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

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

• wave 1: Friday 19 March 2021 and Wednesday 31 March 2021
• wave 2: Monday 12 April and Wednesday 5 May 2021
• wave 3: Monday 10 May and Wednesday 2 June 2021

Data for some measures has been presented for all three waves combined, while some are broken down by wave, where appropriate and where sample sizes allow. Analysis is ongoing and further breakdown by wave, where appropriate, will be made in the final report. This report builds on the previous interim reports.

Initial observations from the qualitative interviews have been included in the summary section of the slides, where appropriate.

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.

While the results are based on all three waves of data collection full tests of statistical significance will only be carried out at the final reporting stage. However, there are a few instances throughout this report where statistical significance is referenced.

Sample

To date, 53,527 eligible adults from Test & Protect have been invited to take part in the survey (wave 1 = 12, 751, wave 2=21,354, wave 3= 19,422).

• a total of 4,325 adults have participated in the survey to date (wave 1=917, wave 2=1748, wave 3=1660).
• response rates vary by case type, with international travellers most likely to take part (wave 1=14%, wave 2=12%, wave 3=12%) and contact cases least likely to participate (waves 1 and 2=4%, wave 3=5%).

Notes on response rate: additional interviews completed after the analysis cut off points for each wave (including by telephone) have been included, therefore, base numbers for waves 1 and 2 have been updated since previous publications.

Findings on index and contact case participants that took part in the survey are presented 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 all three waves: when asked directly how well they thought they managed to comply with self-isolation, the vast majority (94%) 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.

However, when explored by behaviours, full compliance was 74%. Similarly, while 5% reported following the guidelines ‘most of the time’, partial compliance according to the behavioural measure stood at 25%. 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 to 3:

• around nine in ten (93%) index and contact case participants reported complying with the requirement to begin self-isolation immediately
• eighty-seven 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)
• around one in ten (11%) reported being in close contact with someone from outside their household during their period of self-isolation
• seven percent 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

Across waves 1 to 3:

• the most common activity index and contact case participants reported carrying out before beginning self-isolation was getting or returning a COVID-19 test kit (27%), which is a permitted activity
• other non-permitted activities mentioned included: going to the shops for groceries or medicine (7%), outdoor recreation or exercise (6%) and/or to go to work, school or university (6%)
• over half (58%) reported that they did not do any of the activities listed, although it is possible that they carried out activities not listed before beginning to self-isolate

Activities undertaken during self-isolation

Across waves 1 to 3:

• the most common activity index and contact case participants reported carrying out during self-isolation was the permitted activity of getting or returning a COVID-19 test kit (68%)
• the next most common non-permitted activity mentioned was outdoor recreation or exercise (20%)
• one in ten (10%) reported that they did not do any of the activities listed, although it is possible that they carried out other activities not listed before beginning to self-isolate
• the biggest differences between case type in wave 3 were going out for another medical reason (14% index, 3% contact) and going for groceries/medicine (14% and 7% respectively), both of which were significant differences
• no noticeable differences were observed for individual activities across waves

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 (88%) index and contact case participants reported 10 days. A further 9% 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 that took part in qualitative follow-up interviews to date, were, on the whole, aware that they were required to self-isolate for 10 days. For qualitative participants who were asked to self-isolate because they lived with someone who had tested positive for COVID-19, but then latterly tested positive for COVID-19 themselves, there did appear to be confusion as to how long they themselves needed to self-isolate for. There were also qualitative interview participants who highlighted that they were initially unclear whether they needed to continue to self-isolate for the full ten days, if their COVID-19 test came back negative.

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 1-3 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 (80% 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. One in ten did not know if getting or returning a COVID-19 test was permissible or not (9%) and a similar proportion (9%) were unsure whether going out to care for a vulnerable person was okay or not.

Knowledge of whether the remaining activities were allowed or not was high with between 89-97% 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 three percent 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 (56%) of index and contact cases said they were offered the option of having their contact details passed on to their Local Authority. Around 3 in 10 (29%) indicated that they were not offered support in any of the ways listed when they were advised to self-isolate.

