COVID-19 support study: index and contact case research findings from April 2021

The findings included here are interim findings only and based on online survey fieldwork for waves 1 and 2 which were carried out between:

• wave 1: Friday 19th March 2021 and Wednesday 31st March 2021
• wave 2: Monday 12th April and Wednesday 5th May 2021 

Data for the majority of measures has been presented for both waves combined. To note, between waves 1 and 2 some additional quality assurance and clarification of the compliance measures was carried out to ensure getting or returning a Covid-19 test during isolation was considered compliant across all relevant measures.  This means some of the findings from wave 1 have been updated in this most recent report. In the final report, wave 1 compliance figures will be updated and provided separately.

Initial observations from the qualitative interviews have been included in this summary, where appropriate. These 30 follow-up qualitative interviews were completed in April and May. These were broken down by case type as follows: 10 index cases, 13 contacts and 7 international travellers.

When interpreting the survey findings included in this report it should be borne in mind that:

• this is an opt-in survey. Therefore findings are representative of survey participants and not all those asked to self-isolate by Test and Protect
• the results are based on two waves of data collection only and tests of statistical significance will only be carried out after data collection has been completed

Sample

To date, 34,105 eligible adults within the Test & Protect system have been invited to take part in the survey (wave 1 = 12,751 and wave 2=21,354).

• a total of 2646 adults have participated in the survey to date (wave 1=908, wave 2=1738).
• response rates vary by case type with international travellers most likely to take part (wave 1=14%, wave 2=12%) and contact cases least likely to participate (waves 1 and 2=4%).
• response rates across waves 1 and 2 were similar for all case types.

Findings on index and contact case participants that took part in waves 1 and 2 of the survey are presented together in this section. International traveller findings are presented separately.

Overall compliance

Please see the study overview section for more information on how compliance was measured.

Across waves 1 and 2: when asked directly how well they thought they managed to comply with self-isolation, the vast majority (95%) of index and contact cases that participated thought they complied ‘all of the time’. Just 5% of index and contact case participants reported managing to comply ‘some of the time’ and no-one reported being unable to comply with the requirement at all.

This very high level of self-assessed compliance is in line with findings from elsewhere in the UK. Recent data from ONS indicated that 84% of index cases (April 2021 fieldwork) and 93% of contact cases (May 2021 fieldwork) stated that they fully adhered to the requirement to self-isolate.

However, when explored by behaviours, full compliance was 76%. Similarly, while 5% reported following the guidelines ‘most of the time’, partial compliance according to the behavioural measure stood at 23%. Non-compliance was low on both the self-assessed and behavioural measures. The low levels of non-compliance on both measures may partially reflect the sample i.e. opt in and social desirability among those who did respond.

The behavioural measure is based on responses to (i) how soon began self-isolation, (ii) whether they left self-isolation and (iii) how many days, in total they isolated for.

Note that a person who didn’t start self-isolation straight away, but who only reported COVID-19 test related activities before starting, was treated as compliant on the ‘when started isolation’ measure. Similarly someone who reported leaving during isolation only for a COVID-19 test related reason was handled as compliant on this measure. This was a change between waves 1 and 2 to ensure Covid-19 tests were appropriately handled across all relevant measures. 

Summary of compliance behaviours

Across waves 1 and 2:

• around nine in ten (92%) index and contact case participants reported complying with the requirement to begin self-isolation immediately.
• eighty-eight percent of index and contact case participants complied with the requirement to not leave their home/accommodation during the self-isolation period (this includes those who did report leaving home but only for a permitted reason i.e. get/return a Covid-19 test).
• around one in ten (10%) reported being in close contact with someone from outside their household during their period of self-isolation.
• just 5% of index and contact case participants failed to comply with the requirement to self-isolate for 10 days.

Activities undertaken before beginning to self-isolate

In addition to asking participants when they started self-isolation, everyone was also asked whether they carried out any of the listed activities before they began their self-isolation. The only permitted activity, ‘get/return’ COVID-19 test’, was also included on this list.

The most common activity index and contact case participants reported carrying out before beginning self-isolation was the permitted activity of getting or returning a COVID-19 test kit (26%).

Other activities mentioned included: going to the shops for groceries or medicine (7%) and outdoor recreation or exercise (7%) both of which are not permitted before self-isolating. Most index and contact case participants did not carry out any of the listed activities before self-isolating.

Activities undertaken during self-isolate

Among those index and contact case participants that reported leaving home during self-isolation, the most common activity cited was for the permitted reason of leaving to get or return a COVID-19 test kit.  Two-thirds (67%) reporting having done this during their isolation period.

Other common activities cited by those that left home during self-isolation were: outdoor recreation/exercise (21%) and going to the shops for groceries/medicine (10%) both of which are not permitted during the isolation period. One in ten (11%) also cited a reason ‘other’ than any of those listed.

