Coronavirus: 0300 phone number test, trace and curse

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The system for tracing people likely to be infected with the coronavirus has changed this week in England, with a central pool of contact tracers, which rely on phone calls and texts, making way for local teams with knowledge of the district.

Contact tracing systems across the UK work something like this: People with symptoms self-isolate and get tested. People who test positive are called by someone from a research team who is trying to establish their recent contacts. And those contacts, assuming they can be reached, will have to self-isolate for 14 days – whether they show symptoms or not.

In England, the call comes from a national team centralized on a ‘0300’ phone number, which councils say many people don’t want to take. It can also be an email or text.

But from this week, local authorities will step in if people cannot be reached by national service.

This role of council teams was announced on Monday. It comes as the national team struggle to reach a third of the people on their roster. And the change has been interpreted by some as a quiet admission that the system has not been as “global” as Prime Minister Boris Johnson has claimed.

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So far, most local authorities have faced “complex” outbreaks – in places like nursing homes, factories and schools. Ironically, these so-called complex cases were much easier to trace and contain, as national figures show. While they may require more immediate and dramatic action, they occur in controlled environments where people can easily be traced.

Not complex is complex

The problems relate to finding infected individuals in the wider community – the so-called “non-complex” cases. These cases occur when a single person – who could have eaten out, gone to work, used transportation, or mingled with a number of other households – tests positive.

So far, it has proved more difficult to get these infected people to remember who they have been in contact with or to persuade them to pass their contact details to a centralized team.

And potential contacts, who could spread coronavirus, are escaping the system at every step. Figures for England show that 80% of people who test positive are reached by testing and tracing teams. Of that number, about 80% provide contacts. And of those contacts, about two-thirds will be reached.

But before that even starts, you lose most of the potential contact in people who never get tested. Only about 30% of infections are detected through a test, according to estimates by the Bureau of National Statistics.

In Wales, which has taken a different approach, contact tracing teams have been formed by redeploying staff from local councils on leave. They live and work in the area and therefore know the nightlife hot spots, transport routes and major local employers, says Dr Giri Shankar, who led the contact tracing program for Public Health Wales.

This “wealth of local knowledge” can help identify where clusters come from, he says. For example, local tracers were able to establish a cluster of cases in a factory that came from the community, not the factory – that’s just where they were spotted. Local plotters knew that the workers at this particular factory mostly lived in one area, in buildings containing many different households and many shared cars to get to work.

The problem in England is that a test and trace caller who rings from their room in Portsmouth to find out the contacts of someone in Oldham will not be able to grasp those finer details, these patterns of transmission and step in to address them. Stop.

Calderdale in West Yorkshire – currently subject to additional restrictions due to the increase in cases – has set up its own local testing and tracing system over concerns that the national system will succeed in detecting enough cases. Council chief Cllr Tim Swift said the national system works for people who “answer their phones, are pretty clear who their contacts are and don’t have a problem with self-isolation.”

But that excluded many young people who were less likely to answer a call, people working in public jobs – like in shops or as taxi drivers – and those who were not entitled to paid sick days. People were more likely to engage with someone with a local accent, he said, by calling from a local number, rather than taking an 0300 number they didn’t recognize that might be ” a hoax ”or“ someone trying to sell them something ”.

So if someone does not answer a call from the national team, a local team will try to call first and then follow them up in other ways, including knocking on their door or using community contacts. local.

Being based in the affected area means that local teams can spot more “diffuse” connections, like clusters around a particular takeout where people hang out – and they can physically go and talk to people. Most importantly, his teams also connect people with local services to help them get food or other support while they are in self-isolation.

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Legend

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In Blackburn, which has also set up a local search system, the council says it is “already seeing its benefits” as a local team manages to reach people “that the national system could not”.

But a contact tracing system will never reach 100% of people, especially when, in many cases, those infected do not have symptoms. Only countries that conduct mass population testing, such as South Korea, have been able to trace and isolate asymptomatic people and their contacts.

The question is whether it is possible to reach enough people and break enough chains of transmission to prevent the virus from spiraling out of control again.

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