Tuesday 5 May 2020
How private is the app they wish me to use?
The problem is whether I believe them, as so far with this pandemic, what I am being told does not always match what I see. The government is trying to persuade the British public that a contact tracing app is the way forward. Yet all around I sense worries. The Isle of Wight is first in line and the rest of the nation is supposed to take its lead from there.
Apps are being developed worldwide and the UK has decided to centralise the data it collects, which is incompatible with the contact-tracing API (Application Programming Interface) presently being developed by Google and Apple. The two giants have planned to introduce a pair of iOS and Android APIs by the middle of this month. Their system seems to work using Bluetooth Low Energy (BLE) and, as best I can tell, is fairly secure. That does not match with what the UK government is requiring, as it wishes to pool the information it collects in a single database operated by the NHS. That is when I start to worry.
The Technical Director of the National Cyber Security Centre (NCSC), Ian Levy, wrote a lengthy article that is clearly designed to put my mind at rest. Although he writes well, and has included a full section headed, “Please install the app, and use it,” there is caution in his tone.
The situation this morning – 5 May 2020 (courtesy Center for Systems Science and Engineering at Johns Hopkins University)
Phrases like:
“…we think the NHS app does a decent job of those.” Why say “we think?”
“…technical, security and privacy issues must be balanced against these primary medical needs, although they still need to be as robust as practical.” He sounds to be covering himself.
“The back end is built to be as secure as is practical…” Here we go again.
“…the NHS app is a good balance in the team’s view.” Why only in the team’s view? Does Mr Levy disagree?
Anything that requires NHS centralised control concerns me. I well remember the beginning of what was called a joint replacement registry in the 1990s. This was a centralised database of all hip and knee replacement operations performed in the UK. I asked then about privacy and how the registry would not end up as a collection of data that might be used against a surgeon, or as a means of comparing one surgeon with another. I was reassured then, by the powers-that-be, that the data would not be released for the government to see. The registry was born and, in the beginning, it went as planned.
However, some years later the database went bust, government money came in, and within two decades the data were being used nationally to compare one surgeon with another. What started out as a brilliant idea, to collate all surgeons’ performance so that operations could be bettered for the benefit of all, ended up as a method of government control. That I have never forgotten.
At the moment the pandemic is ongoing, and all countries are seeking ways of controlling it. We are not allowed to even suggest the NHS might be behaving in any way other than perfectly, even if it was being criticised from many quarters barely six months ago. Healthcare practitioners working within it talk with me daily, and I know some of the frustrations they are experiencing. What is going on is far from perfect right now, but most dare not speak out.
You would not believe the amount of paperwork it takes to volunteer (Photo by Cytonn Photography from Pexels)
Meanwhile, I have agreed to help with the disaster taking shape at the moment in the nation’s care homes. There is far more trouble there than in the hospitals. As best I can tell, UK healthcare has missed a trick by not supporting care homes from the very beginning. Yet even if I wish to offer my services, doing so is a logistic challenge. You try the documentation.
Yesterday the NHS asked me to provide a Disclosure and Barring Service (DBS) certificate, a copy of my curriculum vitae, two proofs of address, evidence of my registration with the General Medical Council, reference details for my most recent post, evidence that I am actually qualified, evidence of training I have undertaken, and a colour photograph. The problem? I have done all of this before, not once, not twice, but three times. Now I am being asked for a fourth. As with many volunteers, I sense that the centralised wheels of the NHS are a modern-day example of Nero playing his fiddle while Rome is burning, not that the story was ever proven. For all I know, the administrative requirements of the UK’s centralised system of healthcare will prevent me from helping as I have offered.
Based on this experience, let alone the nation’s wider worries, do I dare put my faith in an NHS-controlled, NHS-inspired, centralised contact tracing app? You see my problem.
Meanwhile London is clearly still suffering, even though there are many more people on its streets. Ambulance sirens are fairly continuous in the background and I would guess most of them are to do with Covid-19. Slowly the media is becoming less filled with items about the pandemic. Climate control is more of a feature, but it is strange to see little sign of sport. It seems that this year’s Premier League season might be cancelled if clubs do not agree to play in neutral venues. There are an astonishing 92 football fixtures remaining for the 2019-2020 season. The football community has dubbed this as Project Restart but a number of specialist medicshave raised concerns. These include the doctors’ own liabilities if a player contracts Covid-19 as a result of playing football. One Manchester City player has already spoken out, to say that players are frightened to return to football at the moment, mainly because they have children and families.
It is interesting to see how different countries are handling the next phase in this pandemic, which seems to be the lifting of lockdown. Each land appears to be behaving differently. The UK cannot really be a pathfinder in this, because we are heading towards being the worst country in Europe. More of that to follow, no doubt. The USA is being surprising. Its economy has essentially been suspended and more than 30 million Americans are out of work. It appears that President Trump is happy to accept the 3000 daily deaths that are predicted by early June, just to get his country back on track again.
Israel has done a full 180-degree about turn. On 25 March, Israelis were told they could only travel 100 metres from their front door, albeit with some exceptions. Their Prime Minister, Benjamin Netanyahu, in a televised address, has now said Israelis can leave their houses and go wherever they wish. Weddings are permitted with up to 50 attendees, but no touching and dancing is permitted. What about that newlyweds’ kiss?
Football is way behind with its matches
China appears to be clamping down on free comment once again. This time it is grieving relatives and activists, who are chasing the Communist Party for answers about what happened in Wuhan. The police have apparently threatened some people and lawyers have been warned not to help them sue. China’s relationship with the rest of the world has a long way to run, I suspect.
It also seems that SARS-CoV-2 was in Europe well before official announcements were made. A scientific paper in the International Journal of Antimicrobial Agents, albeit of only a single case, reported on a 46-year-old man who was admitted to a hospital near Paris on 27 December 2019. The first official cases of Covid-19 in France were on 24 January 2020, in two patients who had returned from Wuhan. The 46-year-old was admitted with an influenza-like illness, ended up on intensive care but was discharged two days later without mishap. He had no history of travel to China, only to Algeria in August 2019. His child had presented with similar symptoms, albeit some time earlier, and had also improved. Subsequently, the father’s specimens were retrospectively tested for Covid-19. He was positive. The authors drew a very simple conclusion. “Covid-19 was already spreading in France in late December 2019,” they said, “a month before the first official cases in the country.”
As I have said on many occasions, at times like this you cannot always believe what you are told.
