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COVID-19 pandemic in Scotland

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COVID-19 pandemic in Scotland
COVID-19 outbreak Scotland per capita cases map.svg
Total confirmed cases map
COVID-19 Cases Map of Scotland.png
Nicolson Street in Edinburgh
John Finnie Street in Kilmarnock
West George Street in Glasgow
(clockwise from top)
Virus strainSARS-CoV-2
First caseTayside
Arrival date1 March 2020
(1 year)
OriginNorthern Italy (local)[1]
Wuhan, China (global)
Confirmed cases19,238 (total)[lower-roman 1][2][3]
326 (7 day total for 6-13 August)
Active cases250 [4]
Recovered4,184 (total)[5]
2,491 (PHS; tested positive)[6]
4,213 (NRS; death certificate)[7]
4,893 (NRS; excess deaths)[8]
Official website

The COVID-19 pandemic was first confirmed to have spread to Scotland on 1 March 2020 with the positive COVID-19 test of a male Tayside resident who had recently travelled between Scotland and northern Italy.[1] The first reported case of community transmission was on 11 March 2020 and the first reported coronavirus death in Scotland was on 13 March 2020.

The UK Government unveiled the Coronavirus Action Plan,[9] and declared the outbreak a "level 4 incident".[10] On 11 March, the outbreak was declared a pandemic.[11][12][13] Four days later—following the outbreak in Italy,[14][15] and based on forecasting by epidemiologists at Imperial College London[16]—the Scottish Government said everyone should avoid all "non-essential" travel and contact with others, also to work from home if possible. Those with symptoms, and their household, were asked to self-isolate. Pregnant women, the over 70s, and those with certain illnesses were asked to self-isolate for longer.[14] On 20 March 2020, schools were told to close, along with pubs, cafes and cinemas. On 23 March 2020, a 'Stay at Home' order was announced which lead to more 'non-essential' work to close and limiting movement to stop the transmission of the virus, this would be referred to as the UK lockdown.[17]

Health care in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own system of publicly funded healthcare, and each accountable to their own government and parliament (except England which is accountable to the UK government). As a result, a number of differences now exist between each system.[18][19] Although, the reporting of the virus transmission and the case data is collected in Scotland, it is also used in the UK figures given out daily which reports the situation in all four nations.

By 27 April, more than 22,000 former staff and students had volunteered to join or rejoin the healthcare and social care services in Scotland since the epidemic began,[20] signalling a significant re-organisation of health care services[21] By 9 May 2020 there had been 4,503 cumulative cases of suspected COVID-19 in care homes and up to 3,672 staff had reported as absent in adult care homes due to COVID-19, representing 8.5% of all adult care home staff (43,403) for whom figures had been provided.[22]

Since the start of the outbreak, Scotland has ramped testing from a capacity of less than 2000 tests a day to 8,000 per day by the middle of May.[23] Overall, by 11 May 2020 a total of 101,122 COVID-19 tests had been carried out by NHS Scotland labs in hospitals, care homes or the community. In addition there were a total of 27,647 drive through and mobile tests carried out by Regional Testing Centres in Scotland.[22]

By 20 May 2020, 14,969 cases of COVID-19 had been confirmed and 2,245 test-confirmed deaths had been reported. 4,175 suspected COVID-19 deaths were reported as of 8 July.[24] This data is from published reports of the National Records of Scotland.

Background[edit source | edit]

On 12 January, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei Province, China, who had initially come to the attention of the WHO on 31 December 2019.[25]

Unlike the SARS outbreak of 2003, the case fatality ratio for COVID-19 [26][27] has been much lower, but the transmission has been significantly greater, with a significant total death toll.[28][26]

On 24 January, the first tests for COVID-19 came back negative, with the then Chief Medical Officer Dr. Catherine Calderwood saying that the risk was low for the Scottish public, although acknowledged that cases would arrive at some point.[29] The first case was detected on 1 March and by 23 March, the country went into lockdown.

