Coronavirus (COVID-19): Our shared role in containing the virus: Analysis of responses submitted as part of the Scottish Government's second public engagement exercise

6) Testing and Use of Information

A number of contributions on this theme indicated confidence in the value of testing, as a key determinant for greater safety and a return to previous conditions. However, much discussion cited lack of access or availability of testing, with suggestions for improvement. The efficacy of tests was also questioned, and issues with the Protect Scotland mobile app were flagged. There were calls to improve the reporting on local statistics, and share greater granularity of the data.

Key themes discussed included:

• Testing, tracking and self-isolation
• Use of information

Testing, tracking and self-isolation^[17]

A number of contributions included concerns about availability of tests in rural areas, and examples of respondents being directed to testing stations outside Scotland, and students’ lack of access to tests. In some cases the booking system was seen as not being able to handle the volume of applications and access to home-test kits was also preceived to be limited.

Suggestions to improve access included involving community nurses and furloughed workers with administering testing, and for Scotland to develop its own testing system.

Some contributors raised issues regarding the waiting times for results, especially given the requirement to self-isolate while waiting and uncertainty around whether self-isolation would have to continue following the result, which was perceived to be a cause of stress and inconvenience.

A range of contributors highlighted the importance of testing to support appropriate public health responses and give a quick outcome to those uncertain about their symptoms. In addition to comments about the efficiency of the testing system, there were respondents who showed support for the concept of test and trace specifically. At the same time, a number of contributors were concerned about the efficacy of tests. ‘False positives’ were seen as leading to unnecessary self-isolation. However there was also some perception that a negative test might not be a guarantee of a lack of infection. Some respondents argued that false positives would give an inaccurate basis for informing decisions about how to manage the pandemic, or judge individual risk.

Others were keen to see ‘rapid testing’ introduced as a way of ensuring that people could have the assurance that they were not infectious. Rapid testing could then be employed at events, for school teachers, at care homes and prior to air travel. There were calls to have testing available at airports upon arrival. However, other contributors cautioned that this was not necessarily a guarantee they were free of infection, merely that it was not detectable at the time.

There were calls for antibody testing to be made available for key workers and to those shielding.

‘Shielders, NHS and care workers should have antibody tests to see if we've already had Covid-19 without any drastic symptoms or consequences. After an antibody test, everyone could make their own decisions about the risks they take in everyday life.’

One contributor argued that being unable to run the Test and Protect app alongside equvalents in other parts of the UK would cause problems for those living and working across the border^[18]. It was suggested retail staff should be able to carry their mobile phones with them on the shop floor during shifts to enable them to know if they have been exposed to the virus.

There were respondents who argued for more contact tracers to be hired to improve the effectiveness of Test and Protect, especially in terms of ensuring those who came into contact with someone who had tested positive be informed promptly. Some respondents reported that there had been instances when close contacts reported after a positive test had not been followed up, or else a positive code had not been provided to input into the Test and Protect app.

It was suggested that there should be more encouragement and incentives for using the Test and Protect system. A number of respondents suggested providing ‘key support workers’ for those being asked to self-isolate (see below), while a number of comments across a range of ideas supported financial incentives to maintain isolation. Some saw the threat of a fine for not self-isolating acting as a disincentive to get tested if you have mild symptoms. Others were concerned that employees should be provided with official confimation that staff should self-isolate in order to protect them from being ‘penalised’.

‘(...) Provide a "key support worker" for those being asked to self isolate. To provide practical advice and moral support to help people do the right thing. A key support worker could check in with the household perhaps twice a day, to check they had food, supplies, be an advocate for them liaising with employers, accessing services and benefits etc. the 3rd sector could be asked to help provide this for households self isolating (…).’

Use of information^[19]

There were various calls to improve the reporting of local statistics in order to ensure people were informed about areas with higher risk of transmission. Some called for the government to report cases based on asymptomatic individuals. There were also calls for greater granularity of the data, for example, information on how many of the people who died of COVID-19 had pre-existing or underlying health conditions. There was an idea to improve the test and trace system by collecting and storing personal data centrally rather than relying on businesses (e.g. in hospitality) having to collect and store such data individually.

‘Instead of relying on each individual business to collect and save their own contact tracing info have every business saves the information daily on a unified system. Therefore, when an outbreak occurs it will be much easier for contact tracers to collect the information and it may be less likely for businesses to fail to collect the information The government can supply a QR code/test message system that allows people to access this system which is connected to the restaurant.’