As the nation starts to prepare for the new world beyond COVID-19, the proposition of digital health/vaccine passports has been highlighted as a means of returning to societal norms. After reading a balanced and well-written article from our friends over at The New Statesman, one statement jumped out during their interview with Andrew Bud, CEO of iProov.
iProov is a biometrics company currently working on such a passport, inbuilt with facial recognition technology. The solution, jointly developed with Mvine and backed by Innovate UK funding, went into live testing in January. In the article, Bud stated he thinks that “people will be willing to make a one-off investment in enrolling their face.” As is, I think this statement is way off the mark, although the simple inclusion of the word ‘most’ may have made it more palatable.
One of the biggest issues in rolling out a digital passport is trust and concerns over the misuse of data, privacy, and data security. Regardless of the capabilities and security of such a tool, convincing the entire general public to download it will be impossible. It is therefore important to note that this would be optional as, in February, vaccines minister Nadhim Zahawi clarified that there would be no state-issued immunity passports.
In 2018, a Healthwatch England survey found that 77% of adults were confident in the ability of the NHS to protect their patient data. Extrapolated across the population of England, this would suggest that almost 13 million citizens would opt out of “enrolling their face” for the passport app. Furthermore, there is another significant body of individuals who will choose not to be vaccinated, for whom the passport would be useless anyway.
These individuals would therefore be at the mercy of the managers/owners of the establishments or events they wish to enter. However, at a time when the hospitality industry is on its knees amid reports from the Centre for Retail Research (CRR) of a 163% rise in redundancies and a 76% increase in branch closures, is much-needed custom really going to be turned away if given the option?
Even for international travel, almost a third of people surveyed by Medicspot did not support vaccination passports for those leaving the UK on holiday and business. This complements a live petition, which has more than tripled its 100,000-signature target, urging the Government to not roll these out to the British public over fears that they could be used to restrict the rights of those who have refused a vaccine.
The notion of a digital passport also comes at a time when health inequalities and digital exclusion are being highlighted across the country, including heightened vaccination hesitancy from black, Asian and minority ethnic (BAME) individuals. Echoing figures from the Office for National Statistics (ONS) and Ofcom, NHS Digital highlights 11.3 million people lack the basic digital skills to use the internet effectively and 4.8 million never go online at all and so would likely not be on board with a digital tool.
Vaccine passports do already exist, however, as evidenced by the paper-based yellow fever certificate, but as expected, this system was plagued by forged, counterfeited, and fake documents. Beyond the piece of paper itself, they also led to the US refusing visa applications for those who had tested positive. We run the risk of discriminating, in the same way, this time around if not handled carefully.
Digitally, it seems as though the UK Government is still trying their best to find a way to force digital down the throats of the general public. Wolfgang Emmerich, founder of Zühlke Engineering, which helped build the COVID-19 app, recently revealed to Digital Health that despite the app having 20 million downloads and 16 million daily users, 40% of the population still do not use it. Maybe the added incentive of a pint down your local will push those numbers up for the passport but unfortunately, if you build it, they still may not come.
So, what is the solution? Well, if I knew, I would be a very rich man indeed, but in the absence of a fool-proof alternative, I could at least make a suggestion. Regardless of whatever plan the UK Government pursues, what is vital is that there is a significant level of engagement with the general public to obtain and gauge feedback. It is also crucial that the chosen plan is laid out as simply and clearly as possible, and it is communicated consistently across the nation. Now is not the time for U-turns in decision-making akin to those made earlier during the pandemic.
Unfortunately, the most viable, yet still imperfect, solution seems to be the current hybrid model whereby those unwilling to download the digital passport can instead present a paper-based certificate issued by their GP, alongside some form of identification. Those who have not been vaccinated may be subjected to testing, where operationally and financially viable, and face the possibility of being refused entry at public places and events. The UK Government has a monumental challenge on its hands and is bound to receive some level of backlash for whichever strategy it pursues, but what is for certain is that there is no one-size-fits-all solution.