Timeline[edit source | edit]

Template:COVID-19 pandemic data/Scotland medical cases chart

January–February 2020[edit source | edit]

Kitchen roll and toilet paper sold out following panic buying in a supermarket in Morningside, Edinburgh.
  • 24 January: Five people were tested for COVID-19 in Scotland, all returning negative as an incident team was established for the disease.[30]
  • 10 February: 57 tests had been conducted (all negatives),[31] a figure which rose to 412 by 25 February.[32]
  • 22 February: COVID-19 was made into a "notifiable disease",[33] and a surveillance network involving 41 GP locations was established to submit samples of suspected patients, even if they had no travel history.[34]
  • 26-27 February: Nike holds a conference in Edinburgh, which 70 people attend.

March 2020[edit source | edit]

  • 1 March: The first confirmed case of COVID-19 in Scotland was detected in Tayside. The person had then recently travelled to Italy. At that time, since the outbreak began in Wuhan, there had been 698 tests resulting negative for the disease.[35]
  • 2 March: Health Protection Scotland was alerted by international authorities about a person, not from the UK, who tested positive after the Nike conference in late February. The public were not told.
  • 3 March: First person from the Nike conference tests positive. Public still not informed, but Scottish Ministers are now told.
  • 4 March: Two further cases were confirmed, one having travelled from Italy and the other having had contact with a known carrier.[36][37]
  • 5 March: Three further cases were confirmed, totalling to 5 cases[38]
  • 6 March: The number of confirmed cases double to 11.[39]
  • 9 March: Cases had more than doubled again to 23 cases out of 2,101 tests conducted.[40]
  • 11 March: First case of community transmission which wasn't linked to travel or confirmed cases. [41]
  • 13 March: The first death from COVID-19 in Scotland was confirmed, of an elderly patient with underlying health conditions. At the time, 85 cases of the disease had been confirmed out of 3,314 tests conducted.[42]
  • 16 March: 171 cases had been confirmed from 4,895 tests, with positive cases being reported by all health boards of NHS Scotland except in NHS Orkney and NHS Western Isles.[43]
  • 20 March: The Scottish Government told cafes, pubs, and restaurants to close.[44][lower-roman 2]
  • 23 March: With the UK death toll hitting 335 deaths and 14 in Scotland, Boris Johnson announced a nationwide 'Stay at Home' order would come into effect as of midnight and it would be reviewed every 3 weeks.[17] Former CMO Catherine Calderwood said, "This is no longer a rehearsal for something that might happen."[45] This would become known as the UK lockdown.
  • 24 March: 16 patients with confirmed cases of COVID-19 had died.[3] Approximately 0.17% of the population had been tested as of 23 March 2020. However those showing symptoms were advised to stay at home and were still not being tested.[citation needed]
  • 25 March: The First Minister confirmed that the Scottish Government was establishing a COVID-19 Advisory group to supplement the advice it was receiving from the UK-wide Scientific Advisory Group on Emergencies. It was to be chaired by Professor Andrew Morris of Edinburgh University, the Director of Health Research UK, with support from vice chair David Crossman, who is the Dean of Medicine at the University of St Andrews and Chief Scientific Advisor for Health at the Scottish Government [46]
  • 26 March: It was announced that 25 deaths had been reported, with 896 confirmed cases in Scotland.[47]
  • 31 March: two cases in NHS Western Isles and one in NHS Orkney mean that COVID-19 cases have now been recorded in all of Scotland's health board areas.[48]

April 2020[edit source | edit]

