Doctors flag logistical hurdles to mass testing and tracing in UK

LONDON — Doctors and public health experts warn the U.K. faces significant logistical hurdles if it plans to use mass coronavirus testing and contact tracing to help ease its lockdown.

This comes as Health Secretary Matt Hancock set out the governments plans to roll out an army of 18,000 contact tracers in a matter of weeks. “This test, tract and trace will be vital to stop a second peak of the virus,” he said, during the daily press conference on Thursday.

Britain initially attempted to test those suspected of having the virus and trace their contacts early in the epidemic but then abandoned the approach, with health experts saying mass testing was “not appropriate” for the U.K.

Hancock has since pushed to rapidly increase the U.K.s testing capacity, which currently stands at just under half of the target of 100,000 tests a day by the end of the month.

However, while welcoming the shift in strategy experts warned that the U.K. is starting from a low baseline to deliver on the plan, following a period in which public health budgets have been cut by over £700 million in real terms between 2015-17 and 2019-20.

U.K. Health Secretary Matt Hancock | Peter Summers/Getty Images

Those drafted in will also, experts said, have to have full criminal records checks in place and require at least some training to effectively conduct the necessary telephone conversations required of a contact tracer.

“The challenge of all of this is that weve had a decade of cuts to public health,” said Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine. “And the question is whether we can deliver this and I suspect that has been a consideration of the very beginning.”

“We shouldnt underestimate how complicated it is,” he added. “We need to be quite careful about getting this right.”

Importance of safeguarding

Of the initial 18,000 people drafted in to help, over 3,000 will be clinicians and public health specialists. Civil servants and local government officials are also set to be called on to help,, according to the Times. The newspaper reported the government hopes to have the scheme up and running by May 7, with Hancock saying that the contact tracers would be trained “over the coming weeks.”

While much emphasis has been placed by government on the development of a new contact-tracing app by the “NHSX” tech innovation unit, experts say that simple manpower is also key to the strategy.

However, one retired public health doctor, who worked in health protection but asked not to be named, warned that the skilled environmental health officers trained to carry out such work were in short supply. “They have absolutely decimated public health in local authorities,” said the doctor.

If new recruits from the ranks of national and local government officials, or even volunteers, are to be used, they will also require training for the task of contact tracing, said Gary McFarlane, the Chartered Institute of Environmental Healths Northern Ireland director.

“You can make this sound very simplistic, but in reality, its actually quite complex, he said. “The critical thing here is the answers that are actually given, because the answers need to inform where the questioning needs to go. Its about following an investigative path.”

However, the public health doctor disagreed. “Its not rocket science,” the doctor said, explaining that a contact tracer simply needs to take a contact through their average day, finding out who they have seen and where they went.

But that doesnt mean the process will be straightforward, with both McKee and the public health doctor raising issues around safeguarding. This could require all contact tracers to have Disclosure and Barring Service (DBS) checks, which highlights if someone has a criminal record and usually take four weeks or more. A similar requirement is already in place for volunteers working with the most vulnerable within the NHSs new volunteer service.

“You must not let people loose on contact tracing who have not been appropriately vetted,” the public health doctor said. “It will just open the floodgates for potential abusers to volunteer and find their way into kids networks and vulnerable peoples networks.”

Government officials have been contacted for comment.

Alternative to full lockdown

According to public health experts, community testing, contact tracing and isolating is one of, if not the most, effective strategy governments could deploy to control the coronavirus epidemic; a “community shield” that could avert the need for repeat lockRead More – Source

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