Test, trace and protect webinar with Public Health Agency - recording

As we move back towards a less restrictive working and living environment, we must keep the virus under control. Failure to do that could set us back immeasurably. The World Health Organisation and every public health authority agrees that to protect our community requires sound testing, contact tracing and isolation of the virus to reduce transmission.

NICVA organised a briefing from Public Health Agency officials for voluntary and community organisations. We were delighted to have four speakers: Dr Philip Veal - Consultant Public Health Doctor; Dr Sarah Milligan - Public Health Doctor; Jennifer Lamont - Programme Lead Contact Tracing Service and Dr Edward O’Neill - Product Manager for the ‘StopCOVID NI’ proximity app.

NICVA Chief Executive Seamus McAleavey introduced the session and the importance of us all working together to minimise the spread of COVID-19 as well as helping people understand the vital role that testing and contract tracing plays. Firstly Philip and Sarah whose role is in the control of communicable infectious diseases, spoke on the medical science of testing and contact tracing. Jennifer gave an overview of the logistics of the operation including the manual tracing, scaling up of the contact tracing and the specific centre for COVID work. Then Edward spoke about the STOPCOVIDNI proximity app, privacy and how it works.

It is important for organisations to get a good understanding of the system, process and plan and help inform the wider public of the facts. Contact tracing is a tried and tested public health response used to fight other communicable diseases like Tuberculosis.  We have contact with many people in our local communities whom we can help to understand the importance of testing and tracing to prevent the spread of COVID 19.

More information about testing and contact tracing is available on the PHA website and information can also be found on the NI Direct website

After the presentations we asked the panel from PHA a series of questions and responses are below.

Watch the webinar here:

Staying out of Lockdown Track and Trace 07Jul20 from NICVA on Vimeo.

Question and Answer

Q. If I am a contact with a person with COVID 19 and I am traced and asked to isolate, do I get a Test and if the test is negative can I leave isolation?

• The Contact Tracing Centre doesn’t currently advise you to get a test if you’ve been in close contact with a person with CV19 unless you develop symptoms. We advise you to isolate for 14 days as this is the incubation period of the disease. 
• You should book a test if you develop any of the symptoms of Covid (new persistent cough, fever or new loss of taste and/or smell).

Q. If I have to isolate every time, I have been contact traced does this mean I could get repeatedly quarantined at home?

• If you are identified as a contact at high risk of COVID-19 infection, you will be asked to isolate for 14 days from last contact with a confirmed case.
• If symptoms present you will be signposted to testing
• If you do not have symptoms at the time of contact with the Contact Tracing Service, you will be advised of how to access testing if you develop symptoms.
• If tested and negative, you will still have to self-isolate as symptoms can still develop up to 14 days after close contact with a confirmed case.
• It is a necessary to repeat this process each time you are identified as a close contact at high risk of COVID 19 infection.

Q. The NHS in England was developing a phone App to trace people, but it’s been scrapped now.  Please tell us more about the Northern Ireland App, are there privacy issues?

• Learning from NHS experience in England.
• The app won’t collect any personal or identifiable information and by taking this approach have assured ICO no violation of privacy
• The app does not record location
• When registering the user receives an anonymised ID to link the phone with the backend, which changes every 24 hours (keeping your number private) and another anonymised ID which transmitted to other nearby devices and changes every 15 minutes.
• This means you can be notified if you have been in close contact with someone who has tested positive for CVOID-19 without ever knowing their identity, and without them knowing your identity

Q. What about manual contact tracing are there privacy issues with this and Who is the information shared with?

• Manual contact tracing is designed to support public health assessment and identify chains of infection and does identify individuals by necessity
• This information will be shared with colleagues across other jurisdictions if the individual travels
• There are however strict processes established to manage privacy and confidentiality and information viewed in the same category as medical records

Q. If people are being tested for COVID 19 could they get an antibodies test as well to see if they had it previously?

• Antibody tests are not currently offered by the HSC as there are still a lot of unknowns around COVID-19. It is unknown if the antibody protects against future infection, or if an immune person can pass COVID-19 infection to others.
• Research is ongoing into their effectiveness and to understand what the resulrs mean in real terms (eg doe the presence of antibodies make someone immune forever, if one has antibodies, does that mean they can't transmit the disease.
• Antibody tests are available privately. Due to the need for more research the PHA can’t advise on the implications of results.

