By Emily O’Hare (Phase 2b Medical Student)

Sheffield Community Contact Tracers (SCCT) is a community-based group of volunteers who work with local health and support groups. Back in March, a group of Sheffield doctors including retired Public Health Specialists, Directors of Public Health and GPs set up this initiative. They noticed that there was no contact tracing available and strongly felt that contact tracing as early as possible, and therefore early isolation, was essential to limiting the spread of COVID-19. They formed a pilot study to demonstrate how a community-based test and trace service could work, more on this later.

SCCT has also delivered “Covid Confidence” sessions to communities that would previously have been labelled “hard to reach.” The aim of these sessions was to enable reliable and trusted members of the community to be equipped with knowledge about COVID-19, so that they could confidently spread important messages within the community. SCCT are also involved with local community groups such as Darnall Wellbeing and Burngreave Fir Vale, where they are in constant contact with members of the community to help in any way possible. New ideas are always being brought up in their weekly meetings to try and spread the message of SCCT: early contact tracing and isolation.

In November a group of medical students joined Sheffield Community Contact Tracers. Our aim was to try and promote the work SCCT were doing. Specifically, we wanted to spread awareness through social media and the student population, so we created new posters, Facebook posts and redesigned the website. We used our contacts at the University and Medical School to try and get them involved in promotion of the SCCT message.

We also contacted local GPs to see if they could spread the word to their patients to encourage early isolation. Another way we wanted to engage the public was through door knocking. We developed a leaflet which could be given to members of the public to explain what SCCT were doing and the importance of contact tracing and early isolation in order to stop the spread of COVID-19. Some students also worked on a conference which allowed listeners to learn about the science behind the virus and how to control transmission.

 A PILOT STUDY

By Emily O’Hare (Phase 2b Medical Student)

A pilot study, a trial run of the same day contact tracing initiative, was carried out in Heeley. It had two main aims: to isolate contacts early and offer support. SCCT recognised how difficult this period of time can be with regards to both the illness and the required isolation. The study involved trained volunteers phoning the index cases (the people with coronavirus) to get the details of their recent close contacts. The volunteers would then contact trace for the index case. With their permission, index cases and contacts were phoned every day to offer support.

SCCT found that they were able to train and support volunteers to effectively contact trace. 13 cases were found and joined the study, and 58 contacts were identified. As expected, not all contacts were able to be successfully followed up due to not having contact details, or they were unwilling to participate. However, 19 of the contacts were followed up and isolated for 14 days and one fell ill and became an index case.

One key finding was the importance of local support. The more local and national support there is with contact tracing, the more people are encouraged to get involved and isolate fully. The success with the pilot study has led to the start of the full Same Day Contact Tracing study.

 SAME DAY CONTACT TRACING

By Thivakar Srikandakumar (Phase 2b Medical Student)

What is the Same Day Contact Tracing Study?

The study aims to see if Sheffield Community Contact Tracers can contact trace earlier than the current NHS Test and Trace programme. What is the need for another contact trace? We believe that the current NHS Test and Trace is not as efficient at contact tracing as it could be. Therefore, this study will be an additional step on top of the Government’s national tracing programme to prevent the spread of the virus.

What are the current problems with the NHS Test and Trace programme?

The NHS only begins contact tracing once a positive test has been confirmed. This means that recent contacts of the infected individual may not realise that they have been infected and it is a possibility that they could pass it on to others at work or at home. If an individual gets COVID-19 symptoms, it can take them a day to get tested and another 2 days before results come back. While the individual in question is isolating during this period, their close contacts may not be told of the possible risk until the NHS test result comes back positive, meaning they are not isolating during this time. The period from when a person gets infected to when they find out about the positive test result is approximately 3-7 days. This key period could stop the spread of the virus if individuals started contact tracing from the moment they have the symptoms, rather than waiting until a positive test has been confirmed. In addition, some people have complained that the NHS has not contacted all of their contacts which means that some people who could have been exposed or possibly infected by the virus were not informed to isolate or get tested.

What do participants get out of the study?

