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Test, Trace, Protect is the Welsh Government’s approach to testing and contact tracing to help us live with Covid-19 (coronavirus) whilst work continues to find more effective treatments and a vaccine. The strategy will enable citizens, education establishments, childcare settings and businesses of Wales to resume normal activity gradually and safely. The strategy is in the interests of protecting people’s health, and works by:

  • testing people with coronavirus symptoms, asking them to isolate from wider family, friends and their community whist waiting for a result
  • tracing people who have been in close contact with anyone who tests positive, requiring them to take precautions through self-isolation for 14 days
  • protecting the vulnerable or those at risk from the virus, providing advice, guidance and support, particularly if they develop symptoms or have been identified as a contact through the contact tracing process

What types of tests are there?

There are 2 types of tests for COVID-19:

  • the antigen (swab) test – this test tells you if you currently have the virus
  • the antibody (blood) test – this test tells you if you have previously had the virus

Antigen Testing

What is the antigen test?

This tests if someone with symptoms has Covid-19. This type of test is now in widespread use in Wales. It plays an important role in supporting contact tracing and managing the spread of the virus.

Anyone experiencing symptoms can ask for a test. Depending on the test setting, the test involves either:

  • a ‘single dry swab’ taken from the back of the throat
  • or a ‘two wet swab’ sample from the nose and throat

When should I request an antigen test?

You must self-isolate and request a test as soon as you develop at least one of the following symptoms:

  • a new continuous cough
  • a high temperature
  • loss of or change to sense of smell or taste

Even if your symptoms are mild, you must not leave your home. This is called self-isolation. Anyone with symptoms must self-isolate for 10 days from when their symptoms started. Anyone in your household who does not have symptoms must self-isolate for 14 days from when the first person in your home started having symptoms. To protect others, you should not go to work, or to places like a GP surgery, pharmacy or hospital if you have any of these symptoms.

How do I apply for an antigen test?

Stay at home (self-isolate) and apply for an antigen test as soon as you start developing symptoms.

All education and childcare workers are critical workers (including support staff working in these settings), so you should request a home testing kit or book a slot at your nearest drive-through testing centre by following the critical worker route.

When is the antigen test most effective?

The antigen test is only effective for those who are experiencing coronavirus symptoms. It needs to be taken in the first 5 days of symptoms. You should not hesitate to book a test as soon as you start experiencing symptoms. The test only checks if you have coronavirus right now and not if you have already had the virus.

Asymptomatic individuals (i.e. those who are not experiencing symptoms) are only tested in exceptional cases, such as residents and staff in care homes and patients (prior to receiving operations) in the health care sector. Another exception is if there is an outbreak in a workplace or setting, where asymptomatic testing of individuals within that setting may be used to help understand the extent to which the virus has spread. A negative asymptomatic test does not exempt someone from self-isolating for the 14 day required period if they have been identified as a confirmed contact through the contact tracing process.

Antibody Testing

What is the antibody test?

This tests to see if someone has previously had the virus. The test works by taking a blood sample and testing for the presence of antibodies to see if you have developed some immunity to the virus. Antibodies are produced by the body in response to an infection (immune response). They can usually be found in the blood around 2 weeks after a recent infection.

As COVID-19 is a new infection, our understanding of the body’s immune response to the virus is currently limited. We do not know how long the antibodies to this virus will last or how effective they are in neutralising the virus, whether they will protect you from getting the virus again, or whether having antibodies means you cannot transmit the virus to others. As the scientific evidence grows, we hope to have the answers to these questions.

Is the antibody test widely available?

The antibody test is currently only available through an initial sample testing programme in some education and healthcare settings.

Why are antibody tests being offered?

The purpose of the current antibody testing programme is to see if the tested individuals have been infected with COVID-19 and to further our understanding of transmission.

If you are not in one of these priority groups and have not been invited for a test, please do not contact your Local Health Board to request an antibody test at this point in time.

Contact tracing

What is the purpose of contact tracing?

Contact tracing is a tried and tested method of controlling the spread of infectious diseases. It will also help us understand how the disease is passing from person to person. We used contact tracing during the initial ‘contain’ phase of our response to coronavirus. Contact tracing is now an essential part of our Test, Trace, Protect strategy.

Since the beginning of June, contact tracing has been operating across Wales, and will need to be maintained at a significant level, potentially for the next year or until a vaccine is found.

What happens if you have tested positive?

If you’ve tested positive as a result of receiving an antigen test (which confirms you currently have the virus), you will be contacted by the NHS Wales Test, Trace, Protect service. The contact tracer will ask for details of your recent close contacts, they will explain what this means and help you through the process. A close contact is:

  • someone within 1 metre of you with whom you have had a face-to-face- conversation, had skin-to-skin physical contact, you have coughed on, or been on other forms of contact within 1 metre for 1 minute or longer
  • someone within 2 metres of you for more than 15 minutes
  • someone you have travelled in a vehicle with, or seated near you in public transport

What happens if you are a confirmed contact?

If you are identified as a confirmed contact, you are at increased risk of catching the disease and passing it on to others. The contact tracer will get in touch and ask you to self-isolate for 14 days. Members of your family are not required to self-isolate, but they should follow the general social distancing guidance and avoid contact with you whilst you are isolating at home.

You’ll also be asked to monitor your symptoms so that you get tested as soon as possible if needed. A range of support is available to individuals being asked to self-isolate as part of contact tracing, particularly if they are vulnerable, and to employers where contact tracing impacts upon business continuity.

As we slowly come out of lockdown, acting quickly to identify cases of coronavirus and isolating those who may have been infected will be vital to stopping the spread and avoiding a second peak. Contact tracing is not about enforcement or surveillance and is in the interests of protecting your health and the health of your contacts.

What is the definition of an ‘outbreak’ and what will happen?

If there is a single positive COVID-19 case amongst children and/or staff then the local contact tracing process will be initiated to minimise the spread of the virus.

An outbreak within this context is defined as two or more cases of COVID-19 in a single setting. In the event of an outbreak, rapid response support will initially be provided by your regional Test, Trace, Protect team who will gather information about the outbreak.

An urgent incident meeting led by an Incident Management Team (IMT) is likely to be put in place to manage the outbreak and support the setting. Key individuals who are needed to investigate and manage the situation will be invited to the incident meeting to consider what adjustments and actions, such as isolation and wider testing should be considered. Testing of a wider group will depend on the risk analysis and the associated safety measures put in place within the individual environment.
 
Antigen testing will be rapidly made available by the NHS Wales Test, Trace, Protect service in partnership with Local Health Boards to support all outbreaks in setting. This might be through the deployment of Mobile Testing Units (MTUs) or temporary testing satellites and drop-off and collection routes. 

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