Local public health director warns of ‘data gaps’ in test-and-trace

The director of public health for City & Hackney has warned of “gaps in the data” in the government’s test-and-trace programme.

The message was delivered at a meeting scrutinising health in the borough by Dr Sandra Husbands, who revealed a month ago that the quality of data being provided to local authorities by the programme was “not particularly useful information”.

Husbands did reassure councillors that London’s local authorities have always received testing data from Pillar 1 (tests in NHS labs) and Pillar 2 (commercial tests), and that she expected to start receiving more detailed information from next week.

But she went on to let attendees know that the Department of Health-commissioned tracing programme continues to have problems.

Husbands said: “We know there are gaps in the data. Test-and-trace is supposed to collect information like where people work, their ethnicity, and things that would help build up a local picture, and would help Public Health England be able to tell us that we’ve had, for instance, 20 people and they’re all of Turkish origin.

“But if they’re not collecting information effectively about ethnicity or their places of work, they can’t associate them with those things – that is a problem, and that is an issue at the moment with test-and-trace. They are not collecting that data as well as they should.

“Public Health England is on top of that and they are feeding back about the difficulty that not having that information puts us in, at regional and local level. But they are not in control of that system, it is commissioned by the Department of Health.

“It just goes down to the inexperience of the call handlers. These are sensitive conversations, and it takes a while to learn how to do those.”

Husbands receives performance reports on the test-and-trace system, which keep local public health professionals informed of how many cases there are in their area, how many cases have been contacted by tracers, and how many of their contacts have been identified and contacted.

The reports currently show a 50-75 per cent performance rate from week to week, with 75 per cent of cases contacted within 48 hours, and between 50-75 per cent of their contacts followed up.

This rate was attributed by Husbands either to contact tracers running out of time, “as if it goes beyond 48 hours they don’t bother contacting them”, or to those contacted not giving correct or real information on their contacts due to a potential lack of trust in the system.

The public health director receives no detail on who those contacted by the programme are, though Public Health England do notify local professionals if an issue relates to a complex case or setting, such as a school or care home.

Postcodes are also provided, leaving local public health officials able to deduce where a cluster may be, as for instance if four or five cases appeared relating to the same postcode, it would be likely that those cases were in the same household.

Names and addresses are not provided to Husbands’ team, and according to the public health director are unlikely to be.

Two weeks ago, there were three cases in seven days in City & Hackney from both Pillar 1 and 2 tests.

Husbands told councillors that her team had seen a “slight uptick”, with seven cases in the last week, and that public health is “closely scrutinising” this to see whether there is a more general issue, or simply the fact that the increase appears significant due to the fact it is starting from a low base.

According to Husbands, the rise in cases relates to a cluster in a particular setting, and does not necessarily represent “wider community spread”.

The public health director said that City & Hackney is “bumping along the bottom” with the numbers of cases faced locally, with the publicity associated with the local lockdown in Leicester resulting in a wider examination of whether councils are getting the data they need.

Moving to reassure those listening, Husbands said that the current low numbers in the area are “not any cause for concern”, with City & Hackney’s local outbreak plan to be updated and amended as new information comes to light, with Husbands yesterday taking part in a London-wide exercise simulating what a local lockdown could look like in the capital.

An early version of a data dashboard presenting information for the public and policymakers is understood to be being tested over the next couple of weeks.

In a round of questions for Dr Husbands, Cllr Peter Snell said: “The one issue, and you’ve not said that it’s sorted, is that we get figures for people testing positive but we were not getting full address and contact details.

“If we’re going to do anything, that has to be the starting point. Why aren’t we enabling and empowering our existing frontline physicians, the GPs, to actively be able to refer cases and even take tests themselves?”

Husbands replied that “the short answer is no, and I can’t answer the why of that”, before going on to say that, with the army currently being stood down, she had asked government representatives why, instead of handing the testing work to private contractors, they could not look at “something completely different”, but received no response.