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%). As well as calling your Local Authority directly, people have the option of calling the National Assistance Helpline. Around a fifth of index and contact case participants indicated that they had been offered the National Assistance Helpline number (21%). A small proportion (5%) of participants indicated that they had contacted the National Assistance Helpline themselves.

Across waves 1-3 financial support and access to supplies were the types of support most often sought from Local Authorities with:

• around a third interested in help to apply for a self-isolation support grant (34%)
• a quarter looking for financial help (bills/access to a crisis grant and/or benefit support) and/or help with food deliveries (25% each)
• just over a fifth wanted help with money to buy food (22%)
• 15% were interested in support with pharmacy deliveries

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

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

Among those index and contact case participants who accepted the offer of their details being passed to their Local Authority for support, 72% agreed to a follow up call later in their self-isolation period.

Of those who accepted a follow up call, the most common reasons were:

• help with accessing food/essential supplies (33%)
• and/or paying for food/bills (26%)

Also, a fifth of those who accepted LA support contact and a follow up call thought they had to agree to a follow up call (20%), while a similar proportion agreed in case their needs changed during self-isolation (19%).

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. Across waves 1-3 the vast majority (87%) 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. 8% 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

84% of index & contact cases offered the support 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. 16% of these respondents 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.

Across waves 1-3, the proportion of index and contact cases who applied for a self-isolation support grant was 8%. Half (50%) of index and contact case respondents did not think that they were eligible to apply. Just over a fifth (21%) of index and contact cases indicated that they did not know about the grant.

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).

Those with household incomes of less than or equal to £16,900 (17% across all three waves) and £16,901 to £30,700 (13% across all waves) were more likely than those with higher household incomes to have applied for a self-isolation support grant.

Testing

Across waves 1-3, just over half of index and contact case respondents who had been tested reported a negative result for their last test (53%), with this proportion highest among contact cases (93%). The majority of index cases reported a positive result for their last COVID-19 test (95%).

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 (67%). A fifth had most recently used an NHS testing kit at home (19%).

The results are indicative of a decrease between waves 1 and 2 for use of a local drive through/walk in site and an increase over the same period in the use of NHS testing kits at home.

Participants that reported having had a COVID-19 test were asked how long they waited for their most recent test result. Just over two-thirds of index and contact case respondents received their result within 24 hours (70%). This was higher among users of a local drive through/ walk in site, with 76% waiting for less than 24 hours for a result. Half of NHS home testing kit users reported waiting less than 24 hours for their result (51%).

Results are indicative of an increase between waves 1 and 3 in the proportion waiting less than an hour for their test result, potentially as a result of greater availability of lateral flow tests.

Those index and contact case participants whose last COVID-19 test was positive were most likely to fully comply with self-isolation (80%, compared with 75% of those that last tested negative). Partial compliance was highest among those whose last test was negative (25% compared with 19%). Non-compliance was 0%-1% for both groups.

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 negatively 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 and contact case respondents, 15% reported having received both doses of vaccine, while a further 36% reported having received their first vaccination dose and 49% had not been vaccinated at the time of survey fieldwork.

No significant difference in compliance based on vaccination status was observed: 73% of those index and contact case participants fully vaccinated against COVID-19 were fully compliant, as were 75% of those who had received one dose and 76% who were not yet vaccinated.

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 (59% compared with 75% and 73% respectively) and/or to visit vulnerable friends or family (43% compared with 60% and 61% respectively).

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

Attitudes and experiences

Mental health

Just under half of index and contact cases (49%) said that self-isolation had impacted negatively on their mental health. ONS data (from 10th to 15th of May 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. 45% reported that their own requirement to self-isolate had negatively impacted on the mental health of others in the home.

Finances

Just over half of index and contact case respondents indicated that they had/were managing comfortably on their household income during self-isolation (54%), while 14% indicated that they had/were struggling.

When analysed by levels of area deprivation across all three 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 (8%).

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’. Support was very high with just over nine in ten agreeing that self-isolation is an effective way of stopping the spread of the virus (92%).

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 all three waves) disagreed that it should be up to individuals to decide whether to self-isolate or not (83%), while just under one in ten (8%) agreed with this statement.

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

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