At more than 5,000sq kilometres, Norfolk is one of the largest counties in England. To cover such a big area, the county council has set up a network of mobile testing teams rather than rely on static sites. It has allowed the teams to target testing at the neighbourhoods with the most need as well as support local businesses and big events.
The 14 local teams
The council quickly decided setting up a network of static rapid testing sites was not viable. Head of COVID Testing Andrew Rodgers said: “We would have needed 25 or 30 sites to cover the county and even then people would have had to travel a long way. It would just not have worked as a model to get people to test regularly."
Instead, Mr Rodgers designed a two-pronged approach – a network of 14 mobile teams who could do targeted testing in different areas and a programme to support local businesses to test their workforces. They have been staffed by more than 80 workers brought in on short-term contracts.
Each of the seven districts have two teams with each team capable of dong 500 assisted tests a day. They have had access to a fleet of converted buses and vans that from which assisted rapid testing has been done, but where possible the teams set up pop-up testing clinics in community venues. Churches, community halls, car showrooms and coffee shops have all been used.
Mr Rodgers said: “The venues are often better than the mobile units so where possible we use them – they have on-site facilities and more space. But that is not always possible depending on the people we are targeting so the buses and vans are a good fall back. The key is you need to be in the community you are targeting – there is no point even being a mile down the road. Over the past 12 months, our teams have set-up and tested in over 150 different venues across Norfolk.”
The teams – known as District Asymptomatic Testing Sites (DATS) – have worked closely with the public health team using the most recent data on which areas have highest levels of prevalence so they can target their testing in the right areas and neighbourhoods.
Supporting our summer music festival
The teams have also worked with specific high-risk groups such as homeless hostels and the organisers of events.
One of the biggest exercises was around the Sundown Festival, a music festival held in September. The teams started working with the organisers three weeks in advance, testing staff and the crews erecting the stages and facilities.
Entry to festival goers was on the basis they had a recent negative test so they helped to publicise this requirement and then during the weekend the festival was held mobile units were stationed at the site to offer testing to those who had not tested themselves.
Mr Rodgers said: “There had been quite a lot of concern about festivals over the summer and we did not want to see a repeat of what had been seen elsewhere with a spike in cases. It worked really well – we did not see a jump in cases afterwards.”
Working with local businesses
The second strand of the work also involved DATS in an advisory role, with the teams working with local employers – big and small – to set up workplace surveillance testing. These included big food production businesses such as Place UK and Bernard Matthews.
Mr Rodgers said: “The teams would go into the workplaces and identify where the testing could be done and then train staff on how to oversee it. Supply chains were then put in place to ensure they had a regular supply of test kids.
“Some of the businesses rely on migrant workers and have their own accommodation centres so we had to make sure there were places where people could isolate if they were positive.
“At one point we had over 300 business involved with 15,000 workers being twice-weekly tested – and even now there are over 200. It really made a difference. Some of them had outbreaks, but we were able to identify and contain them and keep their businesses running due to this regular surveillance testing.”
Mr Rodgers said: “When we started we could only do observed testing, but of course we then started handing out self-testing kits and the figures show in Norfolk we have consistently had good rates of public self-testing. As a local authority, we have been in the top five nationally for the number of observed tests completed through our programmes since April 2020.
“And our model has proved to be very cost effective too. We got the cost per test down to £1.69 – the national target was £14. It is about having scale and scope. It has been very demanding on the teams – they have been going from place to place, setting up new testing sites. But they have risen to the challenge.”
Norfolk Director of Public Health Dr Louise Smith added: “The Norfolk Testing Programme has been a key part of our response to the pandemic and a core operational function of our Outbreak Management Centre’s activities.
“The ability to use testing in a surveillance capacity, targeted at key areas of the community and hard to reach cohorts has enabled us to break chains of transmission, slow the spread of the virus and make timely decisions and take actions which enabled members of the public and businesses to continue operating in challenging circumstances.”