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		<title>contact tracing - UnHerd</title>
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		<description>think again</description>
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					<title>How Covid stole our privacy</title>
					<link>https://unherd.com/2022/01/how-covid-stole-our-privacy/?edition=us</link>
											<comments>https://unherd.com/2022/01/how-covid-stole-our-privacy/?edition=us#comments</comments>
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						<![CDATA[Timandra Harkness]]>
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							<![CDATA[Is Apple defending our privacy or enabling its erosion?(Sheldon Cooper/SOPA Images/LightRocket via Getty Images)]]>
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							<![CDATA[<p><strong>Timandra Harkness</strong> presents the BBC Radio 4 series, <a href="https://www.bbc.co.uk/programmes/b064z7f2">FutureProofing</a> and <a href="https://www.bbc.co.uk/programmes/b0bfd2qr">How To Disagree</a>. Her book, <em><a href="https://harpercollins.co.uk/products/technology-is-not-the-problem-timandra-harkness?variant=40663002579022">Technology is Not the Problem</a>, </em>is published by Harper Collins.</p>
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						<unherd:twitter_handle>TimandraHarknes</unherd:twitter_handle>
															<unherd:author_bio>
						<![CDATA[ presents the BBC Radio 4 series, <a href="https://www.bbc.co.uk/programmes/b064z7f2">FutureProofing</a> and <a href="https://www.bbc.co.uk/programmes/b0bfd2qr">How To Disagree</a>. Her book, <em><a href="https://harpercollins.co.uk/products/technology-is-not-the-problem-timandra-harkness?variant=40663002579022">Technology is Not the Problem</a>, </em>is published by Harper Collins.]]>
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										<pubDate>Mon, 31 Jan 2022 00:00:17 +0000</pubDate>
					<updated>Wed, 09 Feb 2022 11:12:38 +0000</updated>
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		<category><![CDATA[Apple]]></category>
		<category><![CDATA[contact tracing]]></category>
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		<category><![CDATA[Ethics]]></category>
		<category><![CDATA[Living with Covid]]></category>
		<category><![CDATA[Morality]]></category>
		<category><![CDATA[Pandemic]]></category>
		<category><![CDATA[Technology]]></category>
					<guid isPermaLink="false">https://old.unherd.com/?p=335986</guid>
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								<![CDATA[We have outsourced morality to machines]]>
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								<![CDATA[<p>As soon as I turn on my phone, it becomes a node in a network, giving me access to the entire world. But it also gives Apple access to information about <em>me</em> and my behaviour; I become another source in their vast banks of data.</p>
<p>So, as Stephanie Hare rightly points out in <em>Technology Is Not Neutral</em>, it&#8217;s never just an object. Technology is as much social as scientific, as much economics as engineering. There’s little point in Silicon Valley companies hiring an <a href="https://www.wired.com/2006/08/apple-looking-t/" target="_blank" rel="noopener">ethicist</a> to decide a product’s value — its effects go far beyond the shiny thing that comes out of the box.</p>
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<p>Apple, for instance, might not have put AirTags on the market in their present form if they had paused to wonder whether a coin-sized tracking device — ideal for keeping track of keys, luggage or children’s toys — could also be ideal for stalkers to electronically track an unsuspecting person. Now they are forced to come up with solutions, most of which rely on the tracked person also having a smartphone.</p>
<p>But, precisely because technology is a social phenomenon, embedding ethics, and ethicists, in its development will never remedy its dangers. Take Facial Recognition Technology, for example. It’s an issue Hare has been actively — and critically — researching for some time. Like other biometric technology, it has been introduced in practice with remarkably little scrutiny, regulation, or debate.</p>
<div class="ref-ar"><a href="https://unherd.com/2021/02/the-dangers-of-compulsory-vaccination/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2021/02/the-dangers-of-compulsory-vaccination/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2021/02/GettyImages-1297015997-1.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2021/02/the-dangers-of-compulsory-vaccination/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2021/02/the-dangers-of-compulsory-vaccination/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>The dangers of compulsory vaccination</h5></a><p class="author"><a href="https://unherd.com/2021/02/the-dangers-of-compulsory-vaccination/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Adam King</a></p></div></a></div>
