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Coronavirus UK: Contract tracing may mean 770k self-isolate a day

Test, track and trace is the Government’s three-point plan for keeping tabs on the coronavirus when the lockdown is lifted. It will move back to a surveillance system similar to what was happening before the major outbreak started in the UK.

Widespread testing will pick up on infections and local clusters early, random population testing will track how many people have had the virus already, and contact tracers will monitor the social networks of people who become ill, and advise them to self-isolate to stop them passing the virus on further.

This is how it is expected to work:

TEST: Test millions of essential workers and their families for current infection

Swab tests will be offered to all key workers and members of their family, if they have symptoms of COVID-19, from tomorrow, Hancock announced in today’s briefing. 

These tests will involve swabbing the inside of the person’s nose and will tell someone if they are currently infected with the coronavirus. It will not tell if they have already had it.

People will be able to order the tests online on the Government’s website, or through their employer if they don’t have internet access. 

After applying, people will receive an email or a text message that same day inviting them to book an appointment.

The tests will be done in one of five places:

  1. At one of 31 drive-through testing centres around the country, which have been positioned to try and make sure nobody is more than a 45 minute drive away from one
  2. At home – home testing kits will be available for some people
  3. NHS hospital – these are most likely to be reserved for NHS staff, because the health service will want to avoid encouraging people who might be infected but don’t need emergency help to enter hospitals   
  4. ‘Satellite’ testing – packages of testing kits are being sent to care homes so they can test residents without having to take them out of the home or send other people in
  5. Mobile testing units that have been developed by the Army may be sent out to high-demand locations such as care homes, police stations and prisons

Test results, which must be returned from a laboratory, will be sent by text message within 48 hours or within 72 hours of a home test being collected.   

Swabs will be run through Government testing labs which, officials say, have the capacity to process 51,000 every day. 

Mr Hancock said today: ‘From today, employers of essential workers will be able to go on to get a test for any of their staff who need a test. 

‘And from tomorrow, any essential workers who need a test will be able to book an appointment on themselves directly. 

‘This all applies for people in essential workers’ households who need a test too. It’s all part of getting Britain back on her feet.’

The aim of the scaled up testing is to reduce the number of people who have to self-isolate from work if they fear they, or someone they live with, has symptoms of COVID-19.

If the person experiencing the symptoms tests negative the employee should be able to return to work.

On the list of essential workers, alongside NHS and social care staff and volunteers, are prison and court workers, religious leaders, funeral directors, journalists, police and support staff, military personnel and office staff and fire service employees.

Crime agency and border workers will also be included, along with utility workers, transport staff and maintenance workers, childcare workers and teaching staff, social workers, people who produce, sell or deliver food and drink, medical supply chain staff and veterinarians. 

Local government and environmental workers will also receive tests, as well as postal staff and financial workers such as bankers. 

The Government has so far put in a lacklustre performance on the testing front, not yet managing to rise above 24,000 tests in a day despite a pledge to hit 100,000 per day by next Thursday, April 30.

Capacity has been expanded with the opening of three government-run ‘Lighthouse Labs’ in Milton Keynes, Cheshire and Glasgow, and widening the criteria for who can get tested will push authorities much closer to this figure. 

According to the Insitute for Fiscal Studies there are 7.1million people in the UK – 22 per cent of the entire workforce – who fit the Government’s description of a key worker.

And their families will be included in the new testing scheme, too.

Almost half of those key workers (42 per cent) have at least one child of school age, the IFS data shows, and 46 per cent of them have partners who are in ‘non-key’ work.

TRACK: Random population testing for past and present infection to track the spread of the virus 

The Department of Health announced today that it will start a widespread public testing scheme, split into two parts.

Thousands of people forming a representative sample of the population will be enrolled into either regular swab testing or antibody testing which will help authorities track where the coronavirus is spreading and where it has been already.

Between 25,000 and 300,000 people will take part in the swab testing scheme which will continue over the next year. 

Everyone involved will complete a swab test every month to spot signs of current infection. This is intended to pick up on local outbreaks and see how the virus is circulating as the current crisis comes to an end. 

Picking up on these cases may be able to alert authorities to outbreaks in certain areas or to detect when large numbers of people are starting to test positive again and another outbreak is happening.

In a second branch of the tracking project, people in 1,000 households across the country will submit to monthly blood testing to see if they have immunity to the coronavirus.

