shefﬁeld community contact tracing...guidelines and infographic n.b. contacts will be included if...

Version 1.5 | 12/05/2020 | Amber Edmondson | SCCT

Sheffield Community Contact Tracing

Volunteer Training


Sheffield Community Contact TracingBackground to the pilot

WHO guidelines recommend that cases are identified, advised to isolate, and that

contacts are traced, advised to quarantine and then followed up to identify new

cases

On 12.3.20 the UK government stopped contact tracing. It has announced this

will be restarted …... the timescale is uncertain.

A group of retired Sheffield doctors set up this initiative to train, supervise and

coordinate volunteers with a local development trust. Referrals have come from

local GPs, community groups and word of mouth. A report will be published to

discuss the feasibility and efficacy of this pilot. If successful, it is hoped that it will

be widely taken on by the NHS, Public Health England, and Local Authorities.


The Sheffield Community Contact Tracing PilotThe good, the bad and the ugly

This pilot aims to find the efficiency, effectiveness

and ups and downs of community contact tracing

and through sharing these change the direction of

government planning.

That means that we’re interested in the challenges

just as much as the successes. We need to

understand whether this model is scalable and

sustainable.

Be honest about your experiences, what

works and what doesn’t.

Always record all decisions, even if just to

say the index case no longer wants to

participate.


Community Contact Tracing Explained


● Steering Group: includes founder members (see pilot overview), representatives of supporting

organisations and other advisors. These are all voluntary.

● Volunteer: trained to this manual and approved by their mentor to support and trace.

● Referral Coordinator: takes referrals from/liaises with NHS or other official sources.

● Mentor: member of the steering group available to each volunteer for support.

● Support circle: daily supported meeting of volunteers to learn together about tracing

● Data Coordinator: receives, holds and collates study data.

● Index Case: a patient with probable or confirmed COVID-19

● Contact: someone who may have been infected by the index case, see below.

● Buddy: another volunteer who can make your follow up calls (if appropriate) when you aren’t

available

Community Contact TracingWho’s involved?

https://docs.google.com/document/d/1H5xJupUcAu7vEqM57q-vE3mT-_niV8GFUP6KsZCUegc/edit?usp=sharing


Patient Experience

https://docs.google.com/file/d/1ePOfiV_uHJTuEZx4EDGbcyRdljax5_IN/preview

https://docs.google.com/file/d/1ePOfiV_uHJTuEZx4EDGbcyRdljax5_IN/preview


What is an index case?Any person who:

Identifying and contacting cases as early as

possible makes contact tracing much more

effective. Therefore, early referrals are

important for an effective contact tracing

program.

● Has had a positive swab result

● Has been diagnosed as Covid-19 positive by a doctor

● Has at least 2 of the following symptoms:

○ Fever

○ New dry cough

○ Loss of taste and smell

Be aware that these do not always happen at the same time


What is Contact Tracing?...and why is it so important?


How do we define a contact?Any person who:

Has had face to face contact

within 2m for more than 15 mins;

For more detail see ECDC

guidelines and infographic

N.B. Contacts will be included if

contact occured from 48 hours

before symptom onset until the

case was isolated.

Has had physical contact;

Had unprotected direct contact

with infectious secretions eg by

being coughed on;

Was in a closed environment (household, meeting

room, waiting room etc) for more than 15 mins;

Was providing care or handling

specimens without proper PPE.

https://www.ecdc.europa.eu/sites/default/files/documents/Contact-tracing-Public-health-management-persons-including-healthcare-workers-having-had-contact-with-COVID-19-cases-in-the-European-Union%E2%80%93second-update_0.pdf

https://www.ecdc.europa.eu/en/publications-data/infographic-covid-19-contact-tracing


These will come from:

● GP surgeries● Neighbourhood/social

media groups● Self-referral

*Sources may change

Referral Coordinator receives referral

Allocates ID number to each index case

Allocates a volunteer and notifies by email copying in mentor and data collector

Calls the index case using First Call with Index Case and fills out the Info Gathering Form for Index Cases to gain contacts.

Then calls the contacts using the First Call with Contact and fills out the Info Gathering Form for Contacts

Sends these forms to Data Coordinator

Receives, holds and collates data from gained from index cases and contacts by volunteer

Referral Coordinator

ReferralData

Coordinator

Contacts

Index Case

Volunteer

The Process

https://drive.google.com/open?id=16sZHM4Flzj6jCCGOCyg3QWep-iEnoWs1IOM3egMsc-0

https://drive.google.com/open?id=16sZHM4Flzj6jCCGOCyg3QWep-iEnoWs1IOM3egMsc-0

https://docs.google.com/document/d/1Ko7c1RkbDvV8nzxBUiXW95yoFc_0NP2k9B7C_EKPgxs/edit?usp=sharing


https://drive.google.com/open?id=1M1XNpg99B6HVmn62NV2siGtKgDXZzWWF5876GxNW4io

https://drive.google.com/open?id=1bcrdlrhJlAEr6_WDu2w4HbXLhp5IUuzQkIK57gd6uZo

https://drive.google.com/open?id=1bcrdlrhJlAEr6_WDu2w4HbXLhp5IUuzQkIK57gd6uZo


Self-Isolation Guidance


Self-Isolation GuidanceIf you live alone

● If you live alone and you have symptoms of coronavirus illness

(COVID-19), however mild, stay at home for 7 days from when

your symptoms started. (The ending isolation section below has

more information)

● After 7 days, if you do not have a high temperature, you do not

need to continue to self-isolate.