Glasgow. Argyle Street during coronavirus lockdown, one of the main shopping streets in the city centre. 7 April 2020.
  • 1 April: Confirmed Cases of COVID-19 passed 2000 across the country, with 76 deaths in hospitals. The Scottish Government announced 3,500 tests a day by the end of the month and construction started on the SEC in Glasgow to become NHS Louisa Jordan which would hold 300 beds, expandable to 1,000. [49][50]
  • 5 April: Despite initially saying she would stay in office, Scotland's chief medical officer, Dr Catherine Calderwood, resigned after making two trips to her second home, breaking the coronavirus lockdown she and First Minister Sturgeon had encouraged.[51]
  • 6 April: The Coronavirus (Scotland) Act 2020 which was introduced as an Emergency Bill in the Scottish Parliament on 31 March 2020 gained Royal Assent, becoming law.
  • 7 April: The Scottish Government announced that 12,000 nursing and midwifery students from across the country and returning workers who had worked in the Health and Social Care sector had signed up to join the NHS workforce to help fight COVID-19, Chief Nursing Officer Fiona McQueen said, "I want to thank each and every student who has volunteered their support so far." In addition, 2,000 final year students had already joined the workforce since the call for help was sent out. [52]
  • 16 April: After reviewing the lockdown with all nations in the UK, the decision was made to extend it for another 3 weeks until the 7 May. First Minister Nicola Sturgeon in her daily briefing said, ". . . I want to stress that the news is positive . . . Early indications are that the lockdown restrictions have resulted in a slowing down in the rate of community transmission of the virus." [53]
  • 20 April: NHS Louisa Jordan in Glasgow opened as confirmed cases passed 8,400 with 915 fatalities in hospitals. [54]
  • 22 April: The National Records of Scotland (NRS) released data up to 19 April. The number of deaths in Scotland was up 80% above the 5-year average. 537 deaths had been recorded in care homes, double the number of the previous week, 910 deaths had been recorded in hospitals, and 168 deaths in homes or other settings. Public Health Scotland's daily figures were under-counting deaths by up to 40%.[lower-roman 3] as it was reporting deaths in hospitals only.[55]
  • 25 April: Confirmed cases surpassed 10,000.
  • 28 April: First Minister Nicola Sturgeon advised the voluntary use of (non-medical grade) cloth face masks to be used in enclosed spaces such as shops and public transport, but not generally in public, excluding those who are under two years old or who have respiratory illnesses such as asthma. However, Sturgeon noted their limitation and said that co-operation with the face mask guidance was voluntary.[56]

May 2020[edit source | edit]

  • 1 May: Confirmed cases of COVID-19 passed 11,500 across the country, with 1515 deaths in hospitals. The Scottish Government announced that it had reached its testing goal of 3,500 tests a day in NHS labs laid out in April with 4,661 tests carried out on 30 April. They also announced that their next target was 8,000 tests a day in NHS labs across Scotland by Mid-May.[57]
  • 8 May: First Minister Nicola Sturgeon reported that there was some recognition that each of the four nations of the UK might move at different speeds with regard to loosening the lockdown and that she would not be pressured into lifting restrictions prematurely. [58]
  • 9 May: The Scottish Ambulance Service (SAS) made 242 attendances for suspected COVID-19, and took 157 people to hospital with suspected COVID-19.[22]
  • 10 May: Prime Minister Boris Johnson unveiled an exit strategy and an easing of the lockdown rules in England. First Minister Nicola Sturgeon in her daily briefing criticised the government for their new slogan, 'Stay Alert, Control the Virus, Save Lives' saying it wasn't clear and she asked the UK Government not to promote their ‘Stay Alert’ advertising campaign in Scotland. Sturgeon eased exercising outside to more than once a day but the public would still have to maintain social distancing at all times. She also stressed leisure activities such as sunbathing, picnics and barbecues were still prohibited. [59]
  • 11 May: In a national address to Scotland on the beginning of the seventh week of lockdown, Nicola Sturgeon asked the nation "to stick with lockdown for a bit longer - so that we can consolidate our progress, not jeopardise it[…] I won't risk unnecessary deaths by acting rashly or prematurely." This marked the moment when the four nations of the UK took different strategies on handling lockdown and lifting it eventually, with Wales and Northern Ireland also continuing the 'Stay at Home' slogan. England adopted the slogan 'Stay Alert' and began to lift restrictions.[60] The public were finally told about the Nike conference outbreak in a BBC documentary, the Scottish Government are still to give more details.
  • 17 May: It was exposed that 10 Nike delegates from the conference were taken for a kilt fitting, during which a woman was infected by them.
  • 18 May: Anyone aged 5 or over, presenting symptoms of COVID-19 became eligible to get tested and Anosmia was added to the COVID-19 symptom list.[61][62] Nicola Sturgeon announced her plans to begin easing lockdown from 28 May and a roadmap will be published on 21 May.[63]
  • 19 May: More information about the Nike conference comes out from the BBC and Sky News, showing that none of the people the Nike delegates were in contact with were approached for testing or support, including the 20 Lloyd's Banking Group employees they shared facilities with. The Nike delegates were taken on a walking tour of Edinburgh, the tour guides were not traced, tested or informed.
  • 21 May: First Minister Nicola Sturgeon outlined a four-phase "route map" for easing lockdown restrictions in Scotland that included allowing people to meet up outside with people from one other household in the first phase. The lockdown would be eased from 28 May subject to the number of new cases of COVID-19 continuing to fall.[64] Schools in Scotland would reopen on 11 August, when students would receive a "blended model" of part-time study at school combined with some learning at home.[65]
  • 24 May: Two Dutch employees attended the Nike conference, one of which is believed to have been the cause of the shutdown of the HQ in the Netherlands. The Nike conference is proven to have started the outbreak in the North-East of England, as one of the delegates was infected and went to a birthday party and infected more people.
  • 28 May: First Minister Nicola Sturgeon announced an easing of the lockdown in Scotland from the following day, with people able to meet friends and family outside in groups of no more than eight but keeping two metres apart.[66]

