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There is evidence from other countries and previous epidemics that testing and tracing are key interventions early in an epidemic and even more as we start to get control in local areas. 1/9
Tracing contacts can be done using apps/big data, and by local contact tracing teams. We need both. The automatic approach can speed and extend to otherwise unknown contacts 2/9 https://science.sciencemag.org/content/early/2020/03/30/science.abb6936.full
Once traced, contacts need to know what to do, how to isolate & get practical & social support.
The contact tracing teams can follow-up, & speak to those who have suspected or confirmed Infection, make sure all their contacts have been told and are in quarantine. 3/9
The contact tracing teams can follow-up, & speak to those who have suspected or confirmed Infection, make sure all their contacts have been told and are in quarantine. 3/9
This combination approach - using an army of thousands of skilled local public health advisers, community health workers, environmental health and volunteers - will create more community engagement and solidarity 4/9
And it will provide much needed knowledge about local pockets of infection which is exactly what we need to know as we move out of complete lockdown. Then local response becomes key to ongoing control. 5/9
Once testing is more widely available this same army of community health workers can help support both access to diagnostic testing, and monitoring of immunity in sectors of the local population. 6/9 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30735-2/fulltext
They can also help support people suffering the negative effects of isolating including mental and physical health problems, financial problems, domestic abuse etc. 7/9
This approach is based on public health epidemic science. It fits slightly outside the remit of SPI-M and SPI-B (the modelling and behaviour groups advising government t). It needs to be refined, worked up and led by the ADOH, PHE and local authorities. 8/9
There is no mathematical model that proves this will work. It is a complex intervention which is difficult to fit into a model, & would include multiple inputs and outcomes. I hope that the government will consider this urgently, and start empirical local trials. ENDS