● If you still have a high temperature, keep self-isolating until your

temperature returns to normal. You do not need to self-isolate if

you just have a cough after 7 days, as a cough can last for several

weeks after the infection has gone


Self-Isolation GuidanceIf you live with others

● If you are the first in the household to have symptoms of

coronavirus (COVID-19), then you must stay at home for 7 days,

but all other household members who remain well must stay at

home and not leave the house for 14 days. The 14-day period

starts from the day when the first person in the house became ill.

See the explanatory diagram

● For anyone else in the household who starts displaying

symptoms, they need to stay at home for 7 days from when the

symptoms appeared, regardless of what day they are on in the

original 14 day isolation period. The ending isolation section below

has more information


Self-Isolation GuidanceIf you live with a vulnerable person

● If you can, move any vulnerable individuals (such as the

elderly and those with underlying health conditions) out of

your home, to stay with friends or family for the duration of

the home isolation period

● If you cannot move vulnerable people out of your home, stay

away from them as much as possible


Self-Isolation GuidanceExplanatory Diagram


Minimising Household Spread


Minimising Household SpreadPart One● Minimise the time any vulnerable family members spend in

shared spaces (e.g. kitchens) and keep shared spaces well

ventilated

● Aim to keep 2 metres away from vulnerable people you live with

and, if possible, sleep in a different bed

● If they can, they should use a separate bathroom from the rest of

the household. Make sure they use separate towels from the

other people in your house, both for drying themselves after

bathing or showering and for hand-hygiene purposes

● If you do share a toilet and bathroom with a vulnerable person, it

is important that you clean them every time you use them (for

example, wiping surfaces you have come into contact with). You

could draw up a rota for bathing, with the vulnerable person using

the facilities first


Minimising Household SpreadPart Two

● If you share a kitchen with a vulnerable person, avoid using it

while they are present. They should take their meals back to their

room to eat. Wash and dry crockery and cutlery thoroughly. If the

vulnerable person is using their own utensils, remember to use a

separate tea towel for drying these

● We understand that it will be difficult for some people to separate

themselves from others at home. You should do your best to

follow this guidance and everyone in your household should

regularly wash their hands, avoid touching their face, and clean

frequently touched surfaces

● Our role as volunteers is to help people find achievability within

these recommendations … best possible rather than perfection


Data Collection


Consent

Simple verbal consent will be taken for entry into this study as

follows:

“Are you happy to take part in this pilot study? I will send you

written information. Please say if you would rather not take part,

you can withdraw at any time.”

Consent given or refused will be recorded for both the index

patient and each contact.

Volunteers will send written information electronically at

enrollment and if email is not possible then send by 1st class post

or dropping it off by hand if this is achievable.

Need to have at least a brief consent discussion with the index

person.

Consent is valid if the person is clearly able to

understand the conversation and process the

information they are given.

If not, that case will have to be dropped. (Tell

data coordinator)

https://docs.google.com/document/d/1wu1IxeZPycatK3f3-NPo4-Y4Axg4hi5LA37eCmHdwRs/edit?ts=5e9853e7


Data Collection


https://docs.google.com/document/d/1bcrdlrhJlAEr6_WDu2w4HbXLhp5IUuzQkIK57gd6uZo/edit?usp=sharing


Contacting Cases


First Call with Index Case

Building trust is the most important thing at this point.

Your index case may well be scared and stressed out due to:

● Fear of the virus itself

● Guilt or anxiety at the idea they may have infected

others

● Fear of losing work and income

Stay calm, be reassuring and let them know that they haven’t

done anything wrong.

Make sure they know how helpful their cooperation is.

Remember you can break the call into parts if it seems the

case is overwhelmed or needs a break.

https://docs.google.com/document/d/16sZHM4Flzj6jCCGOCyg3QWep-iEnoWs1IOM3egMsc-0/edit?usp=sharing


First Call with Contact

You may be the first person to tell them they are at

risk.

Be patient while they take in this information and

reassure them.

If the contact develops symptoms, volunteers will

enrol her/him as a second wave index case. Record

all data as above.

If the contact doesn’t want to participate, record

refusal to be involved/reason.

https://docs.google.com/document/d/1M1XNpg99B6HVmn62NV2siGtKgDXZzWWF5876GxNW4io/edit?usp=sharing


Daily Phone Call

Volunteers will contact each index and contact case daily to:

● assess symptoms

● offer support/advice for at least 7 days (index) 14 days (contact)

● help overcome any problems accessing further help/referral from

GP/111/ hospital, should symptoms progress.

● May need referral to local community organisations for practical

help / scripts/ etc.

Volunteers are not taking on a medical role

BUT can appropriately share their observations if

the index or contact is more unwell…

Especially deteriorating physical capabilities e.g.

breathlessness coming on sooner, not coping etc.

may all trigger suggestions to contact medical

services.

With Index & Contact Case


Volunteer Support


Volunteer SupportWho to talk to about your experiencesSupport Circle ● This is a group zoom call held at 5pm daily

● This a chance to update everyone with your cases and discuss any successes or challenges

you’ve had and share any advice or tips with other volunteers

● This will be facilitated by each of the mentors in turn on a rolling basis. The rota will be

shared with volunteers

Mentor You will be assigned a mentor from the Steering Group who is there to offer long term to support

and to advise you and to be first point of contact for urgent questions.

Buddy Buddying up with another volunteer will allow you cover if you aren’t available when your contact

or index is

Whatsapp Group You will be added to the Volunteers’ Whatsapp group


Thank you!

www.communitycontacttracers.comsheffieldcommunitytracers@gmail.com

This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

http://www.communitycontacttracers.com

mailto:[email protected]

shefﬁeld community contact tracing...guidelines and infographic n.b. contacts will be included if...

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