2. Policy Aim
The Scottish Government published its paper "COVID-19 - Test, Trace, Isolate, Support" (TTIS) on 4 May 2020, setting out the approach to controlling the spread of coronavirus in the community. Test and Protect, the public-facing name for the TTIS strategy, was successfully rolled out across all Health Boards across Scotland from 28 May. It is designed to reduce the public health risks posed by Covid-19 by limiting the further spread of the disease and are therefore designed to prevent harm to people in Scotland. This has and continues to allow us to gradually change the restrictions that help to suppress the virus, when the virus is suppressed sufficiently, TTIS allows most people to live their life as normal as possible, within the current restrictions.
The three pillars of Test & Protect are:
Testing - to identify cases of coronavirus:
- Under Test and Protect, if someone develops coronavirus symptoms – a continuous cough, high temperature or loss/change in sense of taste or smell – they should arrange to get tested immediately through the UK government's testing portal or if they need help, contact the NHS to arrange to be tested at NHS Inform or 0800 028 2816. They should self-isolate at home immediately along with other members of their household. Testing is available to anyone in Scotland who is experiencing symptoms of Covid-19. In addition, to find asymptomatic cases, testing is now available in a range of settings detailed below.
Contact tracing - tracing those who may have become infected by spending time in close contact with the infected person:
- Individuals who test positive for COVID-19 are be contacted by the contact tracing team so their close contacts can be identified.
- Contact tracing is used to trace the contacts of known positive cases of COVID-19, and asks them to isolate to stop potential onward transmission in the community. The fewer close contacts each confirmed case has, the more straightforward contact tracing is , and the less likely that disease transmission has occurred. During lockdown most people have few close contacts due to people working from home and having limited social interactions. These numbers increase when restrictions are eased, but not to a level that is unmanageable for the contact tracing service.
- The contact tracing cases are split into two tiers:
- Tier 1: non-complex - easy, straightforward with a low number of contacts
- Tier 2: complex cases - e.g. in a healthcare setting where a risk assessment needs to be performed to establish whether contacts of the individual were wearing PPE, for example or if the protection offered by PPE and other preventative measures is sufficient to mitigate the risk.
- contact positive cases by phone;
- ask them who they live with, who they have been physically close to recently and where they have been;
- decide which of these people might be infected based on how long they spent with the infected person and how physically close they were
- contact these people to tell them to isolate for the recommended period of isolation in line with clinical advice available at that time.
Supported isolation - supporting cases and close contacts to safely self-isolate to reduce onwards transmission.
- Everyone who tests positive for Covid-19 is contacted by the contact tracing service to help identify who they have been in close contact with. Close contacts are then asked to self-isolate for the appropriate period of time, which reduced from 14 to 10 days in late 2020.
- People asked to self-isolate should remain at home or the accommodation they are residing in, should not go to work, school, public areas, on public transport and should not leave their place of residence to buy food or for any other reason.
- The National Assistance Helpline and Local-Self-Isolation Assistance Service are available to people who are self-isolating and triage the isolation-related needs of people in contact with the services and, where required, provide a range of services including:
- access to food and essential medication;
- financial advice and support including the Self-Isolation Support Grant;
- referrals into local voluntary and statutory support services.
The Test & Protect system is led by the NHS in Scotland, and is a collaborative, multi-public agency partnership comprising Public Health Scotland, territorial Health Boards, NHS National Services Scotland, the Scottish Government and Local Authorities. It has expanded rapidly since its inception, in response to the pandemic, and we have been learning from the emerging Scottish evidence base and international comparisons, and continue to refine and adapt the approach as the pandemic changes. We have built on the expertise and experience of our health protection workforce; made use of new and existing digital infrastructure; and an expanded accessible testing programme.