid-19 is disproportionately harming members of BAME communities, it’s even more important that the analysis of the pilot learnings takes this into acute consideration.²

The local reaction

Residents have voiced reasonable concerns on local newsgroups about the safety of their data, as well as how the trial plans to take into account of the particular demographics of the local population. Local radio has reported that 80% of their listeners would be willing to download the app and take part in the pilot, but it’s hard to know if this is representative of the population of a whole.

Aside from local news and the odd socially-distanced chat, my main source of general island-feeling is the chalk graffiti on the seafront which vacillates wildly between supportive rainbows and song lyrics, to highly concerning conspiracy theories around 5G and even questioning the existence of the virus itself.



The debate rages on the shorefront.

Health app and ‘shoe leather epidemiology’ will go ‘hand in hand’

At least in terms of app accessibility not undermining the trial’s success, Matt Hancock and Professor John Newton had answers to help alleviate some concerns. Whilst the contact tracing app will trigger an almost immediate automated response to individuals who have been in contact with potential Covid-19 sufferers, this will be accompanied by a task force of contact tracers in and around the community, telephoning individuals on the Island who may have been infected. Newton explained, ‘It’s a multi-layered approach and one of the points of the Isle of Wight test is to try and see how those different elements integrate together to support each other.’

The verdict?

In a previous article, we outlined a number of communication strategies to help win over a population to put their faith – and personal data – into new health tech.

Aside from concerns about accessibility and general public awareness, the government still has work to do to ease public fear around data privacy. A legal challenge has already been made, which states that the centralised approach taken by the UK’s contact tracing app could be in breach of UK legislation. For enough of the population to trust in the technology, discussions of the app in terms of its development and ongoing evolution should be as open and transparent as possible to avoid damaging the relationship between the people and the state further.

On Thursday, like 80,000 other households, we will be poised to receive our letter from the Chief Nurse imploring us to download the app and take part in the next phase of pandemic control. ‘Testing’ remains the first point of the new strategy and is still an area of contention, with targets falling short of the 100,000 for two days in a row now. With a willing and waiting Island population, it’s time for the government to keep to their part and ensure that this pilot is a success and gains meaningful results. Whatever the outcome, we’ll be sure to report back…

References

1. Oliver Wright and Chris Smith, ‘Coronavirus: Virtual city build in an Oxford University lab shows how the tracing app could work.’ The Times

https://www.thetimes.co.uk/article/coronavirus-virtual-city-built-in-an-oxford-university-lab-shows-how-the-tracing-app-could-work-mh8wnc3cc

2. Thomas Mackintosh, ‘Coronavirus: Ethnic breakdown of London deaths revealed’

https://www.bbc.co.uk/news/uk-england-london-52453782


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