UK contact tracing system is 'full of weak links', warns leader of volunteer pilot scheme

A retired GP in Sheffield who set up the UK's first volunteer-led contact tracing trial has warned that the national system is "shaky" and full of "weak links".

The comments from Dr Bing Jones come as the government faces a storm of criticism over the low numbers being reached by its system - and even questions of whether it is aware of the total numbers being tracked.

"Contact tracing is a chain and it is only as strong as the weakest link. And this chain is laden with weak links, so there is lots to be done," Dr Jones told the Telegraph.

NHS Test and Trace, launched last week with a team of 25,000 contact tracers, is part of a solution that has been branded as "world-beating" by the government, but Dr Jones said it was full of flaws and this was just "government by soundbite".

"Some of our group have seen the scripts [for the contact tracers] - and the support and training looks really shaky. There are lots of problems, so to make it work looks very difficult. The government needs to be challenged and encouraged on this because there are lives at risk," he said.

He said there were also issues around the speed of the system, considering that test results can take up to 48 hours to come back.

"Testing is really key. Patients are often infectious for two days before they have symptoms, then if it is another two days for the test, they have probably done all their infecting before we have done anything. It has to be nifty," he said.

The Department for Health and Social Care told The Telegraph it was aiming to get all test results back within 24 hours by the end of June.

In the trial run by Dr Jones, Sheffield Community Contact Tracers, community volunteers worked with retired GPs and public health officials to find 13 coronavirus cases. They managed to persuade one-third of their contacts to go into quarantine for 14 days. One of the contacts became ill. However, the remaining two-thirds did not self-isolate, either because they were not reached or because their employers did not co-operate. 

Dr Jones said the proof-of-concept trial - after separate, national efforts for coronavirus were started, then dropped in March - showed the contact tracing was "very doable" even with non-medical teams, the same model as the national system launched last week. He pointed to the one extra case that was uncovered. However, he added: "Our little trial here was in a way ineffective, because ideally you want to be finding 80 per cent of contacts then stopping them from passing it on. We were nowhere near that."

In Sheffield, just under three-quarters of the identified contacts worked in the NHS or social care sector, which Dr Jones said also showed two things - one, that people working in these sectors were clearly among the biggest spreaders of the disease, and two, that the national system needed to provide some kind of back-up plan for institutions - particularly care homes - if large numbers of their staff had to self-isolate.

"The only way to manage this is to have national resources with very local supervision and support," he said.

"There's no robust system for encouraging people to self-isolate. For care homes - it must be gruesome, you have just enough staff to get by, then there's an outbreak, and they've all been in contact with each other. What do you do? Shut the care home? The problems are massive."

The government has said it had a robust package of measures to support employers, including claiming back statutory sick pay for isolating employees.

Dr Jones said that the Sheffield scheme also benefited from being run locally, which helped with the administration. When NHS Test and Trace was launched, regional public health directors said they would be unable to provide proper support for at least a month.

He said the local element also helped with gaining public trust -something which had become "much more difficult" for the national government after the Dominic Cummings affair. 

"The key to the whole thing is getting that index case to give you the names of their contacts, and if they only have 50 per cent confidence, they'll only give you say 50 per cent of their names, and you've probably lost it already," he said.

A Department of Health and Social Care spokesperson said: "The new NHS Test and Trace service is up and running and will help save lives. These claims do not reflect the huge amount of work already under way.

“Anyone in this country can now book a test and we aim to get all results back within 24 hours by the end of June. We have over 25,000 contact tracers in place, who have all been trained and are fully supported in their work by public health experts.

“We are also working closely with local government, and providing support to businesses that are struggling as a result of the pandemic.”

It has also made £300m available for local authorities to work with Public Health England to develop local outbreak plans.

Dr Jones said his team of tracers were talking to the local health authorities about how to use their experience to help. But he was not confident.

"I would not be surprised if we have this same conversation with the same feelings in a month's time," he said.

"They've told us: 'We have a world-beating contact tracing system!' I'm sorry, but I don't think that's true," he said, adding that the lack of auditing within the system meant this would probably continue to be the case.

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