Lack of positive Covid-19 cases has blocked Shetland’s contact tracing programme

Michael Dickson

Shetland’s health board is ready to begin contact tracing to tackle Covid-19 – but the lack of confirmed cases means it cannot begin.

NHS Shetland’s chief executive Michael Dickson said contact tracing was “the big focus” for the next stage of the fight against the virus.

However, with no new cases confirmed in Shetland since 20th April, Mr Dickson said the programme had been unable to get going.

While the lack of new cases is a positive indication of Shetland’s battle against Covid-19, it also means there are no patients available to trace the possible spread of infection.

“We are ready to go, the teams are in place, we’ve got everything we need to kick off, but we don’t have a positive case to start with,” Mr Dickson said.

Shetland has used contact tracing previously – in the very earliest days after the virus’s arrival.

It involves talking to people who have been infected to find out who they had been in contact with recently. Those people can then undergo further tests with the hope of slowing the spread of the disease.

Soon after the outbreak, however, the national response moved from the “contain” phase to “delay” and most contact tracing was halted.

This week has seen it return as a key part of the national strategy.

The government announced yesterday (Monday) that a new contact tracing app was going to be piloted in the Isle of Wight as part of the first phase of the “test, track and trace” programme.

When someone reports symptoms through the app, it will alert other users whom the person has been in recent contact with. Those users will then be sent advice, including how to get a test.

The app is hoped to ramp up contact tracing and reduce the spread of the virus.

Mr Dickson said it  was an important part of the strategy – and he felt the Isle of Wight pilot could have useful implications for Shetland, which shares some similarities, as an island community.

Although the Isle of Wight is closer to the mainland and has a larger population, it has a single health board and Mr Dickson said it faced many of the same challenges as Shetland.

In order to be effective, however, the app needs a significant proportion of the population to sign-up, which could pose difficulties in isolated communities such as Shetland, where connectivity is poor in some areas.

There have also been concerns raised about data privacy.

But Mr Dickson said he was optimistic that folk in Shetland would support the programme if and when it was rolled out locally.

“I’ve always found the people of Shetland to be hugely positive at responding to these sorts of challenges,” he said.

“I’ve got no doubt that they will do the same here.”

Until the app is rolled out more widely, however, Shetland’s contact tracing programme will be along the traditional  methodology.

“Right now the digital platform is not available for us,” said Mr Dickson. ” So it’s back to the grind stone and the hard work of checking where people have been.”

Nationally, 18,000 staff have been recruited to help with the manual checking of people’s movements, as an alternative tracing programme for those who do not have access to a smartphone or good connectivity.

Mr Dickson said that in Shetland, health workers who have been unable to perform their usual work, due to the Covid-19 crisis, such as dentists, would be ready to help with the programme.

But although Mr Dickson said it was possible to carry out this method of contact tracing effectively in Shetland, he said it would be a “Herculean” task to do it on a national level requiring an estimated 100,000 staff.

With the digital platform, he said much of that need for labour could be reduced.

But while the contact tracing is a useful step forward, Mr Dickson said it must be considered as part of a wider picture.

“I think it’s a really useful string to the bow of the wider orchestra that we need to overcome this,” he said.

He highlighted the NHS’s work helping care homes and delivering PPE as other ongoing parts of its work fighting the virus.