<p>Today, with ubiquitous CCTV cameras and widespread availability of facial recognition software, British police forces are <a href="https://www.met.police.uk/advice/advice-and-information/fr/facial-recognition/" target="_blank" rel="noopener">using</a> it to pick out individuals in public spaces, with AI programmes that match faces seen on camera to faces in databases. But private spaces like shops, museums, casinos and arts centres were using Facial Recognition Technology first. Some cities and states in the US have moved to forbid or control its use, but in the UK there is no legal framework to prevent somebody from matching your face to your identity, and other data about your life.</p>
<p>How did we end up here, unable to reliably go about our lives anonymously in public spaces? Just as technology is inseparable from wider social structures, “tech ethics” can’t be seen as merely part of the technology development process. They make sense only in the context of wider social and moral frameworks.</p>
<p>It’s entirely possible that the designers of the Facial Recognition systems looked at the millions of photographs that people upload to social media every day, tagging themselves, their friends and families, and couldn’t see anything wrong with gathering all that information into one handy index. True, it could result in specific harms, like stalkers finding their victims, or innocent people being unjustly targeted by the police. But those could be relegated to the “unforeseen consequences” of a generally desirable change.</p>
<p>Yet the indifference of governments, businesses, and many individuals, to privacy is a much deeper problem than a few irresponsible tech bros. As the recent pandemic years have shown, the desire to be free from scrutiny unless there’s a good reason to be scrutinised is widely seen as, at best, eccentric and, at worst, automatic grounds for suspicion.</p>
<p>We simply can’t articulate why a private life is valuable. We have no sense of ourselves as autonomous beings, persons who need a space in which to reflect, to share thoughts with a few others, before venturing into public space with words and actions that we feel ready to defend.</p>
<p>Few question the desirability of exposing private messages that fall short of today’s acceptable attitudes. In-jokes are regularly taken out of context and used to condemn the joker. If a wrong thought has been expressed, even privately to friends or associates, it’s evidence of bad character and subject to public judgement. The use of Implicit Bias tests by employers shows that even subconscious thoughts are not safe from dissection and testing for impurity.</p>
<div class="ref-ar"><a href="https://unherd.com/2020/08/can-our-leaders-cope-with-freedom/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2020/08/can-our-leaders-cope-with-freedom/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2020/08/GettyImages-1227715546.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2020/08/can-our-leaders-cope-with-freedom/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">More from this author</span></a><a href="https://unherd.com/2020/08/can-our-leaders-cope-with-freedom/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Can our leaders cope with freedom?</h5></a><p class="author"><a href="https://unherd.com/2020/08/can-our-leaders-cope-with-freedom/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Timandra Harkness</a></p></div></a></div>
<p>And since Covid struck, the ethical implications of our relationship with technology have only become more profound. Consider the use of “contact tracing” apps which, as Hare notes, could be more accurately described as “exposure notification apps” since they don’t facilitate contact tracing, because they’re designed to be anonymous.</p>
<p>We owe that design element to Google and Apple, who added to their operating systems the capacity for devices to exchange tokens with nearby devices, using <a href="https://unherd.com/2020/04/can-your-smartphone-crack-covid/" target="_blank" rel="noopener">Bluetooth</a>, but only anonymously.</p>
<p>Many governments, including in UK and France, didn’t want this anonymous system. They wanted to know the patterns of who was infecting whom, as well as the possibility of contacting individuals to make sure they were isolating when they should. Arguably, public health might justify that kind of intrusion. But the tech giants didn’t want to gift governments information about who spends time within a few metres of whom.</p>