Your information will be processed carefully and once we have received the details for your recent contacts, we will contact them within 24 hours to inform them that they may be at risk and advise them accordingly. We also offer daily phone calls, which are optional, to check on you and give you the support and information you need. The people on the other end of the call are volunteers who have been trained and can support you throughout the difficult period.

Who can take part in the study?

Anyone with COVID-19 symptoms can be contact traced by us. Let us know if you have any of the following:

• Fever

• New continuous cough

• Loss or change to smell or taste

• New severe fatigue

• New breathlessness

• Any recent exposure to an increased risk (contact with someone who has been tested positive)

Go to: https://www.communitycontacttracers.com/referral/ and click on ‘start same day contact tracing’, which will take you to the referral form. Complete the short form and you will receive a call within 24 hours guiding you through the next steps.

Do you still need to contact NHS Test and Trace if you have taken part in our contact tracing?

Yes. Sheffield Community Contact Tracers are not replacing the NHS Test and Trace programme, but adding another step that will help isolate individuals early on, whilst you wait for your swab results.

What should you do if you think you have COVID symptoms?

1. Book a test on https://www.gov.uk/get-coronavirus-test or contact 119 for additional information and self-isolate.

2. Whilst waiting on the results to come back, go to: https://www.communitycontacttracers.com/referral/

3. If you do not wish to take part in the study, DIY! Please inform your close contacts that you may have COVID and that they should isolate until your results come back.

Where can you get reliable information from?

https://www.nhs.uk/conditions/coronavirus-covid-19/ https://www.sheffield.gov.uk/home/your-city-council/coronavirus-hub https://www.communitycontacttracers.com/

 HOSPITAL INPATIENTS

By Abigail Reynolds (Phase 2b Medical Student)

Contact tracing patients in hospital can be challenging for numerous reasons. Language barriers and the inability to answer the phone due to illness or connectivity makes contact tracing remotely very difficult. This leads to contacts of people who are COVID-19 positive in hospital not being informed and therefore not isolating, further increasing the spread of coronavirus.

In a pilot study, we are aiming to find whether in-person contact tracing could add to (or compliment) NHS Test and Trace. This involves finding patients with COVID-19 on the wards and speaking to them to discover whether they have been contacted by NHS Test and Trace and whether they have managed to tell them all the relevant information. If they haven’t been contacted or were unable to communicate with them for various reasons, we do the contact tracing ourselves which is then fed back to Sheffield City Council.

We do both backwards tracing (asking about where, when, what, and with whom the patient was spending time with, in the week prior to the onset of symptoms), and forwards tracing (asking where, when, what, and with whom the patient spent time, since the onset of symptoms).

We include patients who are highly suspected to have COVID-19 but have not yet tested positive, enabling us to contact trace them earlier. Currently the National Test and Trace process only works for those who have had a positive test result. It misses those who may not have access to a test, those who do not get a test as they are confident, they know the diagnosis, those who avoid a test for fear of loss of income, and those who have a false-negative result. This unfortunately limits attempts to prevent the spread of infection.

We hope our ongoing work could lead to reducing onward transmission, and identifying hot spots of acquisition, through a more comprehensive and timely method of face-to-face contact tracing, which is more suited to the needs of inpatients. Ultimately this will lead to reduced cases and therefore a reduction in mortality.

 WHY WE NEED STUDENTS

By Emily Greenaway (Phase 2b Medical Student)

Since September, students have been villainised for spreading COVID-19. The return of students to university cities did correspond to a sharp rise in cases in those areas… but should the blame be placed on students or the Government’s Eat Out to Help Out Scheme? Admittedly, simply the return of students to houses where they mix with others from around the country did cause some transmission of the virus. However, attributing all the new cases to students misbehaving is not the way forward.

It is therefore incredibly important that student coronavirus cases are low and stay low to avoid unnecessary scapegoating in the new year.

If students carry out contact tracing effectively, asymptomatic and contact cases can be isolated early. This will mean cases don’t rise in January and ensures students are not criticized for returning to university.

This is why we need the student population to go to https://www.communitycontacttracers.com/referral/ as soon as they have symptoms. We can contact trace for you, on the same day, or explain how you can do it yourself. If you and your contacts isolate early, we can stop the spread of the virus.