Intended for healthcare professionals

Letters Controlling the spread of covid-19

Train and deploy a community level public health workforce to combat covid-19

BMJ 2020; 369 doi: (Published 05 May 2020) Cite this as: BMJ 2020;369:m1821
  1. Paul Redgrave, retired director of public health1,
  2. Joan Miller, former consultant in public health2,
  3. Jack Czauderna, former GP2,
  4. Tom Heller, former GP2,
  5. Mike Tomson, former GP and Médecins sans Frontières volunteer2,
  6. Bing Jones, artist and former haematology specialist2,
  7. Jeremy Wight, former director of public health
  1. 1Todmorden OL14 6JQ, UK
  2. 2Sheffield, UK
  1. paulredgrave68{at}

We strongly support Pollock and colleagues’ views.1 We do not understand why the government did not follow World Health Organization guidelines regarding basic infection control practice2 on contact tracing in the early days of the pandemic. We welcome the plan to train 18 000 contact tracers but, in the government’s current proposal, the public are in danger of being seen as passive disaster victims; a network of community based responders could become a significant resource to find, isolate, and test each index case and trace contacts to break the chain of covid-19 transmission.

It is a shame that the numbers of public health staff have been reduced so much over the past decade, but it is possible to quickly upskill lay volunteers to perform some essential public health duties. Within a short period, the new workforce could be trained to identify cases of covid-19, trace close contacts, give simple instructions regarding management, and advise on isolation and quarantine. The basics of where, how, and when to seek help from 111 or primary care can also be taught. Currently these ideas are being piloted in a district of Sheffield and will be reported on soon (see website

In communities throughout the UK there is enormous goodwill. Thousands of volunteers are being recruited to ensure that vulnerable people have food and social contact. Clearly these activities are important, alongside the highest priority which is reducing the number of cases. All of this helps build resilience in communities.

We supported the lockdown strategy which looks as if it has been effective. As we come out of lockdown a mass programme to identify cases, contact trace, and quarantine will be essential to stop further flare ups in the coming months. It will also be needed in the event of a second wave of infections.