The new Test and Trace operation eventually established in May 2020 was a step in the right direction but set up much too late. Because of that delay there was huge pressure to get results quickly which meant that it followed a centralised model initially, meaning assistance from laboratories outside PHE—particularly university laboratories—was rebuffed. The same was true for contact tracing, where the established capabilities of local Directors of Public Health and their teams were Coronavirus: lessons learned to date 129 not effectively harnessed during the initial response to the pandemic, despite local approaches providing effective in places where they were pursued. It is now clear that the optimal structure for test and trace is one that is locally driven with the ability to draw on central surge capacity—but it took the best part of a year to get to that point. In short, implementation was too centralised when it ought to have been more decentralised.