Tim Lush, Environmental Health Officer at Glasgow City Council, has been working on the Contact Tracing team for NHS Test and Protect. His contribution gives an insight into the role of contact tracing which is becoming more difficult with rise in cases but also increasingly important in combating the pandemic.

1.         Describe your work before the pandemic? 

Before the pandemic is a difficult time to pinpoint, given how the transition was rapid, but gradual.  Before the lockdown I was primarily focusing on food hygiene inspections in the Govanhill area of Glasgow, as well as becoming more involved in the inspection of approved premises.

I recall my last inspection before lockdown was a revisit on 19th March 2020, so four days before lockdown officially commenced.  I remember the date so well because it was Gold Cup Day, and the premises I inspected was described as a ‘sports bar’.  At 11am, this bar could have been any other pub in town at 11pm on a Friday evening.  Even before I entered, I noticed from the outside the condensation forming on the windows.  Inside, there wasn’t even any standing room left, and people pressed up against each other at the bar, waiting for their pint.  I recall holding my breath as I hurried past everyone and straight into the kitchen, and after the inspection asked to exit from the back door to avoid passing the crowd. 

2.         What have you been doing since the pandemic started? 

The first few months post-lockdown were all a blur.  Apart from listening to the radio for news of a potential vaccine, therapeutics, testing capacity, antibody test developments or latest in job retention efforts, work was limited due to the mass lockdown of pubs and restaurants.  There were service requests to be resolved with phone calls, or intelligence being received which I was able to feed into our database.  

Work on a PPE prioritisation programme started once the dust had settled. The idea was to allocate council PPE to different services, based on their risk.  This was at a time where face masks and hand sanitiser were at a premium, with shops limiting how much you could buy, so such a programme was essential.  We managed to achieve this through an excel algorithm, which ensured that those in highest risk jobs were prioritised. 

The call then came for contact tracers, and myself and five others were asked to join the NHS until an initial period ending in September.  

Like any new programme of work there has been a steep learning curve and as the NHS Public Health teams have become more familiar with the work of EHO’s this work has developed.  

Initially, we were contacted by contact tracers, given a case reference number and asked to review a case, with little other information.  Over time, the information shared has developed and this has allowed for more efficient working.  I would find myself on the phone for an hour with a business, verifying what control measures were in place to prevent spread.  During the time I was on the phone, another two cases ‘for review’ would then be sent to me.  For a number of weeks, I was barely finishing before 9pm.  

As cases exponentially rose, more effective means of recording and monitoring relevant data have been implemented.  Most recently, we have been working with the NHS to establish a standard operating procedure, or list of questions, for when a hospitality setting is mentioned and ensuring all those involved in contact tracing receive the appropriate training on the questions to ask.

3.         What are/were the challenges? 

There are inherent challenges with training new staff but this would commonly involve fully trained people training new people.  In this case, the contact tracing system for Covid was new and everyone is learning on the job, while setting up new systems.

The nature of viral infection adds its own challenges, for example, if a person goes for a meal on a Saturday, then develops symptoms on Monday, has a test on Tuesday which returns on Wednesday, then we are already five days down the road by the time a call to that person has been made.

The biggest challenge in Glasgow has been how to handle a mass surge in cases, and this is best done through data analytics, which can then focus our attention.  

While it has been a challenging time, it is interesting to see, and be a part of a new, evolving system.

4.         Do you think any of these changes will last beyond the pandemic period? 

As all involved become more experienced with the systems and more efficient in responses to those receiving a positive result, the process, in relation to establishing and contacting contacts, will be streamlined.

Currently there does not seem an end to the pandemic and I feel, for now, it is just about improving, and everyone becoming efficient with, our procedures in order to limit the spread of the virus.