The Scottish Government says that they hope the numbers which they report around coronavirus will be more accurate.
Admitting that there could well have been underreporting till now, the system to be used from today onwards is already used each winter for cases of flu and so is well tested. The Scottish Government is confident in the methodology, and the system is being extended to cover as much as a fifth of the country’s population.
The First Minister, Nicola Sturgeon, alongside the Chief Medical Officer and the Health Secretary invited the media to a briefing this morning at St Andrew’s House.
Ms Sturgeon explained they wanted to provide an operational update offering ‘a sense of clarity’ about how The Scottish Government intends keeping the media and the public up to date with news about coronavirus from now on.
The First Minister said: “It is fair to say that we face a very challenging, and in our lifetime an unprecedented situation in the months to come. It is really vital that we are as clear and transparent with you as possible, so that you can report properly and responsibly to the public.
“At times that will inevitably include being frank if there are questions to which right now we don’t have simple answers. We are still learning about this virus.”
The First Minister reminded journalists that health is a devolved matter, and in the main while The Scottish Government is taking decisions that are entirely for them alone to make, the approach as far as possible is to proceed on a four nations basis. Decisions are being coordinated right now through the Cobra decision making infrastructure, informed by the UK Scientific Advisory Group.
To ensure such decisions are understood in the Scottish context, with the different NHS structures here, Ms Sturgeon said it is important to communicate these decisions clearly. At the same time, she cautioned against thinking that anything announced for the rest of the UK would automatically apply to Scotland.
For example last week Scotland took a different tack over stopping mass gatherings, so it is perfectly possible for Scotland to take different decisions to the rest of the UK or take the same decisions at different times. But the First Minister said: “When that is the case, and I expect that to be the exception not the rule, we will set out the reasons and rationale for that.”
Ms Sturgeon was very clear that it is not the Scottish or UK’s policy to achieve ‘herd immunity’. Rather she said it is a by-product of people getting an infection. “It is not our policy to achieve that. Our clear aim in every step we are taking and will take is to reduce the impact of this infection and crucially to save lives.
“That strategy is based on a realism that a virus like this cannot be stamped out for ever or indefinitely. the key thing is about how we manage the spread, and reduce the peak impact which is important for the capacity of our NHS.”
She was endorsed by the Chief Medical Officer Dr Catherine Calderwood who reaffirmed that ‘herd immunity is not a policy we are pursuing’, nor did she want people to hold ‘chicken pox parties’ where people mix in an effort to get antibodies. She said that if this is a seasonal virus then we will have a vaccine by next year, but the aim meantime is to take measures to prevent transmission.
TESTING TO BE EXPANDED
The Scottish Government will monitor the spread of coronavirus in a different way in future. Until now they have only been testing people if they fit a particular case definition. That case definition has changed over recent weeks, but in simple terms they have been testing people if they fit a case definition related to particular symptoms and travel history. They have also tested some people admitted to hospital.
The First Minister said: “It is likely that the numbers we have been reporting are underestimates of the spread of the infection so far. As we ask people with symptoms to self isolate, it is not feasible, nor is it the best use of resources, to test absolutely everyone. Also because we are asking people with symptoms to self-isolate, it is not necessarily adding to the protection that self-isolation is designed to deliver.”
The Chief Medical Officer explained there would be logistical problems in delivering and then picking up testing kits for people in self-isolation.
In Scotland from today onwards The Scottish Government will test large numbers of people so that they can monitor the spread and the profile of how the infection is behaving. These will be largely the same as those used around 10 years ago during the Swine flu pandemic.
People with symptoms in hospital will also continue to be tested.
The GP Sentinel Surveillance System used routinely to monitor flu every year is being significantly expanded from 41 GP practices to 200. These will do sample testing and the number of people who could possibly be monitored by this scheme will increase from 240,000 to 1.2 million.
The Chief Medical Officer explained that the method of testing and sampling of the population was a well established epidemiological practice already used in 41 GP practices to monitor flu each winter. It is anonymised, and is a useful way of keeping tabs on the infection rate. The way the 200 practices has been chosen is that some will be rural and some urban, and they are picked scientifically to be a snapshot of what the virus is doing in the whole Scottish population. While it is an estimate it could provide important data regarding local clustering. Dr Calderwood also said that more types of surveillance may be added in the future.
The First Minister explained: “The information from that will allow us to assess and report on the spread and profile of coronavirus. In many ways this will be a far more robust indicator than the figures we have been publishing so far and we will set out later today or tomorrow exactly how we will report these figures.”
There will also be information about how these figures differ from those reported thus far. It is possible that there will appear to be a dip over the next day or two and then also an apparent increase while the government moves to the new system which will be based on estimated figures. This information is published every winter relating to flu.
The government will also test key workers, such as critical front line NHS staff, so that they can avoid self-isolating unnecessarily.
She was clear that it is important not to forget the simple advice – if you have a fever or persistent cough the advice is to stay at home and self-isolate for a period of at least seven days. Hand washing is still the most important part of prevention.
Scotland has now advised that from today any mass gatherings of over 500 people either inside or outside, will be cancelled, and the hope is that organisers of events will comply with that advice. The First Minister was clear however that this advice may be reviewed and gatherings of fewer than 500 may be affected in due course.
As to the matter of social distancing for people over 70 apparently leaked to the press over the weekend, the First Minister was unequivocal. Scotland is not proposing anything different on this than the rest of the UK is. It is a policy that has been discussed at COBRA meetings – and will be discussed again later today. It is also possible that if one person in a household has symptoms and is self-isolating then all members of the household may be asked to do the same for a period of time. No decisions have been made about any of this as yet, nor have decisions been made about school closures. But there may be more news later this afternoon.
‘We are facing a highly complex and challenging situation. Regarding communication I am sure we will not always get it right but the intention here is to be as open and transparent as possible, so that together we can provide clear and responsible information to the public.”
First Minister, Nicola Sturgeon
The Chief Medical Officer explained that self isolation and social distancing are two different things, and if more draconian measures were to be taken then these might be required for at least three months to suppress this type of virus. This is partly the reason for delaying in taking the kind of decisions we have witnessed in Spain and Italy.
The government intends to give daily updates and briefings, both on camera and on the record, from today onwards. These will involve the First Minister, the Chief Medical Officer Dr Catherine Calderwood and Health Secretary Jeane Freeman or other government ministers as required.
The Health Secretary will also make statements to Holyrood which may replace a media briefing per se. (She will make a statement on Tuesday to Holyrood.) The purpose of the daily updates is to update the media on the spread of the infection ‘as we understand it in Scotland’ and measures being taken so that they can pass that on to the public.
The First Minister reminded all members of the press that they have an important role to play in scrutiny and accountability, which she unreservedly accepts. She also said: “You have a role to play in helping us to communicate important messages to the public in a responsible and measured way. I hope we can have a degree of working together in which we are as open and transparent with you to allow you to report that to the public.”
There will be a further briefing later on camera after the First Minister and others have joined the COBRA meeting by telephone.
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