June 2020[edit source | edit]

  • 8 June: A route map for easing restrictions was published by the Scottish Government.[67]
  • 19 June: Some easing of lockdown restrictions with meeting outdoors of up to 8 people from two other households whilst maintaining social distancing, for single people or singles with children they may meet with another household indoors without social distancing. Face coverings mandatory on public transport. Exercise within 5 miles of home.[68]
  • 29 June: Further easing of lockdown with indoor workplaces allowed to open, street access retail and outdoor markets opening, outdoor sports playgrounds, zoos and parks open, outdoor marriages allowed and people can move house. All with social distancing.[69]

July 2020[edit source | edit]

  • 3 July: The 5 mile travel ban is lifted, self contained holiday accommodation may re-open for business, visits to care homes by one "key visitor" are permitted but meetings must be outdoors and a 2m distance maintained, young people under 12 do not need to social distance and 12-17 year olds may meet in groups of up to 8 people provided social distancing is maintained. Beer gardens and outdoor cafe's can open from 6 July.[70] It will be compulsory to wear face coverings in shops from 10th July. [71]
  • 10 July: Air Bridge system starts which will not require self isolation for people returning from any of 57 countries, similar to, but less than the list of Air Bridges from England and Wales.[72] Up to 15 people from five different households may meet outdoors whilst maintaining 2m social distancing, up to 8 people from three households may meet indoors and people from outside a household may stay overnight.[73]

August 2020[edit source | edit]

  • 11 August: Pupils return to schools. They do not need to socially distance but teachers have to wear masks if they are in close proximity of others and socially distance from each other.
  • 20 August: 77 new cases were recorded in the past 24 hours - the highest amount for nearly 3 months.

Government response plan[edit source | edit]

Key government officials
Nicola Sturgeon
First Minister of Scotland
Jeane Freeman
Cabinet Secretary for Health
Joe FitzPatrick
Minister for Public Health
Professor Jason Leitch
National Clinical Director

The main coordinating bodies responsible for Scotland's coronavirus response is the Scottish Government Resilience Division and the COVID Health Response Directorate of the Health and Social Care Directorates. On 25 March the Scottish Government set up an expert advisory group to help develop and improve its COVID-19 response plan. [74] Dr Catherine Calderwood was Chief Medical Officer until her resignation from the post on 5 April. Nicola Sturgeon accepted her resignation on 5 April, and replaced Calderwood on an acting basis with the Deputy Chief Medical Officer, Dr Gregor Smith. As of 12 May, the Key Scottish Government officials in Scotland leading the response to the outbreak are:

Containment measures[edit source | edit]

File:Glasgow. "Fear and Love".Graffiti by The Rebel Bear.DSC 1676..JPG
Glasgow. Graffiti in the time of pandemic COVID-19.

