Drawing on a qualitative study consisting of five focus groups, Simon Williams, Christopher J Armitage, Tova Tampe and Kimberly Dienes find that people are currently torn over whether or not they will use the contract-tracing app when it is available. They discuss the main concerns that emerged from the research and offer some key recommendations for ensuring that there will be sufficient uptake.
As lockdown restrictions start to ease, attention turns to other ways to contain the spread of the virus. One of the key strategies being used by many countries is ‘test and trace’ (contact tracing), officially announced in England at the end of May. In combination with a more traditional manual contact-tracing approach, this effort will use a new smartphone app developed by NHSX that is currently being trialed on the Isle of Wight. Although the app does not collect personally identifiable information from users, it has already courted much controversy, in part because the UK, unlike many other countries, has decided to use a system where de-identified contact data is stored centrally instead of only on the phones themselves.
Modelling evidence suggests that in order for the app to be effective, use and adherence would need to be very high, with 80% of smartphone users (equivalent to 56% of the UK population) needing to use the app in order to completely stop the pandemic spreading, although lower rates of use could still have beneficial impacts. Some surveys have suggested that a majority of smartphone users would use the app, but emerging evidence from early adopting countries like Singapore and Australia suggests that actual uptake might be considerably lower.
Building on our research on public experiences of lockdown, we have published a new report on people’s attitudes towards the app. Findings suggest that the people are currently torn over whether or not they will use the app when it is widely available, and have a number of concerns, particularly over privacy and over whether there will be sufficient uptake. One group of people in support of the app noted its contribution to ‘the greater good’, and felt that any benefits from reduced transmission would easily outweigh any concerns over privacy. Another group felt that the app was simply an infringement of civil liberties and would not entertain using it. Crucially, a third group was currently unsure, and whether or not they decide to use the app will play a significant role in whether the app succeeds or fails.
In order to maximize uptake of the app, the government have a steep hill to climb in terms of gaining public trust. One of the central themes we are finding in our research is that there is a growing distrust in government over their handling of the pandemic. The wave of criticism following the initial lockdown easing announcement on 11 May, including widespread confusion over the interpretation of new social distancing regulations, will have done little to restore public confidence in government. The worry is that this growing lack of trust may lead to more people being discouraged from using the app.
Findings from our focus groups revealed that people were concerned about poor uptake, concerns that were framed in terms of social inequalities and cultural norms around state interventionism. It was argued that because certain social groups (e.g. very low-income, homeless populations, and the elderly) have less access to or lower use of smartphones, and because the UK public would not be willing to accept contact tracing in general as a strategy, it would not be as effective as it had been in countries like Singapore or South Korea. The risk here is that if enough people believe that it is not going to be effective because it is not going to be used by enough people, then this becomes a sort of self-fulfilling prophesy. Uptake will only be high if normative beliefs in the potential effectiveness are favourable, which in turn are at least partly linked to the level of trust in government.
What are some of the implications of these findings? Evidence is starting to document that there are a number of health disparities related to COVID-19, including the fact that incidence is higher in more socio-economically deprived areas. As you might imagine, the proportion of those who own a smartphone is also generally lower amongst those from lower-income groups. As such, government and mobile phone companies might consider ways in which they can fund and provide reduced-cost smartphones to those who are currently unable to afford them.
Another challenge for government is ensuring effective public communication. Our research suggests that many people are either not getting enough information or are misinformed. For example, our findings revealed that one of the most common misconceptions over the app was that it would enable individuals to identify or even map those in their contacts or in their vicinity who have symptoms of, or have tested positive for COVID-19. This perhaps tells us something about how COVID-19 infection is perceived and may be seen by some as a stigmatized disease. As one participant put it: ‘It would be like SnapMaps … [but] I wouldn’t want to be on the ‘Snapmap of Shame’. For the time being, the lesson here is that government needs to communicate the nature, purpose, and security of the app more clearly.
Despite the ubiquity of COVID-19 news coverage, there is likely a proportion of the population who are actively avoiding it, in order to protect their mental wellbeing (in fact, limiting exposure to the news has been officially recommended). As such, government should explore a wide variety of communication channels and approaches, as it did with lockdown, including social media ads, postal information, text messaging and other emergency alert systems. In addition, it will be important for messaging to continue to harness the public’s collective responsibility and belief in ‘the greater good’.
Simon Williams is Senior Lecturer at the Centre for People and Organisation, School of Management, Swansea University.
Christopher J Armitage is Professor of Health Psychology in the Manchester Centre for Health Psychology at the University of Manchester.
Tova Tampe is an Independent Consultant, World Health Organisation.
Kimberly Dienes is Lecturer in Clinical and Health Psychology in the School of Health Sciences at University of Manchester.
All articles posted on this blog give the views of the author(s), and not the position of LSE British Politics and Policy, nor of the London School of Economics and Political Science. Featured image credit: by Sung Jin Cho on Unsplash.