The Scottish Government has published a paper outlining their “test, trace, isolate, support” strategy for COVID-19, within which the Environmental Health profession plays a key role. It is expected to be in place end of May.
The strategy is part of a range public health measures to be deployed to ensure low levels of community transmission of the disease while easing lockdown. The strategy follows the Scottish Government’s COVID-19: A Framework for Decision-Making which sets out the steps required for a managed transition out of lockdown.
The “test, trace, isolate, support” approach is a well-established public health intervention, designed to help us interrupt chains of community transmission by identifying cases of COVID-19, tracing the people who may have become infected by being in close contact with them, and then supporting those close contacts to self-isolate, so that if they have the disease, they are less likely transmit to it to others.
In order for this approach to work, the levels of disease need to be sufficiently low and stay low.
Work is continuing to increase the capacity for coronavirus testing, with the paper estimating the need to provide sufficient tests for around 2% of the population and will therefore need to be able to deliver up to 15,500 tests per day when ‘test, trace, isolate, support’ is fully rolled out.
For contract tracing services, NHS boards are leading collaborative work with environmental health included to put in place local teams, that will be supported nationally for COVID-19 contact tracing. The local teams will require around 2,000 additional staff to increase capacity to respond. This is a skilled job and through their discussions with cases and contacts they must conduct careful risk assessment and provide active support. Environmental Health Officers (EHO) already have wide experience in contact tracing and the paper states EHO’s as already been drafted in for this work.
Digital infrastructure that already exists for this type of work for other infections with Public Health Scotland is also being improved so that is can be delivered as efficiently as possible.
In addition to the digital platform being developed, the UK government is also leading the development of a proximity-tracing app which people could download to their smartphones, which is being trialled on the Isle of Wight. This app uses Bluetooth technology to identify close contacts among other app users, and may be particularly useful for identifying people who have been in close physical proximity but who are unknown, such as a stranger on public transport. This app however will not replace the need for the contact tracing detailed above but will be used as an important enhancement.
It will be important that everyone living in Scotland understands the symptoms to look out for in themselves and their household, and what to do if they do get those symptoms. It will also require us all to be ready to self-isolate on each occasion someone we have been in close contact with is diagnosed, in order to protect the people, we would otherwise have come into contact with.
The strategy will not be effective on its own and it must be used alongside other public health measures to reduce transmission, such as physical distancing, good hand and respiratory hygiene, including appropriate use of face coverings, and disease surveillance.