What do the public and staff think about digital tools to support COVID-19 contact tracing in Scotland?

Problem

‘Contact tracing’ is a key feature of global governments’ public health response to COVID-19 outbreaks; countries with robust contact tracing systems are typically amongst those thought to have been ‘better’ at containing the virus. Scotland established ‘Test and Protect’ in the summer of 2020 to identify contacts of those testing positive. Test and Protect is part of NHS Scotland, with many contact tracers coming from public health and other parts of the health system. To speed up contact tracing, digital online tools have been developed to collect information on people and places positive cases have been in contact with. We explored the views of members of the public, stakeholders representing marginalised groups, and staff involved in contact tracing to understand how such digital tools and viewed and used.

Approach

Data collection has covered two periods of roll-out. 42 were interviewed people in June-August 2020 as the digital tools were being developed: 29 members of the public, in either interviews or focus groups; and 13 key informants from a range of community-based organisations. Further interviews with public users and contact tracers (n=25) are taking place in February-March 2021, when the digital tolls are operational. All interviews and focus groups were conducted on Zoom v5. Thematic analysis was conducted by the team with key findings and illustrative verbatim codes extracted from sound files.

Findings

Participants were familiar with the Test and Protect programme; most gained their information from the daily government briefings or online research. Participants were uniformly supportive of the programme and saw adherence as a civic responsibility. In the summer of 202, most were willing to share their own information, although many were cautious about sharing information on their contacts. Concerns about data governance was an issue for some, but the clear involvement of NHS Scotland was a reassurance. Most participants envisaged a range of potential challenges with the programme including recollection, and issues related to self-isolation. Interviews exploring the experience of those actually using the online contact tracing are currently ongoing. Contact tracers working either in the National Centre or in Health Boards report mixed responses when they contact those who have completed contact information online; while some expected to be contacted personally, others did not and this can be a source of concern.

Consequences

Digital tools to collect information on recent contact of those testing positive are feasible and acceptable. Consideration must be given to those who cannot use such tools and care must be taken not to increase workload for contact tracers. Contact tracing appears acceptable when it is clearly part of the health system and integrated with the NHS.