<p>Perhaps they were right — but either way, we never got to have that argument. Governments largely evaded public debate about the measures they used against Covid, and tech companies decided what capabilities to build into their products. The successes and failures of the apps were only partly technical; they were largely down to the wider strengths and failings of Covid policies. It is, after all, little use telling somebody they may have been infected if they can’t get a speedy test result, or if they can’t afford to self-isolate without sick pay. Again, no amount of ethical tech development would have changed that.</p>
<p>As the pandemic moved on, the attention of the UK government moved from “Contact Tracing Apps” that weren’t, to “Vaccine Passports” that weren’t, but were really. Despite almost universal rejection of the idea by health, cyber-security and equality organisations, and repeated insistence that the government was not considering vaccine passports, the Government funded eight pilot schemes for vaccine passports, and gave the green light for private organisations to demand them.</p>
<div class="ref-ar"><a href="https://unherd.com/2021/12/why-should-humans-be-in-charge/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2021/12/why-should-humans-be-in-charge/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2021/12/GettyImages-1180744476-1.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2021/12/why-should-humans-be-in-charge/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2021/12/why-should-humans-be-in-charge/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Why should humans be in charge?</h5></a><p class="author"><a href="https://unherd.com/2021/12/why-should-humans-be-in-charge/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Mary Harrington</a></p></div></a></div>
<p>Ethicists <a href="https://www.bbc.co.uk/news/uk-56755161" target="_blank" rel="noopener">went public</a> with their many warnings: vaccine passports would be socially divisive, discriminatory, needlessly intrusive, and a perverse incentive to get infected. But none of this had any impact on government plans: principles like privacy and social solidarity found no resonance in opportunistic policymaking. Neither did the Government have the courage to argue that these undesirable measures were proportionate and necessary, and trust the public to accept exceptional infringements in exceptional times.</p>
<p>This is the other limitation of technology ethics: they are no match for power. Britain is currently an outlier among European and other governments that are imposing highly divisive and restrictive vaccine passport regimes, and using physical force against dissenters.</p>
<p>And yet masses of people do seem prepared to accept restrictions on their lives that would have been unthinkable a couple of years ago. Why are we so willing to accept that a condition of participation in public life is an app that affirms our medical status? Why have we been so willing to accept the repeated reduction of society to one household in one space, connected mainly through screens to the wider world?</p>
<p>One answer is that technology has ridden to the rescue. Without the constant ability to connect to that digital network — a network of other humans, as well as data — it would simply have been impossible for half the population to just stay home for months on end. Work would have been done in offices or not at all. Education would have been unable to stagger on, even in its unequal and truncated form. The severance of social connections would not have been a reduction to two-dimensional faces on screens, but near-complete isolation.</p>
<p>But that is only half an answer. A retreat from shared public space, alongside the penetration of private space by always-on connection, was far advanced before governments told us to Stay Home. When bedrooms and kitchen tables became classrooms and desks, was it so great a change from answering work emails from the sofa, or chatting about homework on screens across many teenage bedrooms?</p>
<p>And that earlier change, accelerated but not precipitated by the pandemic, was as much social as technological. Through technology, we can be apart, but never completely alone. Interacting through screens, we are insulated by space and — when we’re exchanging messages — by time. Public space is increasingly digital, so we need never be fully there, but with a smartphone there is no fully private space either.</p>
