Surge testing in Norfolk

The Government announced that surge testing was to take place in Norfolk on Tuesday 16 February.  The testing started the following day focussing on the market towns of Diss and Roydon, which are home to around 10,000 people.  

This is part of a series of case-studies published on 16 March 2021  

  • Surge testing carried out in two neighbouring market towns
  • On-the-ground teams led by South Norfolk district council, comprising leisure, library, trading standards and fire and rescue staff supplemented by mobile testing units
  • Liaised with GPs to identify housebound residents and those with vulnerabilities that needed testing delivered to their home

What was done? 

In late January Norfolk County Council was alerted to a case of the South African variant that could not be directly linked to travel to the country. 

The individual had been admitted to hospital – and because the local university is one of the key genomic sequencing labs the council’s public health team was provided with an early warning of potential community spread. A second, household, case soon followed. 

Director of Public Health Dr Louise Smith said: “We have had other cases in the county, but all have been linked to travel. These cases couldn’t be and we had talks with the government about surge testing. We thought we might be part of the first phase –- but we weren’t. So we carried on doing a deep dive into all the cases and extensive contact tracing.”

The government made the announcement that surge testing was to take place in Norfolk on Tuesday 16 February.  The testing started the following day focussed on the market towns of Diss and Roydon, which are home to around 10,000 people. 

Nearly 7,500 tests were carried out – and just over 50 positive. Norfolk is still waiting for the results of genomic sequencing.

How was it done?

Three mobile testing units were deployed and drop-and-collect facilities set up at locations including a leisure centre, community centre, local church and pub. 

A letter was published and sent to everyone’s homes offering to bring testing kits to people’s homes for those who were shielding, housebound or felt unable to leave their home.  

The on-the-ground team were made up of district council staff and leisure staff which were supplemented by staff from the county council’s library and trading standards teams, while the public health team along with county council’s data analysts and communications teams provided support. 

Norfolk County Council Director of Public Health Dr Louise Smith said: “It was a real collaboration. Each of our districts has a community hub that has played a crucial role in everything from supporting people who are shielding to helping out with local contact tracing.  They were also supported by staff from a neighbouring district. We had more than 20 people on the ground in the end. It is so labour intensive that you need that mutual aid. 

“But you have to draw on the knowledge of others too. We liaised with local GPs. We knew who was on the shielding list and adult social care clients, but not who was housebound or had other vulnerabilities. We took tests to their door and even offered to help them with the test if needed.  We also worked closely with some of the larger employers in the area.

"The response was great. When you look at the proportion who came forward for testing, you can see people were really keen to take part. The local postman also got involved. He noticed people had been dropping the home testing kits into the post box and took them to the collection unit. They would have been sent to the Lighthouse labs for processing and not necessarily ended up getting sequenced for the variant if it wasn’t for that.”

What was learnt?

The launch of surge testing was not without problems, said Dr Smith. "In the days before it was announced we had been told it was happening and then it wasn't - so it took us somewhat by surprise when it came. 

"It was just announced as a postcode area. But the postcode straddled Norfolk and part of Suffolk. It was a much wider area than the two wards. We had to spend quite a bit of time correcting that and making it clear to the public where we were focussing the surge testing on.

"The communications is a massive exercise. We also had the problem that the mobile testing booking system did not go live until Thursday evening at 8pm for Friday bookings. It meant there was massive pent up demand on the drop-and-collect services. By Saturday we had run out of home testing kits. It felt like the government did not fully understand the implications - especially in a two-tier area."

Dr Smith said the council has started making plans for future cases.

Across the county, we are investing £5.5m of outbreak management money into district council teams. We know with all the work going on we are going to need to do this sort of thing again. It is going to get busier as the restrictions lift.

“But it is not sustainable without investment. We were lucky with the surge testing this time in that infection rates had dropped so the pressure was off the contact tracing element a little. But going forward we need to expand capacity.”

Contact details

Dr Louise Smith
Director of Public Health
Norfolk County Council