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Covid-19: Local public health teams being denied access to data that could help them trace cases

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2883 (Published 17 July 2020) Cite this as: BMJ 2020;370:m2883

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  1. Ingrid Torjesen
  1. London

Local public health teams are not being provided with the patient identifiable information on covid-19 cases that they need to manage and prevent local outbreaks effectively, directors of public health have said.

Data they are receiving from community drive-through testing centres and home testing kits (from “pillar 2” of the government’s testing scheme) are anonymised, and postcode and occupational data are often missing or of low quality. As a result, local teams say they cannot use the data to examine possible connections between cases, such as a common workplace, or whether one of the cases could be a “super-spreader.” They are also being denied access to identifiable information held by the national NHS Test and Trace programme, preventing them undertaking contact tracing themselves.

Public health directors said the set up was hampering their ability to detect the virus, to understand how it is transmitting through the community, and to intervene to stop outbreaks.

Kate Ardern, director of public health for Wigan council and lead for protection and emergency planning at the Greater Manchester Combined Authority, said, “I am going to have to go and knock up at least 200 households [to track down an individual case], which is a bit silly when someone has actually got the address and the contact details.”

Public health officials in Leicester, which had to go into local lockdown because of rising infections, repeatedly complained that they were denied access to detailed data they requested to look for early signs of outbreaks.12

And Lisa McNally, director of public health for Sandwell, said her request to have access to the contact details of positive cases in her area so that her team could take on the contact tracing themselves to try to improve rates was rejected. “40% of new positive cases in my area aren’t being reached by Test and Trace,” she tweeted on Wednesday 15 July.3

Contracts for pillar 2 testing, data processing, and contact tracing have been given to private companies such as Serco,4 and thousands of contact tracer call handlers have been recruited.

Ardern said that contact tracing doesn’t stop with advising people to self-isolate, highlighting that local public health teams can provide advice to people such as informal carers or self-employed people ewho may be concerned about being asked to self-isolate.

“You can’t do that as a call handler reading a script,” she said. “We have people who are very skilled in having difficult and sensitive conversations, and we need to do that because if contact tracing is going to be successful the public has to have faith in it.

The Department for Health and Social Care agreed that it was vital that directors of public health had access to local health data for their area during an outbreak, and it said that Public Health England would be introducing a new platform on Monday 20 July to give directors of public health easier access to positive test results and case data.

The department added that it had also called in the management consultancy firm McKinsey to advise on potential reconfiguration of data and analytics in testing. The project focuses on scaling and adapting for the next phase of the pandemic.

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