<div class="ref-ar"><a href="https://unherd.com/2020/06/was-the-two-metre-rule-one-big-lie/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2020/06/was-the-two-metre-rule-one-big-lie/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2020/06/GettyImages-1210496932.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2020/06/was-the-two-metre-rule-one-big-lie/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">More from this author</span></a><a href="https://unherd.com/2020/06/was-the-two-metre-rule-one-big-lie/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Was the two-metre rule one big lie?</h5></a><p class="author"><a href="https://unherd.com/2020/06/was-the-two-metre-rule-one-big-lie/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Timandra Harkness</a></p></div></a></div>
<p>This shift away from shared social lives began in the mid 20th century. We lead more solitary lives than our grandparents. We start families later, we belong to fewer social organisations. Most of all, we lack a shared framework of morality and ideas about a shared future. When difficult times hit us, we lack a foundation on which to base our judgments. This is true of us as individuals, but also as a society. No wonder our governments cast about for technological solutions to moral questions.</p>
<p>Hare quotes John von Neumann in 1954, testifying about the development of the atomic bomb:</p>
<p style="padding-left: 40px;"><em>“We were all little children with respect to the situation which had developed… None of us had been educated or conditioned to exist in this situation, and we had to make our rationalisation and our code of conduct as we went along.”</em></p>
<p>Today, it’s hard to find anyone who doesn’t act — and probably feel — like a young child when confronted with adult responsibilities.</p>
<p>Part of the appeal of technologies like AI is the fantasy that a machine can take the role of wise parent, immune to the emotion and unpredictability of mere humans. But this tells us less about the real capabilities of AI, and more about our disillusionment with ourselves</p>
<p>The urge to fix Covid, or other social problems, with technology springs from this lack of trust in other people. So does the cavalier disregard for privacy as an expression of moral autonomy. Technology ethics can’t save us, any more than technology can. Even during a pandemic, how we regard one another is the fundamental question at the root of ethics. So we do need to treat technology as just a tool, after all. Otherwise we risk being made its instruments in a world without morals.</p>
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					<title>What&#8217;s the point of contact tracing?</title>
					<link>https://unherd.com/2020/06/is-contact-tracing-really-necessary/?edition=us</link>
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					<dc:creator>
						<![CDATA[Tom Chivers]]>
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							<![CDATA[If you can't trust the British Government to organise a hugely complicated IT project, who can you? Photo by GLYN KIRK/AFP via Getty Images]]>
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							<![CDATA[<p><strong>Tom Chivers</strong> is a science writer. His second book, <em>How to Read Numbers</em>, is out now.</p>
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						<unherd:twitter_handle>TomChivers</unherd:twitter_handle>
															<unherd:author_bio>
						<![CDATA[ is a science writer. His second book, <em>How to Read Numbers</em>, is out now.]]>
					</unherd:author_bio>
										<pubDate>Mon, 15 Jun 2020 23:25:07 +0000</pubDate>
					<updated>Tue, 16 Jun 2020 10:55:53 +0000</updated>
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		<category><![CDATA[Coronavirus]]></category>
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		<category><![CDATA[lockdown]]></category>
		<category><![CDATA[track and trace]]></category>
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								<![CDATA[Compared to continual lockdown or the virus spreading, even an imperfect tracking system might be the least bad of all options]]>
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								<![CDATA[<p><span style="font-weight: 400;">Lockdown isn’t over. Nowhere near.  You can’t go and sit in a pub; hardly any children are back at school; and there are still </span><span style="font-weight: 400;">severe </span><span style="font-weight: 400;">restrictions on who you can meet and when. Most people are still complying with those rules.</span></p>
<p><span style="font-weight: 400;">But we do need to start coming out of it soon, or </span><a href="https://unherd.com/2020/05/is-the-lockdown-doing-more-harm-than-good/"><span style="font-weight: 400;">the cure will become worse than the disease</span></a><span style="font-weight: 400;">. So we need a way of returning to a sort of normality, and allowing the economy to restart, while avoiding that </span><a href="https://unherd.com/2020/06/should-we-expect-a-covid-second-wave/"><span style="font-weight: 400;">second wave</span></a><span style="font-weight: 400;">. </span></p>
