Contact tracing: what is it and can it lead us out of lockdown?

But what is it? How does it work? And is it enough to support us coming out of lockdown? Can it really help prevent a second surge of mass infection?

This core disease control measure, of course implemented with a regime of social distancing and emphasis on hand hygiene, has been credited with making it possible for other countries to begin emerging from lockdown, as it allows the health service to map out, monitor and treat infected people and those they have interacted with. It is a means of containing the pandemic by geographically identifying clusters of the disease.

The Contact Tracing Service here is run by the Public Health Agency and involves the delicate work of pinpointing those in the community testing positive for Covid-19, urging them to self-isolate, and then contacting, via telephone, all of those who were in close contact with the infected person within a two metre distance and for longer than 15 minutes without the protection of PPE.

They will then be advised to self-isolate with members of their household for 14 days even if asymptomatic, to reduce the chances of further spread of the disease.

If that individual or members of their household develop symptoms, which include a high temperature, persistent cough and loss of taste or smell, then they too can request to be tested and treated, their contacts traced, informed and quarantined.

Again, it is worth remembering that you can have the virus without developing symptoms, although this is relatively rare.

The process here is part of the Department of Health’s Test, Trace and Protect strategy and was announced by its minister Robin Swann several weeks ago.

It is now fully operational, something yet to be achieved on the mainland where the development of a contact tracing app means the strategy may not be implemented there until late June, despite Government plans to lift some lockdown measures in defiance of the scientific consensus.

On April 27, the Department of Health in Northern Ireland began an “enhanced contact tracing pilot”, running on a five-day-a-week basis.

From mid-May it was was then rolled out more widely to include all confirmed positive Covid-19 cases and now operates seven days a week.

The service is staffed by professionals such as nurses and environmental health officers with lead clinicians and health protection consultants, plus trained volunteers, who will assess situations of infection and local clusters or outbreaks.

The call centre element of the service ‘contacts and traces’ those who have been exposed to a confirmed Covid diagnosis.

The Executive’s most recent figures state that in the first two weeks of its operation, from May 19 to May 31, 388 people who have Covid-19 were contacted.

Those calls have led to 518 contacts being traced.

Testing is completed at drive-through sites across the province operating at the SSE test centre, Odyssey car park, Belfast; City of Derry Rugby Club test centre, Judges Road, Londonderry; Craigavon MOT Centre; and St Angelo Airport, Killadeas Road, Enniskillen.

In addition to the three fixed sites at Belfast, Craigavon and Londonderry, there is also now a mobile testing unit based at Newry Leisure Centre car park.

The sites are drive through only to prevent contamination and tests are booked in advance either online or by telephone.

The test is self-administered and consists of a swab which will be analysed in a laboratory.

You will receive the result by email within 72 hours of taking the test, sometimes within as little as eight hours, depending on demand. It is also possible to order a postal self-test kit which will be dispatched to your home.

These tests, as distinct from an antigen or antibody test, will confirm if a person currently has the virus, not whether they have had it in the past and subsequently recovered.

Everyone who develops Covid-19 symptoms, having immediately begun to self-isolate, is urged by the health authorities to book a test without delay.

Doctor Patrick McAleavey is a GP who works in the health protection service at the Public Health Agency, which has always had the task of addressing and controlling the spread of communicable diseases.

“We would advise anyone who is experiencing symptoms to begin self-isolating and to book a test. Healthcare workers can be tested through the various health trusts and key workers or members of the general public at one of the various sites. Anyone can refer themselves for a test.

“All hospital admissions are swabbed at the point of admission.

“Those in care homes are tested through the acute health protection service, with testing being undertaken by the trusts. If there is an outbreak in a care home then all residents should be tested.

“If you are a member of the public experiencing symptoms and have requested a test, you will be contacted by the National Tracing Service and given a date and time to arrive at a specific site to be swabbed. 24-hours later you should ideally have the result.

“We are then notified and after speaking with the infected person can find out and track who they have been in contact with.

“We will not identify that person but instead let contacts know they have been in the vicinity of a confirmed case so that they can isolate.”

McAleavey continues: “It is a marathon process. Throughout the UK there are various contact tracing teams in different areas.

“I am very encouraged by the response and engagement with contact tracing activities. People have been receptive and very understanding of the process. I really do feel that this method will attenuate the chances of a second surge here in Northern Ireland.”

But he emphasises that contact tracing measures will not be sufficient on their own to combat a rising incidence of coronavirus, or to safeguard against the potential of a second phase of the pandemic.

“People need to remember that contact tracing is only one strand of our approach. It must be made very clear that social distancing and frequent handwashing remain vital.

“Contact tracing is not a silver bullet. It will help to reduce the number of cases of Covid and it will accordingly reduce fatalities and the burden of the disease on our health system, but it will not completely eradicate it. Everyone has a responsibility to do their bit to reduce the spread of the virus by washing their hands regularly.”

The practitioner added: “Picking up on and isolating disease activity is vital to help us reach a place where we can start to ease lockdown measures.”

Doctor Connor Bamford, a virologist based at Queen’s University Belfast, who is working towards finding anti-viral drugs that could help patients battling Covid, agrees that contact tracing combined with sufficient testing is the only way out of lockdown.

Dr Bamford believes we must proceed with caution in terms of easing social distancing measures while prioritising public health.

He said: “Contact tracing in Northern Ireland is all being done by telephone, but elsewhere in the UK they have been trying to develop apps that would make it much easier to track all the people an infected individual has contact with.

“If for example they were on a bus and had contact with various people, an app would be able to give us that kind of information much more quickly, using bluetooth on mobile phones.

“I think an app would prove more effective and I think the PHA will move towards the use of this kind of tool eventually. The NHS on the mainland have been working on one but it is not yet up and running.

“In terms of easing lockdown, I think the Northern Ireland Executive has made wise and informed decisions based on the science to date.”