Workplace hygiene advice was published on 9 March 2020 which included routine deep cleaning in regularly used touch points such as phones, card machines or door handles.[75] Later, the First Minister Nicola Sturgeon announced a ban on mass gatherings (500 or more) on 12 March, with the ban starting on 16 March.[76] A number of schools were closed due to reported symptoms, and underwent deep cleaning.[77] On 18 March, it was announced that schools in Scotland would be closed starting on 20 March.[78]

Public Health Scotland[edit source | edit]

On 1 April 2020, the Scottish Government launched the new Public Health Scotland (PHS) agency, as a result of a three-way merger between NHS Health Scotland and the Information Services Division (ISD) and Health Protection Scotland (HPS) sections of Public Health and Intelligence (PHI) (which was in itself a strategic business unit of NHS National Services Scotland (NSS)).[79] According to a 6 May 2020 report by the Press and Journal, PHS employs 1,100 staff and has a budget this year of £71 million, and it is jointly accountable to the Scottish Government and the Convention of Scottish Local Authorities (Cosla).[80]

'Scotland Cares' campaign[edit source | edit]

A new 'Scotland Cares' campaign was launched on Monday 30 March to encourage people to volunteer during the coronavirus (COVID-19) pandemic. More than 21,000 people signed up on the first day. By 4 April, the number of registrations to volunteer stood at 50,330. Cabinet Secretary for Social Security and Older People Shirley-Anne Somerville said, "The response to the Scotland Cares campaign has been outstanding and I want to thank each and every person who has signed up to volunteer during the coronavirus outbreak. Your support at this critical time is invaluable and will make a huge difference over the coming weeks and months."[81][82] In addition, people who are healthy and not at risk can volunteer via the Ready Scotland website.[83]

Vulnerable groups[edit source | edit]

Mailed information about COVID-19, from First Minister

Those in vulnerable groups were able from 3 April to register for deliveries of food and medicine. This included around 120,000 people in Scotland who had been advised to shield[84] at home (12 weeks of self-isolation), those with suppressed or compromised immune systems, and those with underlying health conditions. The Scottish Government mailed out information about self-isolating if symptoms developed in a household member and about protective measures during the pandemic.[85]

Testing and contact tracing[edit source | edit]

Testing capacity[edit source | edit]

For further information, see COVID-19 testing

NHS Scotland's testing capacity for COVID-19 increased from around 750 a day in early March[86] to about 1,900 a day in early April.[87]

By 15 March coronavirus testing was extended into Scotland's communities but there would be no routine testing of people with minor symptoms.[88]

NHS Scotland plans to reach a testing capacity of around 3,500 a day by the end of April.[89][90]

Glasgow University is to launch a major coronavirus testing facility in mid-April, staffed 24/7 by more than 500 volunteers including molecular scientists, technicians and bioinformaticians.

Aberdeen University has provided three machines to NHS Grampian to speed up coronavirus testing.[91]

By 2 April 2020, around 3,500 tests have been conducted on NHS workers and family members in Scotland. It was also reported in that week that around 6pc of Scotland's frontline NHS staff are not currently working, either because they have coronavirus symptoms or live with someone who has.[92] A coronavirus testing facility for NHS staff was opened at Glasgow Airport car park on 5 April.[93]

Chief Medical Officer for Scotland Catherine Calderwood described mass testing as a distraction that will not slow down the spread of the virus. She said: "I have been saying and advising the First Minister and the Cabinet Secretary for several weeks now about the distraction that I think the focus on testing may become. The testing is extremely useful but it is only going to be positive within a short window of perhaps 48 to 72 hours while somebody has symptoms, because there needs to be an amount of virus in that person to be able for that to be detected. But the thought that the testing in some way slows the virus or is a part of our strategy to prevent transmission is a fallacy, I'm afraid. The testing gives us more information but the social distancing and all of these stringent measures are what we actually need to prevent spread and prevent serious illnesses and death."[94][92]

Cam Donaldson, a health economist and Pro Vice Chancellor Research, Glasgow Caledonian University has written of his scepticism of a "mass testing" strategy.[95]

Derek Gatherer a leading Scottish virologist has warned plans to test, trace and isolate everyone infected with the coronavirus after lockdown will not slow its spread.[96](subscription required)

Experts who have advocated a mass or large scale testing approach include Harry Burns former Scotland Chief Medical Officer[97](subscription required) and Allan Wilson President of the Institute of Biomedical Science[98]

Professor Hugh Pennington one of the leading bacteriologists said laboratory testing could have been easily scaled up ten-fold and criticised former chief medical officer Catherine Calderwood for dismissing testing as a 'distraction' that would not help to contain the virus. Pennington believed a failure to increase testing to adequate levels will prove to be an enormous embarrassment to the UK and Scottish governments. He said: "You test, so you can trace then take appropriate action, it's basic shoe leather epidemiology," adding he would not be surprised if the lack of testing had cost lives, particularly in care homes. "We know [care homes] are hotbeds of infection, vulnerable in annual flu outbreaks and that you have to look after them by stopping the virus getting in. Much of that comes back to testing, tracing and isolating."