These tests, called antibody tests or ‘have you had it’ tests, show whether someone has been infected with COVID-19 in the past and recovered. They are most accurate around three weeks or more after someone becomes infected.

Tracking the number of people who have developed immunity can give scientists a clear picture of how widely the virus has spread already, which may affect its ability to spread in the future.

The more people who test positive for antibodies, the fewer people there are who could get infected in a second outbreak. This is called herd immunity. 

Antibody testing, which has been picked up on much larger scale in other countries, forms a vital part of the Government’s ‘five-pillar’ testing strategy – but officials have so far only managed 4,900 tests and just 51 were done yesterday. 

The hope for this scheme is that, when rolled out more widely, it will give a clearer, more permanent picture of the size of the country’s outbreak and the extent to which the nation has developed herd immunity.

Currently, the numbers of people in hospital are the most accurate day-by-day measure but represent only a small proportion of all people infected.

The data can also be out of date because it may take a week or more for someone to become ill enough to need a hospital bed, and then up to three weeks, or longer, to recover.

Professor Ian Jones, a virus expert at the University of Reading, said today: ‘The newly announced tests should at last address the level of virus circulation in the community and, to a lesser extent, the level of past infections.

‘Together they will give important data on how prevalent the infection is and has been. Where this has been done elsewhere the level of infection has been 20 to 50 times higher than the known positives and we must wait to see if this is also the case in the UK.’ 

How much immunity people actually develop to the coronavirus after having it remains unclear.

Top scientists have admitted it is still possible that people are only protected for a short period of time and then become capable of spreading it or developing symptoms again. 

The Health Secretary said improving understanding of immunity levels is ‘vital’.

Of the antibody testing scheme, Mr Hancock said: ‘This survey will help to track the current extent of transmission and infection in the UK, while also answering crucial questions about immunity as we continue to build up our understanding of this new virus.

‘Together, these results will help us better understand the spread of the virus to date, predict the future trajectory and inform future action we take.’ 

TRACE: Trace contacts of infected patients and warn them they have been exposed to the virus

An army of 18,000 contact tracers will be trained in the coming weeks to help Britain recover from its lockdown.

The job of these people will be to quiz anyone who tests positive for the coronavirus about who they have been in contact with and where they have been around the time they become ill and the days before it.

The tracers will make a list of people considered to have been put at risk by the patient, and those people will be notified that they might have the coronavirus.

If contacted by tracers, people will be asked to self-isolate and to be vigilant about changes in their health and about social distancing. If they become ill they will be tested.

If a contact becomes infected the same process begins for them and their social network. The idea is to keep track of how the virus moves through social circles and to try to stay a step ahead of it and prevent wider spread. 

Experts expect to be able to track at least 80 per cent of the people a coronavirus patient has come into contact with within 24 hours of diagnosis. 

Council staff and civil servants are expected to be at the frontline of this effort.

Chief executive of the NHS Confederation, a body that represents healthcare organisations, Niall Dickson, said: ‘This is an important moment as we see real commitment and details of how we will develop contract tracing to help us track and control the virus when the current restrictions are relaxed. The recruitment of an army of 18,000 tracers will be critical, though any strategy will need to be linked into local organisations.’

One key aspect of the Government’s contact tracing plan is believed to be its NHS app which is still in the development phase.

NHSX, the health service’s technological arm, is believed to have been working on software which uses bluetooth technology, alongside Google and Apple, who run the two main smartphone operating systems.

Mr Hancock explained: ‘If you become unwell with the symptoms of coronavirus you can securely tell this new NHS app and the app will then send an alert anonymously to other app users that you’ve been in significant contact with over the past few days, even before (they) have symptoms so that they know and can act accordingly.’

The app is currently being tested at a Royal Air Force base in North Yorkshire and Mr Hancock said the trials ‘are going well,’ the BBC reported.

Similar approaches have been used with success in Singapore and South Korea but there are concerns about privacy and that not enough people will sign up to use it.

Researchers at the University of Oxford warned it would only work effectively if 80 per cent of the population downloaded it and used it, but surveys had found this level of engagement would be unlikely in practice.   

Nevertheless, lower levels of uptake coupled with social distancing efforts would still help to slow the spread of COVID-19 and put off a second lockdown period. In fact, the Oxford team predicted that, regardless of overall uptake, a contact-tracing app could ‘prevent approximately one infection for every one or two users of the app.’