<p><span style="font-weight: 400;">“Test, trace and isolate” — finding infected people, tracking down the people they’ve been in contact with, and getting them all to isolate for a period — is the most promising avenue, and the government says that it has put in place a “world-beating” system. But their handling of the testing regime — full of self-congratulatory bluster and </span><a href="https://www.theguardian.com/world/2020/jun/02/statistics-watchdog-ministers-still-misleading-public-on-coronavirus-tests"><span style="font-weight: 400;">statistical malfeasance</span></a><span style="font-weight: 400;"> — has not instilled confidence; and while the first tranche of results from the system have been reasonably promising, it has been slow to be developed at all, so it is already fighting uphill. So: can it work?</span></p>
<p>Well, one<a href="https://github.com/ptti/ptti/blob/master/docs/PTTI-Covid-19-UK.pdf"><span style="font-weight: 400;"> interesting paper</span></a><span style="font-weight: 400;"> just published by researchers at University College London looks at the impact contact tracing will have on the economy relative to lockdown. I spoke to one of the authors, the policy researcher David Manheim, to find out whether test and trace could indeed work for the UK. </span></p>
<p><span style="font-weight: 400;">Some caveats: modelling is </span><a href="https://unherd.com/2020/04/how-likely-are-you-to-die-of-coronavirus/"><span style="font-weight: 400;">inherently uncertain</span></a><span style="font-weight: 400;">. Manheim says that the model is robust — the headline outcomes remain broadly consistent even if the assumptions and inputs are tweaked — but it’s just one paper, and so far not peer-reviewed. As the situation develops we can compare its scenarios with reality.</span></p>
<p><span style="font-weight: 400;">It is worth noting how bad the two extreme situations, “doing nothing” and “staying locked down”, are. The most widely used estimate for the infection fatality rate (IFR) of Covid-19 is about 1%, and that’s what the paper uses. (<em>UnHerd</em> has </span><a href="https://unherd.com/2020/05/oxford-doubles-down-sunetra-gupta-interview/"><span style="font-weight: 400;">spoken</span></a><span style="font-weight: 400;"> to </span><a href="https://unherd.com/thepost/coming-up-epidemiologist-prof-johan-giesecke-shares-lessons-from-sweden/"><span style="font-weight: 400;">various people</span></a><span style="font-weight: 400;"> who think it’s lower than that, and I perhaps over-optimistically </span><a href="https://unherd.com/2020/04/could-anyone-have-predicted-covid-19/"><span style="font-weight: 400;">predicted a few weeks ago </span></a><span style="font-weight: 400;">that it would be below that level, but that seems to be the standard estimate.)</span></p>
<p><span style="font-weight: 400;">So here’s the background situation. If we come out of lockdown entirely, without any attempt at tracing and isolation, the paper estimates that between 60% and 80% of the country would end up infected, and between about 250,000 and 550,000 people would die. People will correctly point out the average age of death is over 80, but nonetheless it is a brutal toll.</span></p>
<p><span style="font-weight: 400;">On the other hand, if we try to reduce spread by only using lockdown, with no testing or tracing, then “we are likely to need lockdown for three of every four months (or four of every six months)” until the development and availability of a vaccine or highly effective drug treatments. That represents an extraordinary hit to the economy — in the worst case, around £1.2 trillion GDP lost by May 2022, when their models ended. To put that in context, the UK’s GDP in 2019 was </span><a href="https://www.imf.org/external/pubs/ft/weo/2019/02/weodata/weorept.aspx?pr.x=43&amp;pr.y=8&amp;sy=2016&amp;ey=2021&amp;scsm=1&amp;ssd=1&amp;sort=country&amp;ds=.&amp;br=1&amp;c=112&amp;s=NGDP_RPCH%2CNGDPD%2CPPPGDP%2CNGDPDPC%2CPPPPC%2CPCPIPCH&amp;grp=0&amp;a="><span style="font-weight: 400;">about £2.2 trillion</span></a><span style="font-weight: 400;">. We are talking about roughly a quarter of the entire UK economy being mothballed, with all the knock-on effects to health, wellbeing and happiness that entails.</span></p>
<div class="ref-ar"><a href="https://unherd.com/2020/06/should-we-expect-a-covid-second-wave/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2020/06/should-we-expect-a-covid-second-wave/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2020/06/GettyImages-1213156715.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2020/06/should-we-expect-a-covid-second-wave/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">More by this author</span></a><a href="https://unherd.com/2020/06/should-we-expect-a-covid-second-wave/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Will there be a second Covid wave?</h5></a><p class="author"><a href="https://unherd.com/2020/06/should-we-expect-a-covid-second-wave/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Tom Chivers</a></p></div></a></div>
