Scotland’s contact tracing operation is successfully reaching a higher proportion of people than its counterpart in England, one of the country’s leading public health experts has said.

Data released by the Scottish NHS Test and Protect programme suggests it is reaching 99% of people who test positive and just over 98% of people they have been in close contact with.

This compares to under 78% of positive cases in England reached by contract tracers and 82% of their contacts.

Linda Bauld, Professor of Public Health at the University of Edinburgh, told healthandcare.scot the initial data published by Public Health Scotland, though limited, suggests Scotland’s model is “working very well”.

It comes as Scotland records the highest rise in positive coronavirus cases since May, with 77 people testing positive for the virus in the last 24 hours, representing 1% of those tested.

Testing data released for Scotland is on a much smaller scale and over a shorter timescale than for England, meaning precise comparisons are difficult.

For example, only 5,068 contacts are recorded as having been reached in Scotland since detailed data was available from the 21^st July, when all health boards began using a new management system, compared to more than 200,000 in England since the end of May.

Professor Bauld, who is also chair of the University of Edinburgh’s Usher Institute, said the “excellent” proportion of Scots being traced could reflect the fact that Scotland’s Test and Protect system “has been built around existing local public health infrastructure rather than as a separate system.”

England’s contact tracing programme has come under criticism for handing responsibilities to large outsourcing companies that have delivered far lower contact rates than local authority teams, amid claims of problems with data-sharing and poor training.

Major changes to public health bodies south of the border were announced this week, including the abolition of Public Health England and the creation of a new body combining its work with the Test and Trace programme.

“It is worth pointing out that Test and Trace [in England] also differentiates between complex and non-complex cases,” said Professor Bauld.

“Complex cases are dealt with by local public health teams, in the main, and not the private company call centres that deal with the less complex cases.

“For the complex cases in England, 98% of contacts are being reached by local public health teams, compared with just 57% for the less complex cases dealt with by the private sector call centres.

“This is part of the reason why the system in England has been criticised and part of the rationale for setting up the new National Institute of Public Health and devolving more contact tracing to local public health.

“In both England and Scotland it looks like testing and tracing works well and at a comparable level when primarily conducted and managed by local public health teams, feeding into national reporting.”

However, Professor Bauld said it was concerning that follow-ups of international arrivals who are returning from at-risk countries were still “fairly minimal”.

Fewer than 7% of people arriving in Scotland from countries on the quarantine list are being contacted by the NHS, according to yesterday's statistics.

“As with other colleagues, I think we should be introducing routine testing on arrival at airports and ports and ideally following up that initial test with a second test a few days later,” Professor Bauld said.

“People who test negative for both tests would then be free to return to work or school and leave quarantine – shortening the time period considerably and probably improving compliance.”

Aberdeen remains in a local lockdown after a surge in cases linked to a city centre bar, action could be taken over a local outbreak at a food factory in Coupar and there are further clusters in North Lanarkshire and Glasgow.

Professor Bauld added: “If cases significantly increase in Scotland then contact tracing becomes even more complex, as other countries are finding out right now across Europe.

“Also, if we test more – keeping in mind that our testing capacity is going to increase to up to 65,000 per day in the coming months – then we may find more cases.

“So, it is essential that Test and Protect is adequately resourced going forward – particularly through the winter months when we all anticipate challenges.”

 

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