Coronavirus (COVID-19): test, trace, isolate, support strategy

Contact Tracing

18. Contact tracing is a well-established public health intervention, and our health protection teams have experience and expertise in delivering contact tracing for a range of infectious diseases. However, contract tracing is resource intensive, and we need to ensure that all areas of Scotland are able to enhance their contact tracing capacity to meet the demands of COVID-19.

19. We are enhancing the digital infrastructure that already exists and is used for this type of tracing work for other infections with Public Health Scotland and NHS Boards are leading collaborative work to put in place a locally delivered, but nationally supported, service for COVID-19 contact tracing. This involves both improving the digital infrastructure that supports contact tracing so that it can be delivered as efficiently as possible, but also supporting local teams to significantly increase their capacity to respond.

20. Digital tools will support our contact tracing work. The Digital Health and Care Institute are developing a secure web-based tool for the NHS in Scotland, accessible on smartphones or computers, which will allow those who are able to input details of people that they have been in close contact with, and for these to be sent directly and securely to contact tracing teams. A diagram setting out how this digital tool will support contact tracing is provided at Annex B. However, we also recognise that not everyone in Scotland will want, or be able, to use a web-based tool, and so we will ensure that telephone support will be available for everyone who needs it.

21. In addition to the digital platform being developed by DHI, NHSX is developing an app which intends to support contact tracing through proximity tracking. This app uses Bluetooth technology to identify close contacts among other app users, and may be particularly useful for identifying people who have been in close physical proximity but who are unknown, such as a stranger on public transport. This is a UK Government led project – which we understand will be trialled soon – and we are seeking to ensure greater involvement for the Scottish Government in its development. In particular, we need to understand how data from this app will interface with the Scottish approach to contact tracing. We do consider that an app of this type can be an important enhancement to contact tracing, but it is also important not to see it as a substitute for the approach to contact tracing we describe here. It is also important that the public have confidence in the use of such technology and in the use of data.

22. Contact tracers are more than simple data gatherers. Through their discussions with cases and contacts they must conduct careful risk assessment and provide active support. Local teams will provide this specialist support where it is required, and additional staff with relevant skills are already being brought into these teams, for example from other NHS services, and Local Authority environmental health teams. These local teams will be supported by a national contact tracing support service which will undertake the routine work. In total we anticipate that up to 2,000 additional contact tracing staff will be required to deliver a sustainable service across Scotland depending on factors such as the number of cases and the typical number of close contacts. Our COVID-19 contact tracing services will be in place for as long as is required.

23. Contact tracing will be scaled up and enhanced in a flexible and iterative way, which meets the needs of local areas. NHS Boards are already planning their COVID-19 contact tracing services, with some Boards already undertaking some contact tracing. This work is already underway and we intend for all Boards to have arrangements in place to deliver enhanced COVID-19 contact tracing by the end of May 2020.