From the beginning of the Coronavirus crisis, contact tracing has been hailed as the main way for countries to get back to normal. The World Health Organization says this strategy can “break the chains of transmission”, and many watched in awe as South Korea successfully delivered its programme. The Government has since been under a huge amount of pressure to get its own system up and running.
The UK process
Although there are different programmes in the UK, they all follow roughly the same idea. If someone comes into contact (defined as being within two metres for more than 15 minutes) with another person who has Covid-19, they will be notified by their respective health authority (or a phone app, in the case of Northern Ireland) to self-isolate for 14 days. They must then stay at home for 14 days while avoiding others, even those that they live with.
NHS Test and Trace (England) advises that if the person gets symptoms of Covid-19, they should take a test as soon as possible, and anyone they live with must self-isolate until the result comes back. Even if they test negative, they must keep self-isolating for the rest of the 14 days, but those they live with can stop if they don’t have symptoms. If they test positive they must self-isolate for at least 10 days from when their symptoms started, and anyone they live with must self-isolate for 14 days.
Some of these systems are facilitated by local contact tracing teams. Scotland’s Test and Protect scheme uses these, for instance, as well as having a National Contact Tracing Service to identify close contacts of an infected person.
And while England originally relied on thousands of call centre workers to carry out tracing, it has since switched approach after it was found that local teams could trace 98 per cent of contacts (compared to 56.1 per cent for call centres). These staff members can knock on people’s doors to obtain close contacts’ information.
As with much of the Covid-19 crisis, there have been different results across different regions. The Government has come under huge criticism, however, over two things.
The first is that its contact tracing app didn’t work (all the while 300,000 users have downloaded Northern Ireland’s). It originally wanted to run a centralised app – something tech experts warned would cause problems, and they were proven right; hence the Government is having to rehaul its initial plan.
The second area of pressure for NHS Test and Trace is its inability to meet a target of 80 per cent for finding close contacts (of those who’ve tested positive for Covid-19). New figures show, in fact, that only 69.4 per cent of contacts were reached (down from 77.1 per cent the previous week). As The Huffington Post points out, it’s the tenth week running that the target has been missed.
The Welsh government’s Test Trace Protect programme, on the other hand, showed that out of 237 positive cases that were eligible for a follow-up, 228 (96 per cent) were reached and asked to provide details of their recent contacts (in the week of August 23 to 29).
When quizzed about the figures, Dido Harding, who heads NHS Test and Trace, said that “we reach 80 per cent of all contacts we have information for”. In other words, the lower figure is because some people haven’t provided details for their close contacts.
Interestingly, The Telegraph recently found that a third of cafes and restaurants are failing to obtain customers’ contact details, so it’s worth bearing in mind that compliance is a big factor, as not everyone is on board with the process.
And perhaps this problem is amplified in countries with bigger populations. Indeed, differences between sample sizes may skew the percentages reached, with some of Wales’s statistics taken from 4,610 people, versus 31,388 for England. Even with bigger teams of contact tracers, they are dealing with enormous numbers of people.
To bolster track and trace, the Government is investing £500 million in increasing testing capacity. Using a range of pilot schemes, it will expand its network of testing sites and invest in new technologies to reach even more people.
This should help things substantially, as one issue that has been identified is regional imbalances in the availability of track and trace. There have been reports of people being directed to centres over 100 miles away to get tested, and one article suggests that the system failed to reach over half of contacts in Hackney and the City of London since it was introduced (compared to other boroughs such as Merton, where 73 per cent of close contacts were reached).
Whether health officials can get up to their target of 80 per cent remains to be seen, and pressure on the Government is only going to ramp up. But the area it will be most criticised over is its contact tracing app, which is currently in trials. With Northern Ireland having a degree of success with its own, and Scotland set to use the same technology, it will only lead to more questions of why ministers cannot get the NHS Test and Trace app moving faster too.