Minutes:
Gill Dicken and Louise Driscoll spoke to the members and answered their questions.
The team last updated the committee in July. In September, we started to pick up on cases. The environmental health team was doing the tracking and tracing in that period, and there was the advisors’ team under Richard Drinkwater. We started to pick up Track & Trace for Caerphilly and north Wales. In October, all of the Track & Trace team came under Public Health and Environmental Protection. We added structure to the advisors and developed the team. In November, the team was in a good place. The numbers were increasing. By December, we hit very high numbers but we were taking on people from around the council – redeployment, from MonLife, volunteers etc., – and we handpicked people with environmental health or medical backgrounds, giving us the ability to respond to cases and clusters very quickly. When the firebreak started, we were confident that we could keep the lid on clusters. By February, numbers were coming down, so we were able to begin scaling the team down. We now wait to see what happens in the next few weeks with schools due to go back, LFT testing going on, and lockdown measures gradually easing. We know now that we can flex the team up and down when needed.
We are now down to 15 tracers, working 8 til 8, 7 days a week. Numbers are declining, so lockdown has very much worked in Monmouthshire, alongside the vaccines. Since we started tracing in June, we have had 4,174 cases in Monmouthshire; out of those, we have responded to 99.7% within a 48-hour period across Gwent (with Monmouthshire stats at the top of the leaderboard). It is a success story in Wales. From those 4,174 cases, we generated over 6,000 contacts. We also work closely, and have daily meetings, with our other partners in Gwent. We have very good communication to enable us to react to any workplaces that might see a cluster of cases. We review that data daily, and report weekly to PHW and Welsh Government on our cases and any spikes. The team has a good link with workplaces, which was established prior to Covid.
Also, we have done a lot of work with schools, which are now rolling out the LFT testing, which gives a result in a few minutes. All staff have been issued with these kits. We have regular meetings with our headteachers, who have been superb in working with us. We have had low numbers, compared with the rest of Gwent, because headteachers have done a brilliant job in getting bubbles to isolate. Whereas, previously, we would isolate the whole year group, now we go back and track and trace to limit as much as possible the amount of staff and children affected. We work very closely with Will McLean and his team. Some of our tracers are ex-teachers, so they understand the culture of the schools. We have been working with care homes and the commissioning team as well.
We have done studies on those who are isolating, working with the Partnerships team, and supporting residents in isolation. Back tracing has been a new introduction. Monmouthshire is alone on this in Gwent. We have done it from the beginning, always going back further than 48 hours, encouraging premises and workplaces to have everyone who had visited contact us, and advise them to get tested. There has been good compliance. Now, all of Wales is doing 14-day backward tracing. They don’t have to isolate if they are out of the 48-hours infectious period but are all advised to get tested – so, hopefully, we can find those asymptomatic people out in the community. And, Welsh Government has now released guidance on anyone who has been a direct contact in their infectious period to be tested twice within the first 8 days. We had 200+ cases per week in January and now are down to 25 in the last 7 days. We expect some increase with restrictions being lifted but are being proactive in our approach with businesses, schools, etc.
Challenge:
When someone has to self-isolate, do we check that they are doing so?
For a positive case, the tracer call is backed up with a letter or SMS message. Then the people in that household are classed as a close contact, and contacted daily for 10 days. They can opt for SMS but we prefer to call and have an actual conversation. We track that they are isolating but also if they are well, and whether they should go for a test. This has changed in the last week: we now say to isolate and also get a test. It’s different in England as it is run by a private company; they don’t contact all of their positive cases, but send e-forms. We tried e-forms for a week at Christmas time and they didn’t work.
Although we are further ahead of the European countries with immunisations, what has been said about preparing for a third wave, and would the nature of it be different?
Welsh Government has said there will be funding for Track & Trace until September. We will therefore retain a core team of tracers. It has always been the environmental health officers that have started it. We are best placed to do it because we have the local connections, and understand the area. That’s why we feel it has worked very well. Welsh Government is predicting a third wave for around May, so the contracts and TTP will continue. Public Health Wales is predicting a third wave but not at the same scale as before. In Track & Trace, we are now monitoring the positive cases who have had the vaccine – this will probably be the basis of the next study. We have weekly updates from PHW and are involved in any decisions that occur.
How useful has the NHS app been?
The app isn’t linked to TTP. The app tells the user to isolate but it is a guide –someone officially only needs to isolate if they are contacted by TTP. We didn’t have any input to the app or its implementation. A tracing interview by phone can take up to two hours and is not related to the app at all.
How reliable are the kits – are they giving out slightly different results?
If someone receives a positive from the kit then they are advised to go and get an official test. We’ve been using the kits in our schools and early years, and have had only 1 case from the LFT tests. If someone has symptoms, we recommend that they don’t use the kit but go to a testing centre.
Chair’s Summary:
Many thanks from the committee to the team for their hard work. Councillor Groucott noted that Wales has dealt with T&T via local authorities, which has been much more successful than in England.