<p><span style="font-weight: 400;">What you need is some sort of way of targeting your interventions. “Think of it as a continuum,” he says. “How good is our ability to figure out if someone has Covid? If we have no ability, then it’s ‘shut everything down’. If we have some ability, then you can isolate people purely based on symptoms. That reduces spread significantly, but isn’t enough on its own.”</span></p>
<p><span style="font-weight: 400;">“If you add testing, it gets better, because testing has a lower false negative rate than symptoms, and it catches it little earlier. But tracing catches it much earlier: you isolate everyone who was in contact with this person for two weeks.”</span></p>
<p><span style="font-weight: 400;">What testing and contact tracing allows is for people to go about their lives in some fairly normal way, and for something like a fully functioning economy to get underway. But the question is whether the scale of the system needed to do that is 1) plausible and 2) available at a cost worth paying. If it would cost a trillion pounds to put one in place, then it wouldn’t really achieve anything over remaining in intermittent lockdown.</span></p>
<p><span style="font-weight: 400;">“What we model in the paper is: how many tracers would you need?” says Manheim. It’s not a small job: the paper assumes that it would take almost exactly a full week’s work (37 hours) for one contact tracer to follow up all the contacts of a single infected person, including interviews with the subject and their contacts, arranging testing, and doing follow-up monitoring calls. </span></p>
<p><span style="font-weight: 400;">Still, the basic result, he says, is that when case counts are relatively low, it is possible to identify and track enough of them to keep the rate of transmission down, at a cost that is relatively manageable. But “when there are too many cases, the costs of tracing are completely out of hand”, he says. If you have millions of cases, then you need many millions of tracers, and it becomes implausible.</span></p>
<div class="ref-ar"><a href="https://unherd.com/2020/05/do-any-covid-19-cures-work/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2020/05/do-any-covid-19-cures-work/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2020/05/GettyImages-1209597481.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2020/05/do-any-covid-19-cures-work/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">More by this author</span></a><a href="https://unherd.com/2020/05/do-any-covid-19-cures-work/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Do any Covid-19 &#039;cures&#039; actually work?</h5></a><p class="author"><a href="https://unherd.com/2020/05/do-any-covid-19-cures-work/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Tom Chivers</a></p></div></a></div>
<p><span style="font-weight: 400;">Eventually it becomes cheaper simply to test </span><i><span style="font-weight: 400;">literally everybody</span></i><span style="font-weight: 400;"> once a week — which ends up being about 10 million people a day — and requiring people who get positive tests to self-isolate. And even that is cheaper and more manageable than the costs of lockdown — the paper estimates it would cost about £36 billion over the next two years to do that many tests, a fraction of the £700 billion hit to GDP (and the smaller but still huge hit to the public finances) that we would otherwise be facing.</span></p>
<p><span style="font-weight: 400;">Luckily, the UK is not in that situation. Despite the somewhat doom-and-gloomy atmosphere, case counts are down somewhere a bit more manageable. The paper includes several scenarios which loosen and re-impose lockdown on given “triggers” — when the number of daily cases goes above 40,000, it is reimposed, and when they fall below 10,000 it is relaxed. The daily number of lab-confirmed cases in the UK, as of Sunday 14 June, was 1,514; that’s probably a low number because the weekend interferes with data collection, but data from the KCL/Zoe Covid-tracker app </span><a href="https://covid.joinzoe.com/post/covid-cases-uk"><span style="font-weight: 400;">suggests</span></a><span style="font-weight: 400;"> that there are fewer than 5,000 daily new cases at the moment. So we are in the “manageable with contact tracing” zone.</span></p>
