The 2020 global Covid-19 pandemic has created unprecedented challenges for citizens of the world and their governments. Controlling a fast spreading and deadly epidemic requires changes in behaviour at an individual level as well as a total change in daily life as we previously knew it. As the world ‘shut down’ and we lock down in our homes, our keyworkers keep the fundamentals of life going.
The coronavirus response requires collaboration on a massive scale, from global and public health bodies, scientists, clinicians, and leaders. A key component of the response has been the use of technology and sharing of information. Behind the transmission of key communication messages sits behavioural science. The use of slogans has been key in delivering the government’s message. At first, we were told to ‘wash our hands’ and not touch our face, then to ‘stay home’ and more recently, to ‘stay alert’. Technology was used to identify at-risk individuals in the extremely vulnerable group and communicate key behavioural messages to them created by the likes of the Behavioural Insights Team, the ‘world’s first nudge unit’.
The Behavioural Insights team blog article ‘Using behavioural insights to create a Covid-19 text service for the NHS’ describes how distilling a complex message is then targeted to individuals by text. This type of communication was a key component in messaging the ‘shielding’ group of people. Telling people to stay indoors and simply open a window for the next 12 weeks or longer requires careful communication and linguistics. Indeed, behind the identification of this group of ‘extremely vulnerable’ people required the development of an algorithm, the SPL (shielded patient list) developed by NHS Digital. The process has been criticised for wrongly including and excluding patients, a recent article in Pulse Today states ‘Vulnerable patients still without shielding advice, warns national cancer lead’. Despite criticisms, in a short space of time around 2.5 million individuals have been identified.
As we look to the future and our attempts to emerge from the pandemic, technology continues to play an important part. One such component of our way out is the use of a contact tracing app. An automated app that alerts individuals on their mobiles that they may have been exposed and take action to mitigate the risk to themselves and others. However, the contact tracing app is not without controversy. The NHS Covid-19 App by NHSX was recently trialled in the Isle of Wight.
The app has been designed with privacy in mind. The app does not collect personally identifiable data from users. Users will always remain anonymous. The anonymous data collected by the NHS COVID-19 App will only ever be used for NHS care, management, evaluation and research.
accessed May 17, 2020
Michael Veale, a lecturer in digital rights at University College London recently stated that the ‘NHS contact-tracing app ‘falls short of data protection law’. Some privacy and campaign groups have also taken opposition to the app, some say it could open the door to general surveillance on the population.
Technology has the power to save lives. As clinicians, I believe we need to understand advances in technology, the importance of effective communication and the influence of behavioural science on health behaviours. However, we will always have a duty of care to protect our patients and ensure that these are in their best interests. Once this pandemic is over there may be many technological innovations that remain with us for the better, for example remote working and digital consultations. The world will undoubtedly be different, we must remain vigilant, curious, and questioning.