Local authority sets up test-and-trace system to plug gaps in English scheme

The local authority with the highest infection rate in England has launched its own contact-tracing system to plug holes in the £10bn national scheme described by Boris Johnson as “world-beating”.

Blackburn with Darwen council, in Lancashire, set up its own virus-hunting team after the national system failed to reach hundreds of its most vulnerable residents.

Contact tracing is one of the most basic planks of public health responses to a pandemic like the coronavirus. It means literally tracking down anyone that somebody with an infection may have had contact with in the days before they became ill. It was – and always will be – central to the fight against Ebola, for instance. In west Africa in 2014-15, there were large teams of people who would trace relatives and knock on the doors of neighbours and friends to find anyone who might have become infected by touching the sick person.

Most people who get Covid-19 will be infected by their friends, neighbours, family or work colleagues, so they will be first on the list. It is not likely anyone will get infected by someone they do not know, passing on the street.

It is still assumed there has to be reasonable exposure – originally experts said people would need to be together for 15 minutes, less than 2 metres apart. So a contact tracer will want to know who the person testing positive met and talked to over the two or three days before they developed symptoms and went into isolation.

South Korea has large teams of contact tracers and notably chased down all the contacts of a religious group, many of whose members fell ill. That outbreak was efficiently stamped out by contact tracing and quarantine.

Singapore and Hong Kong have also espoused testing and contact tracing and so has Germany. All those countries have had relatively low death rates so far. The World Health Organization says it should be the “backbone of the response” in every country.

Sarah Boseley Health editor

Dominic Harrison, the council’s director of public health, said the government programme was “simply not tracing enough cases and contacts fast enough”.

The move reflects growing frustration among local health officials with the national test-and-trace system, which was launched in May as a central plank of the strategy to ease England out of lockdown. The NHS system, which is run by the former TalkTalk executive Dido Harding, involves more than 20,000 contact tracers employed by private firms such as Serco and Sitel.

Labour said the response by local authorities showed the top-down approach had failed and resources should be given to local authorities nationwide to develop their own systems.

In Blackburn with Darwen, where the infection rate is more than 10 times England’s average, dozens of staff have been seconded from other departments to contact residents who could not be reached by the national system.

The council said under its new model, which was supported by Public Health England, local teams would track down people who could not be reached by the national system after 48 hours. If local officials still did not make contact after two days, council workers would visit their address to pass on advice and offer support.

Crucially, the Blackburn model will factor in potential language issues and any other vulnerabilities using the knowledge of community-based teams.

It is understood that health officials in Greater Manchester are working on a similar locally run system. Sandwell council in the West Midlands became the first local authority to set up its own system last week after its public health director, Lisa McNally, said the national system was failing.

In other areas, including Leicester and Liverpool, council workers have also been carrying out door-to-door tracing – but local health officials say their work has been frustrated by incomplete data coming from the national system.

Mohammed Khan, the leader of Blackburn with Darwen council, said: “Once again we see how local government, with its knowledge and connection to the local area, can rise to the challenge and deliver for our residents.

“I am proud that we have designed and delivered an effective and efficient local system to complement the national programme very quickly. Once again the council has shown local leadership in our battle against this terrible virus.”

The shadow health secretary, Jon Ashworth, told the Guardian: “For months we have warned ministers that without a vaccine, an effective, locally delivered test, trace and isolate regime would be critical to safe easing from lockdown.

“Instead, Boris Johnson handed multimillion pound contacts to firms like Serco and the claimed his approach was ‘world beating’. Given infection rates are now rising and local areas are in lockdown it’s no wonder local authorities are now abandoning Johnson’s failed approach and setting up their own systems.

“Local directors of public health, primary care and NHS labs were always better placed to do this vital work effectively and should be given resources and data to get on with it.”

Under the NHS test-and-trace programme, call handlers aim to make contact with all infected people and their contacts to advise them to self-isolate. But if they cannot make contact after 10 calls, they are advised to move on to the next case.

The government’s Scientific Advisory Group for Emergencies has said it needs to reach at least 80% of people within 48 hours to be effective. The government says it is contacting 81% of Covid-positive people each week and reaching 75% of their contacts.

However, researchers said on Monday only 50% of contacts were being traced, according to an analysis of government figures. The researchers, from University College London and the London School of Hygiene and Tropical Medicine, said the national system must improve significantly if schools were to safely reopen next month.

Simon Clarke, the local government minister, said the national system had contacted 184,000 people so far and told them to self-isolate. He added: “It’s obviously vital that we always continue to keep up the progress that we are making with test and trace, which is a massive national undertaking and it is working.

“This is a programme which is delivering and which is helping to keep us all safer. There’s always more to do. We continue to work very hard to boost our testing capacity, and we heard from Joe about the fact we are on track to deliver half a million by the end of October.”