Q. Will social care organisations staff get contact traced repeatedly because of the client group they work with?

• There are many mitigating factors, including use of PPE and observing good practice to reduce transmission of infection, which are put in place for staff in these settings
• The risk assessment is undertaken on a case by case basis and depending on the nature of contact there may not be a need to self-isolate

Q. What assurance is there that accessibility will be considered at the design phase to allow blind and partially sighted people and those with a range of physical and sensory disabilities to fully participate and engage, should they wish to do so? 

The DoH have engaged companies who specialise in this area and considered appropriate user interface - language/fonts. Formulas and ways of screening language to ensure is it accessible. Audible access/contrasts to enhance what they are seeing.

Q. In a Homeless Hostel setting would clients and staff alike be tested, without showing symptoms or is this programme specifically for those who have tested positive for C-19.  Do those on the Programme require a smart phone? Within this sector of society phones are randomly exchanged/swapped, I envisage this would present with inaccuracy.

• Positive cases are interviewed via telephone and information gained about people they have been in contact with
• A risk assessment is carried out to determine those at high risk of COVID-19 infection.
• If a potential cluster of COVID-19 is identified, this is alerted to the PHA acute Health Protection team for further assessment.
• Following this assessment, the Health Protection team will work with management of a setting if required, to set in place control measures to help limit further transmission of the virus.

Q. What level of detail we must get from people entering our offices/courts etc to help with the tracing?  What the data security elements are being covered?   Not sure if part of discussion but is there any guidance re. destroying of PPE etc Any requirements from businesses in relation to this? Will the antibody test be available for anyone?

• At minute no requirement for businesses / leisure centres to keep record. Guidance issued in England for orgs to do this.
• They will be asked to facilitate contract tracing overall. Will likely issue guidance locally.
• PPE - guidance about disposing and when to where. Changed so frequently. Encourage people to keep looking at PHA website to provide links to guidance.
• PHA does not have policy position on antibody testing on validity or encouraging to get or not.
• Guidance changes so frequently – it is led by science, Policy decisions led by that advice. Keep up to date with trusted sources PHA/ NI Direct.
• NICVA have own guidance on returning to work and risk assessment. Links back to PHA and government guidance.

Q. What happens if people ignore advice.

Hope that people act responsibility. Co-operate with each other all benefit. If individuals behave responsibility would hope peers say that harms everybody.

Q. Will there be a second spike?

We cannot be sure if there will be a second wave, however historically with flu, we have seen two waves; one severe and the second less severe, however COVID-19 is different to flu viruses. Current models suggest we should expect a second spike. Furthermore, if we have a severe flu season later in the year, with high numbers of cases, this could have a significant impact on the health service. This reinforces why measures such as self-isolation are so necessary to minimise spread of the virus.

Q. Given the prevalence of COVID transmission among younger people and the fact that they are likely to be less risk adverse as we emerge from Lockdown, what steps have those developing the Test Trace and Protect App taken to ensure that the processes they are proposing are fit for purpose for young people? In the context that young people have told CLC they will not download Apps because they take up too much space, have young people been consulted to determine if they will download an App or what is the most suitable technological medium which will be used by young people? How will the young person’s age be determined and how in compliance with GDPR and their right to privacy will they secure informed consent from young people or from their parent/guardian if they are too young to give consent? What safeguarding considerations have been put in place?

• In NI there is no defined age of consent lower than 18. To meet with legal obligations, it would be necessary to gain parental consent to have people younger than 18 use the app. In respect of the GDPR legislation, the position of ICO is clear – we cannot have identifiable information captured by the app - so how do you get parental consent whilst complying with an obligation for privacy.
• Unfortunately, we are having to proceed, limiting use of app to 18 and over.
• Plan to reach out to Children’s commissioner and ICO to see how these competing rights can be addressed.