The successful use of volunteers to enhance NHS Test and Trace contact tracing of in-patients with Covid-19: a Pilot Study

  1. Rachel Foster
  2. Bing Jones
  3. Ian Carey
  4. Andzelika Duda
  5. Abigail Reynolds
  6. Jack Czauderna
  7. Alex Westran
  8. Consultant in Infectious Diseases Sheffield Teaching Hospital Foundation Trust

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Abstract

Contact tracing in the UK for Covid-19 is performed by NHS Test and Trace (NHSTT) via telephone or email. This study estimates how many patients who have been admitted to hospital are not reached by NHSTT and the number of their contacts who were not advised to self-isolate.

Medical Student volunteers conducted face to face interviews with patients diagnosed with Covid-19 on an infectious diseases ward. Data on their close contacts were sent to NHSTT.

20 cases were enrolled. 13(65%) did not engage with NHSTT, 4(20%) because they had no positive PCR, 9(45%) because of severity of illness, language or intellectual difficulties. 49 close contacts were identified of whom 33(67%) were from cases who had not engaged with NHSTT. “Backwards” contacts tracing information was collected from 11(55%) cases and 8(40%) gave detailed information.

These data suggest that NHSTT fails to engage nearly two thirds of Covid-19 in-patients and fails to advise two thirds of their close contacts to self isolate.Volunteers used face to face interviews to overcome false negative tests, illness and communication problems to identify both close contacts and data on sources of infection.

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  1. ScreenIT

    SciScore for 10.1101/2021.01.28.21250096: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Failure to detect untested and false negative community cases are also limitations of NHSTT, but are more difficult to resolve. 33 close contacts were identified from the 13 (65%) of cases that NHSTT had failed to engage. This suggests that 67% of all the contacts identified were not traced by NHSTT. If extrapolated, this suggests a major omission nationally. The Contacts of patients ill enough to be admitted may be more likely to effectively self-isolate than the disappointing current estimate of 2 0%9. This study found 20% of cases with a clear clinical diagnosis were awaiting results or had tested PCR negative. Currently, these cannot be detected by NHSTT or entered onto the national computerised (CTAS)10 system. This is despite a current legal requirement for suspected cases to be notified11 to the Proper Officer. Solutions need to be explored to enable clinically diagnosed and false negative patients to be registered to enable the tracing of their contacts. Data on contacts were transferred to the City Council Contact Tracing service who had difficulties using information because they can only add data if patients already have an NHSTT computerised record. This means that inpatients and their contacts that have been missed by NHSTT cannot be registered by NHSTT. Local authority staff have repeatedly complained about this feature of CTAS, the national IT system. Financial and other support, normally available, cannot be offered to these index cases or their contacts. This...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.01.28.21250096 on medRxiv