Questions remain over success of contact tracing
Does Test, Trace, Protect actually work in Wales and is it value for money? Welsh affairs editor Will Hayward reports
IT APPEARS people in Wales will be asked to self-isolate as close contacts until at least March 2022.
Under current plans, the Welsh Government will invest a further £32m to extend contact tracing to next March.
On receiving a positive Covid result in Wales, people are supposed to be contacted by the NHS Wales Test, Trace, Protect (TTP) service to report recent contacts to the local contact tracer so they can be contacted and notified to self-isolate (and take a test if they too are displaying symptoms) to help stop the virus’ spread.
Given that Test, Trace, Protect has been in place for more than a year, it is worth working out if it has been a success.
Last month, Health and Social Services Minister Eluned Morgan said: “Test, Trace, Protect has been extremely effective at supporting people who have tested positive and their contacts to isolate and providing advice, guidance and support. It is critical to stopping the virus spreading in our communities.
“It’s a year since we set up Test, Trace, Protect from scratch – at what the Auditor General for Wales described as an extraordinary scale and at pace. A great deal of hard work across NHS Wales, local authorities, the voluntary sector and partner organisations has created a highlyeffective programme to help us keep Wales safe. Everyone involved can be extremely proud of their efforts.”
But is it really a success? We have taken a look at the latest data to see how TTP has worked for Wales.
■ How much has been spent on TTP?
Just over £40m was spent on contact tracing in the financial year 202021. The Welsh Government has invested an additional £92m in contact tracing in 2021-22, of which £81m has been allocated to health boards and local authorities to support their contact tracing teams.
They say this is sufficient to maintain the current total contact tracing workforce of around 2,000 (including some 1,600 contact tracers and advisers) until the end of March 2022.
■ How many people do contact tracing?
During the spring when case numbers were low, contact tracers were able to support the wider Covid response including vaccination bookings, supporting local business to reopen, managing arriving travellers and delivering the Welsh Vaccination Certification Service.
As cases have increased in the third wave, the majority of tracers and advisers are now returning to regular contact tracing. The Welsh Government has also said it is in the process of doubling the National Team, which provides surge support to the regions, from 100 to 200 staff. ■ Has TTP been good value for money?
This is a hard question to answer. If you measure a contract tracing system on whether it prevents the virus growing out of control, it has totally and utterly failed.
TTP was well-established when the second wave took off and was completely overwhelmed.
It is also in place again now as the Delta-variant-driven third wave gets going with no signs of stopping.
So in terms of preventing fresh Covid waves, it simply hasn’t worked. The reason for this is complex. The first could be down to definitions of a “close contact”.
Taiwan has an average of 17 per case, whereas the UK average is two.
This broader definition means they are more likely to get people with the virus to self-isolate – although this is at great inconvenience to more individuals and short-term cost to the economy.
The other reason it hasn’t worked is that it is simply taking too long to reach people.
The World Health Organisation defines a successful contact-tracing system as one where a country can trace and quarantine 80% of close contacts within three days.
Given it is not uncommon for it to be over a week since a meeting for a close contact to be contacted, it is no surprise TTP is not able to get on top of the virus unless cases are very, very low. The tracers are also battling against a lockdown-fatigued population who are not always keen to follow their instructions.
When you look at the Welsh Government data, latest figures show that almost a year after TTP was launched in Wales, contact tracers have reached 99.7% of the positive cases that were eligible for followup.
They also successfully contacted almost 95% of the close contacts that were eligible for follow-up, and provided them with advice or helped to resolve their cases.
But this doesn’t address the issue that it is taking too long to do it.
This is not a criticism of the workers within the TTP system.
Nor is it to say there haven’t been successes for the TTP system.
Last summer it was very effective at containing outbreaks at meatprocessing factories, for example.
We also don’t know how many cases have been prevented by their attempts to get people to isolate – these efforts have likely saved lives.
In addition, they have also provided intelligence on how the virus spreads and what activities are higher-risk.