In the qualitative follow-up interviews participants reported leaving home during self-isolation for the following reasons:

• get/return COVID-19 test
• medical reason
• to walk dog (though participants tended to report doing this early in the morning / late at night to avoid meeting others)
• drive child to school or work (where public transport was not available and travel was at time of day deemed to be unsafe for the child to walk)
• to deliver shopping to someone outside their household who was also self-isolating (but in their bubble)
• to meet people outside their household in their garden (socially-distanced)
• to go out for a drive

Those index and contact case participants that reported leaving home/accommodation during their self-isolation were asked to indicate which days of self-isolation they went out on, irrespective of whether it was for a permitted activity or not. Around a quarter (28%) of those that left home/accommodation at least once during self-isolation, did so on day 1. Twenty-three percent of those that left home during the isolation period did so on day 2, with a similar percentage reporting doing so on day 3 (22%) and day 4 (22%).

Knowledge of rules and guidance

When asked how many days someone should self-isolate for if they tested positive for COVID-19, around nine in ten (89%) index and contact case participants reported 10 days. A further 8% reported that self-isolation should be for 11 days or more, with 14 days being the most common answer given among this group. On the whole, knowledge of the required length of time to self-isolate was high among index and contact case participants, with just 3% reporting that the official guidance was to isolate for fewer days than is actually the case.

Participants were presented with a list of activities and asked whether they thought each of them was “allowed” or “not allowed” during the period of self-isolation. “Not sure” was also available as a valid response option. Across waves 1 and 2 the activities that index and contact cases were most likely to report as being allowed while self-isolating were:

• getting or returning a COVID-19 test (78% allowed)
• going out for another medical reason (18% allowed)

Sixteen percent of index and contact cases weren’t sure if going out for a medical reason was allowed or not during self-isolation. While one in ten did not know if getting or returning a COVID-19 test was permissible or not and a similar proportion (8%) were unsure whether going out to care for a  vulnerable person was acceptable or not. Knowledge of whether the remaining activities were allowed or not was high with between 90-97% correctly identifying that these activities were not allowed during self-isolation.

Ninety-one percent of index and contact case participants reported that it was ‘correct’ that a person should self-isolate for 10 days if they’ve been informed they have been in close contact with a person who tested positive for COVID-19, even if they later tested negative themselves. Five percent were of the view that the statement was ‘incorrect,’ while 4% were unsure either way.

Support for index and contact cases

All index and contact cases should be offered the opportunity for their details to be passed on to their Local Authority, solely for the purpose of identifying and providing support during self-isolation. Those who agree, should receive:

• an initial call to identify support needs
• appropriate support with those needs – a core offer of support will be available across all local authorities, though additional supports may vary by local area
• the offer of up to 2 follow-up calls later on in the self-isolation period to check on support needs, general wellbeing, and so on

When asked if they had been offered support in any of the ways listed, just over half of index and contact cases said they were offered the option of having their contact details passed on to their Local Authority (55%). Around 3 in 10 indicated that they were not offered support in any of the ways listed when they were advised to self-isolate (29%).

When analysed by whether participants had been advised to shield or not, those who had been advised to shield (n=90) were more likely to say that they had been offered the option of their details being passed on to their Local Authority than those who had not been advised to shield (67% and 56% respectively).

Of the index and contact cases that reported being offered the option of having their contact details passed on to their Local Authority, 14% indicated that they had accepted this offer.

Around one in ten index and contact case participants across both waves reported that they contacted their Local Authority directly themselves (11%).

People were frequently looking for support that is provided as part of the local authority core offer.  Across waves 1 and 2 (n= 99 participants):

• 3 in 10 interested in help to apply for a self-isolation support grant (30%)
• a similar proportion looking for financial help with bills/access to a crisis grant and/or benefit support (27%)
• around a quarter wanted help with food deliveries (25%) and/or help with money to buy food (24%)
• just under a fifth were interested in support with pharmacy deliveries (16%)

Participants that took part in the follow-up qualitative interviews reported the following requirements from local authority support:

• food parcel delivery
• advice on financial support
• referral for grant to cover utilities
• delivery of prescription medication

Those who did not accept the offer of local authority support were asked to choose from a list of reasons as to why they declined the offer. The vast majority (88%) indicated that they declined because they didn’t need any additional support. A sizeable proportion (14%) declined because they felt the information they needed was accessible online. 7% did not accept the offer because they weren’t sure what kind of support was on offer and whether they needed it. Reasons given, during qualitative follow-up interviews, for not accepting LA support included:

• not needing additional support (already had sufficient help from family, friends, employer or neighbours)
• not being sure what kind of support was available and whether they needed it (they were asked if they needed support but not given any examples of what this support could be)
• the support required was not available from the LA
• not being eligible for the financial support on offer
• not wanting to accept support in case it was taking it away from others that needed it more

Around a quarter of index and contact case participants indicated that they had been offered the National Assistance Helpline number (21%). A small proportion (5%) of participants across both waves indicated that they had contacted the National Assistance Helpline themselves.

