How one county escaped the worst of COVID-19

A localised approach to contact tracing has helped to keep Ceredigion’s rates of COVID-19 among the lowest in the UK.

The local authority set up its own bespoke test-and-trace system in mid-April. This system has since been adopted by neighbouring authorities, while the national tracing scheme struggles to get up and running.

Ceredigion has had by far the fewest COVID-19 infections in Wales, at just 57 per 100,000 – or a total of 45 cases to date*. The national Welsh average is 461 cases per 100,000 people (288 in Scotland, 255 in Northern Ireland and 278 in England). Seven people have died of the virus in Ceredigion, out of 1,410 in all of Wales.

Geography explains this to some extent, as the region is rural. But neighbouring counties have fared far worse. Ceredigion’s proactive approach at the beginning of the pandemic undoubtedly made a difference. It shut down holiday and caravan parks before the national lockdown was announced, and Aberystwyth University was one of the first in Wales to close.

Alongside that, Ceredigion Council decided to create its own test-and-trace system from scratch. Corporate director Barry Rees – with a directive from the council’s chief executive to “see if there’s anything else we can do to prevent the spread” – assembled a team to do this in the very early days of the pandemic.

Carwen Evans, corporate manager for public protection, was on that team. “It was my team that had the skills to do contact tracing so it automatically came to us to [help] get things moving,” she said. The legal, data protection and IT teams were also represented. Together they set up a questionnaire for people who had tested positive for COVID-19. The public protection team would then identify those people from the national communicable disease database, and call them to go through the questionnaire. “That information was captured in a database so that we could see if there were any patterns emerging,” Evans said. The first tracing call was made on 22 April. Just under 60 calls have been made to date.

The training that Evans’s team – mostly EH officers – underwent for this built on their expertise in dealing with food poisoning outbreaks.

“The reason it came to public protection to do the contact tracing was because we already had the skillset that was necessary. The principles are the same,” Evans said. “If it’s a food poisoning outbreak you establish where they’ve eaten and so forth. And it’s really important to be sympathetic and to appreciate how ill people are.

“But obviously COVID-19 is different from food poisoning so there was a need for us to discuss the symptoms people are likely to experience but then be open-minded to receive new symptoms – because during this period the loss of taste and smell was brought in as a new symptom. So being able to be open to pick up anything that was perhaps changing as the disease progressed.”

Evans said people were receptive and even glad to receive the call from the council. “Once you introduce yourself from the LA, people are more than happy to talk and to receive advice and to ask for advice as well. And I’m sure giving that advice had some kind of input in preventing the spread.”

* Correct on 11 June 2020.