Working Paper Series

Latest publications

Abstract:

This report focuses on the development and implementation of test, trace and isolate strategies (TTIS) in England during the COVID-19 pandemic. The research comprised interviews with key stakeholders at central and local government levels. The interviews focused on the evolution of test, trace and isolate strategies and associated challenges, aspects that worked well and less well, measures to prepare for future pandemics and what was learned for public health.

As regards the development of testing strategies issues concerned the testing infrastructure, the development of testing technologies, the purpose of testing over time, and the testing process and research. Successes included the mass roll out of testing, and novel innovation regarding the use of testing for different purposes. Issues identified regarding the implementation of testing strategies concerned access to data; asymptomatic testing; test to release; digital exclusion and hard to reach groups; testing and care homes; LFTs and schools; and logistical and funding issues. Key challenges at the outset included setting up a national testing infrastructure, access to data and access to testing for those from low income and certain minority ethnic groups. Successes included the introduction of local testing sites, lateral flow tests and the introduction of daily contact testing.

Turning to contact tracing, issues raised concerned the role played by NHS Test and Trace (NHST&T); NHST&T and local contact tracing; the decentralisation of contact tracing; data and data sharing; outbreaks and contact tracing; contact tracing and vulnerable communities; schools and businesses and contact tracing; and the NHS COVID-19 App. Problems associated with national contact tracing were highlighted by interviewees at the local level including lack of local knowledge and understanding, and limited capacity during surges, with local contact tracing enabling contacts to be identified and reached more effectively.

The research revealed a number of issues regarding isolation strategies including data and information, financial support and accommodation. Initially there was no financial support for those in isolation who were unable to work from home; once central government support was provided the amount was not necessarily sufficient for many households, with some local councils providing additional financial support for self-isolation for particular groups of people. A further issue identified in the interviews which cross-cut test, trace and isolate strategies was that of communication from central government, and communication at a local level particularly in the context of diverse communities.

A range of measures to prepare for future pandemics were proposed including planning (for different levels of government), business continuity and dedicated funding for local authorities. Key themes to emerge regarding learning for public health concerned the importance of national and regional partnership, leadership and partnership at a local level (including with community groups), and the relationship between central and local government.

Keywords: COVID-19, TTI, testing, contact tracing, isolation strategies

Latest publications

Working Paper Series submission guidelines

Publications Read the latest

CASE Publications Papers, briefs and reports

III Working papers and reports