<p><span style="font-weight: 400;">But is the testing and contact tracing system we actually have fit for purpose? The British government has been making very loud noises about meeting the targets it set itself, of 100,000 tests by the end of April and 200,000 by the end of May. But those numbers were </span><a href="https://unherd.com/thepost/i-told-you-so-the-100000-target-was-pointless/"><span style="font-weight: 400;">largely nonsense</span></a><span style="font-weight: 400;">: the 100,000 tests included tests put in the post but not carried out, and multiple tests being carried out on the same person; the 200,000 included those but also included antibody tests, which are good and important things but entirely different. (And both also referred to “capacity”, rather than actual tests carried out.) Radio 4’s </span><a href="https://www.bbc.co.uk/programmes/b006qshd"><span style="font-weight: 400;">magnificent More or Less team</span></a><span style="font-weight: 400;"> have been digging away at this dispiriting little bit of governmental misinformation for weeks. Sadly, the virus does not seem to be reading the Department for Health and Social Care’s press releases.</span></p>
<p><span style="font-weight: 400;">The actual, real number of individual people being tested is about 50,000 a day. That’s not negligible, but </span><span style="font-weight: 400;">in the paper’s best-case scenario (which still involves many thousands more people dying than have already), we will need to test at least 75,000 people now, and about 300,000 people a day over the winter</span><span style="font-weight: 400;">. That’s assuming that we have enough contact tracers in place – if I’m reading the paper right, somewhere around 80,000 “public health community officers”, ie recruits, and a smaller number of more senior people to manage them – to contact all the contacts of each person with a positive test result. </span></p>
<div class="ref-ar"><a href="https://unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2020/03/GettyImages-1204884025.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Why the Government changed tack on Covid-19</h5></a><p class="author"><a href="https://unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Saloni Dattani</a></p></div></a></div>
<p><span style="font-weight: 400;">The system doesn’t have to be perfect. The paper assumes that 64% of the contacts are traced within a day, and then self-isolate; but there’s no guarantee they will do so; in Israel, where Manheim lives, there are legal sanctions — people who leave their home when expected to isolate are texted a warning and can be given a ticket or arrested — but that may not be feasible here. </span></p>
<p><span style="font-weight: 400;">And, Manheim points out, we shouldn’t throw up our hands and say that the British Government’s difficulties with testing and tracing now mean that the whole enterprise is doomed: we can improve it. “The sooner we find out what does and doesn’t work, the better. You’re not going to have a perfect system on day one.” There have been reports of the contact tracers saying that they have signed up and not been given any work, which sounds bad, but “that’s like any new for-profit company building a new thing. The public sector isn’t going to magically do any better. The question isn’t whether it’s doing well on day one, but whether it’s doing OK on day 30, and doing well enough on day 60.”</span></p>
<p><span style="font-weight: 400;">That said, the Government has not covered itself in glory. “One big bottom line thing that I think is important is that this study should never have been needed,” says Manheim. “We’ve known we needed test-and-trace for a long time.”  </span><span style="font-weight: 400;">They wrote it with the intention of showing policymakers what may and may not work. </span><span style="font-weight: 400;">It may be, he says, that in two months we learn that the Governments’ systems that they already have in place could be scaled up fast, and will do the job. But even if they aren’t, it’s better to start now than to leave it. </span></p>
<p><span style="font-weight: 400;">“What they absolutely can’t do, and is a danger in the interim, is print out giant ‘mission accomplished’ banners and declare they’ve got everything done.” It’s not easy for politicians to tell the population that we’re going to have a tough time for the next two years; you don’t get rewarded for that. So it’s easier, in the short term, to declare victory.</span></p>
<p><span style="font-weight: 400;">But in the end, the numbers of deaths and hospitalisations will be the yardstick of success, and they’re very hard to explain away. The temptation to soft-pedal, to pay lip service to test-and-trace but actually just quietly let lockdown dissolve, will be great, but then we could end up in the worst of all worlds — a huge economic hit due to the pointless 12 weeks of lockdown, and vast numbers of dead all the same.</span></p>
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