85% of those who took up the offer of their Local Authority contacting them, who contacted their Local Authority directly and/or who contacted the National Assistance Helpline indicated that their support needs were met. 15% indicated that this was not the case.

Self-isolation support grant

Qualification for a Self-Isolation Support Grant: if someone asked to self-isolate by NHS Test and Protect is on a low income, can't work from home and will lose income as a result, they may be entitled to a payment of £500 from their local authority.

The proportion of index and contact cases who applied for a self-isolation support grant remained consistent between waves at 8%. Around half of respondents did not think that they were eligible to apply (50% across both waves). Just over a fifth of index and contact cases (across both waves) indicated that they did not know about the grant (21% across both waves).

In both waves, respondents who were index or contact cases living in the two most deprived SIMD quintiles were more than twice as likely to have applied for a self-isolation support grant compared with those living in the other three quintiles (13% and 5% respectively across both waves). In both waves, those with household incomes of less than or equal to £16,900 (16% across both waves) and £16,901 to £30,700 (12% across both waves) were more likely than those with higher household incomes to have applied for a self-isolation support grant.

Testing

Across both waves 1 and 2, just under half of index and contact case respondents who had been tested reported a negative result for their last test (48%), with this proportion highest among contact cases (92%).

Just over two-thirds of index and contact case respondents who reported having been tested for COVID-19 said that their most recent test took place at a local drive through or walk-in site (69%). The next largest grouping, at just over a fifth, had most recently used an NHS testing kit at home (18%). 

Participants that reported having had a COVID-19 test were asked how long they waited for their most recent test result. Across both waves 1 and 2 combined, just over two-thirds of index and contact case respondents received their result within 24 hours (69%). This was higher among users of a local drive through/ walk in site (75%). Just over half of NHS home testing kit users reported waiting 24 hours or more for their result (56%) – home testing kits may have to be sent away for results.

Similar levels of full compliance with self-isolation were recorded among index and contact case participants whose last COVID-19 test was positive and those whose last result was negative (80%, compared with 77%). Around a fifth of both groups were partially compliant (19% among those whose last result was positive compared with 22% among those who last result was negative). Non-compliance was 1% for both groups.

However, those who tested positive for COVID-19 were more likely than those whose last result was negative to report non-compliant activities before isolating (18%, compared with 10%). While those who tested negative most recently were more likely than those testing positive to leave home during isolation or to end their self-isolation period early.

Vaccination

Among index & contact case respondents across waves 1 and 2 combined, 37% reported having received their first vaccination dose, while a further 9% had received both doses and 53% had not been vaccinated at the time of survey fieldwork.

Full compliance levels were high irrespective of vaccination status but were slightly lower among those who had received both doses (73% compared with 77% each for those who had received one dose and those not vaccinated at all at the time of interview).

Just over a quarter of those fully vaccinated were partially compliant with the requirement to self-isolate based on their responses to the questions assessing behaviour (26%).

Those index and contact case participants who had already received both doses of the vaccine were less likely than those who had received one or those who were not vaccinated at all to indicate a likelihood to come into close contact with others (53% compared with 73% and 71% respectively) and/or to visit vulnerable friends or family (32% compared with 57% and 58% respectively).

Those who were not vaccinated at all at the time of the survey were least likely to indicate that they would self-isolate again once (or if) they are fully vaccinated (77%).

Attitudes and Experiences

Mental Health

Index and contact case respondents across both wave 1 and 2 were asked whether they thought self-isolation had a positive or negative impact on their own mental health (or neither a positive nor negative impact). Just under half (46%) said it impacted negatively on their mental health. ONS data (from 12th to 16th of April 2021) indicated that 37% of those self-isolating reported a negative impact on their wellbeing and mental health.

Participants were also asked what impact, if any, their own requirement to self-isolate had on the mental health of others in their household/accommodation. 44% reported that their own requirement to self-isolate had negatively impacted on the mental health of others in the home.

Finances

Around half of respondents indicated that they had/were managing comfortably on their household income during self-isolation (52%), while a third indicated that they had/were struggling (14%).

When analysed by levels of area deprivation across both waves, those living in the two most deprived SIMD quintiles were more likely to indicate that they had/were struggling (21%) compared with those living in the other three deprivation quintiles (9%).

Self-isolation as a strategy

To assess the level of acceptance of self-isolation as a strategy, participants were asked how much they agreed or disagreed with the statement that ‘self-isolation is an effective way to help prevent the spread of COVID-19’. Across both waves 1 and 2 support was very high with around nine in ten index and contact cases agreeing that self-isolation is an effective way of stopping the spread of the virus (91%).

Government or individual decision-making on self-isolation

Participants were asked the extent to which they agreed or disagreed with the statement ‘It should be up to the individual, not the government, to decide whether they need to self-isolate or not’.

The majority of index & contact case respondents (across both waves) disagreed that it should be up to individuals to decide whether to self-isolate or not (83%), while around one in ten (9%) agreed with the statement.

Research findings from April 2021

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