Taken from Big Issue North magazine 13-19 July 2020
Sheffield group set up for track and trace
Frustration with the government’s inaction
Medical professionals and health campaigners in Sheffield have set up a coronavirus track and trace scheme because of their frustration at government inaction.
Paul Redgrave, a former South Yorkshire director of public health, and Andrew Jackson, who runs regeneration charity the Heeley Development Trust, have established Sheffield Community Contact Tracers (SCCT), which has trained six volunteers to speak to people who have tested positive for Covid-19 and find out who else they may have been in contact with.
In its pilot scheme, SCCT has taken referrals from local GPs, although attempts to persuade people have met with mixed results. However, the founders believe community-led track and trace can be effective, and have urged the establishment of similar groups across the country.
Redgrave became concerned when the government abandoned proposals for contact tracing in March, even though the World Health Organisation had said testing, isolation and tracing new Covid-19 cases should be the “backbone of the response in every country”.
According to UK testing chief Professor John Newton, fears that over a million cases would be uncovered, overwhelming any capacity for track and trace, led to the proposals being ditched. Britain’s attempt to create a track and trace app has also met with little success.
At the same time, a friend of Redgrave’s, whose partner was a GP, contracted Covid-19 and was frustrated in her attempts to get healthcare, despite her knowledge of the medical system. Redgrave, who had worked on tracking meningitis outbreaks in his career, decided to act.
“The press were reporting how many people were dying within 24 hours of entering hospital,” he said. “People were waiting too long to ask for help.”
He sought support from former colleagues and SCCT was the result. Heeley Development Trust’s Andrew Jackson calls its role “structural back-up”. HDT, which was already supporting people by delivering medicines and food supplies to coronavirus patients, has been particularly helpful in helping SCCT make contact with hard-to-reach Yemeni and Kashmiri communities.
“The national system does not appear to be functioning well,” said Jackson. “I already knew the people who approached me from the good works they had done to improve public health.
“SCCT is educating people to alter their behaviours. This will help reduce the spread of the virus.
“The group is also making contact with people who have the virus and actively looking to find and advise and help those they have been in contact with.
“Crucially, they are sharing their expertise and learning from doing.”
Redgrave admits SCCT’s initial 13 cases are a “tiny number” and that it does not have the statutory powers environmental health officers had when he was investigating meningitis cases.
“Ten were happy to work with us but three refused to engage after becoming unhappy at being asked to isolate,” he said.
Those 10 passed on details of 58 people they had contact with. Of those, only 19 were prepared to engage.
Redgrave said: “Not good, but amongst those we discovered one new case and we supported everyone, including the original 10 people, for the two weeks – or longer if they remained unwell – with a daily call. We also offered specific needs like collecting medicines or food supplies or dog walking. People really appreciated our help.”
Of the remaining 38 people, Redgrave said: “An 88-year- old women broke her hip and was in hospital. When she got home she came down with the virus. She identified 10 carers who she had been in close contact with. She only knew them via the supplying care agency, who told us they could not afford to lose so many staff. There was not anything we could do.”
He also referred to a staff nurse with the virus who had passed on details of five work colleagues. SCCT’s initial call was welcomed by all five but their attitudes later hardened after they had been told by senior management not to respond to the organisation.
Redgrave said: “The assessment shows contact tracing is complex, a local angle can strengthen neighbourhoods to become self supporting, that we need official and potentially legal back-up from environmental health officers, and that local volunteers can be trained and can support people to make the system work, as has been the case in other countries.”
SCCT has written to the government calling for more support for community- led Covid-19 responses. Its research and details of how to establish similar groups is online. This has encouraged the establishment in the Upper Calder Valley of a Covid-19 contact tracing and support association, whose members are Covid-19 Mutual Aid volunteers and others with clinical or public health experience.
“We have got support from many different local groups,” said the association’s Jenny Shepherd, who is worried that those fearing they have contracted coronavirus have been directed towards contacting 111 rather than their local GP.
“Covid-19 is a notifiable disease and the process for notifying such diseases is through GPs who have been cut out of the process. It is crazy. GPs have people’s trust and should have been central to tackling Covid-19.”
Shepherd praised SCCT. “New groups can be set up much more easily and on our own new website we have also added our experiences to the already accumulated information,” she said.
Big Issue North asked the Department for Health and Social Care why it had chosen not to immediately follow WHO’s advice to test, trace and isolate new Covid-19 cases, had marginalised GPs and given itself little time to develop an effective app when it is known that large software projects with tight deadlines have historically had a high failure rate.
In response, a department spokesperson said: “This is an unprecedented global pandemic and we have been guided by the best scientific advice at all times.
“NHS Test and Trace has already helped to stop more than 100,000 people from unknowingly spreading the virus and we have been working closely with our local partners to provide them with the resources and tools they need to take swift action to deal with any new local spikes in infections.”
The spokesperson said an improved version of the app was being worked on with Google, Apple and others. Public Health England did not respond to questions about whether it would be contacting groups such as SCCT to share experiences and about why the government has been unwilling to use environmental health officers during the pandemic.
13 - 19 JULY BIG ISSUE NORTH