Former Scottish health secretary Alex Neil agreed, "the countries that have done this since day one are those with the lowest death and infection rates and mass testing allows you to identify a second wave of infection if it appears."[99]

Professor of Immunology Denis Kinane said Scotland would need to conduct at least 15,000 tests a day to get on top of the disease.

Research carried out by scientific online publication Our World In Data on COVID-19 test rates across EU member states ranked Scotland at 19 out of 25 countries that publish such data.[99]

As of 11 May 2020, [22] a total of 74,063 people in Scotland had been tested for COVID-19 in NHS labs. Of these, 13,627 tests were confirmed positive, 60,436 tests were confirmed negative and 1,862 patients who tested positive have died. A total of 101,122 COVID-19 tests had been carried out by NHS Scotland labs in hospitals, care homes or the community. In addition there were a total of 27,647 drive through and mobile tests carried out by Regional Testing Centres in Scotland.

Contact tracing system[edit source | edit]

Ciaran Jenkins of Channel 4 News contrasted the differing approaches on contact-tracing strategy between the Republic of Ireland and the health authorities in the UK including Scotland's.[100][101]

Public health expert Prof Allyson Pollock has argued that a bespoke test-trace-isolate approach could work well in Scottish island communities[102]

Public healthcare infrastructure[edit source | edit]

Primary care network[edit source | edit]

Health Secretary Jeane Freeman said in a statement in the Scottish Parliament a network of COVID-19 local assessment centres was to be set up across Scotland with 50 planned in the first wave.[103][104][105][106] A network of "humanitarian assistance centres" is also to be set up, working with GPs and other local partners to arrange delivery of medicine, care services and grocery delivery.[107]

Hospital capacity[edit source | edit]

Scotland has an estimated 3,000 hospital beds expected to be available for coronavirus patients in hospitals across Scotland.[87]

ICU capacity across Scotland has doubled to 360 beds since the emergency began, 250 of which will be for the exclusive use of coronavirus patients, with that number expected to increase to more than 500 in the first week of April as preparations continue towards eventually quadrupling the number to more than 700 ICU beds.[87][needs update]

The NHS Louisa Jordan emergency coronavirus hospital facility at the SEC Centre will initially have capacity for 300 patients, which could be expanded in the future to more than 1,000.[87]

Scottish hospitals plan to have around 1,000 ventilators by the summer for coronavirus patients.[108]

By 1 April 2020, NHS clinical and technical staff have converted over 200 anaesthetic machines into ventilators to increase ICU bed availability to more than 500, tripling the usual capacity.[109]

By 24 March more than 3,000 retired Scottish nurses, doctors and other medical workers have volunteered to return to work as part of efforts to help the NHS cope. As well as using retired workers, all final year nursing and midwifery students will also be given paid work placements on wards during the final six months of their degree programmes.[110]

On 30 March, First Minister Nicola Sturgeon announced the suspension of several non-coronavirus screens (such as diabetic eye screening) to help free up NHS staff and reduce the risk of virus exposure to patients. All elective and non-urgent surgeries had already been cancelled across Scotland to free up hospital beds.[111]

On 27 April 121 junior doctors have started their careers early to support NHS Greater Glasgow and Clyde Scotland's largest health board in its coronavirus response. A new post, foundation intermediate year, was created to allow them to start earlier instead of August and they would be placed at Glasgow Royal Infirmary; Queen Elizabeth University Hospital; Royal Alexandra Hospital, Paisley; and Inverclyde Royal Hospital, Greenock.[112]

As of 11 May 2020, [22] 3,114 inpatients have been discharged from Scottish hospitals since 5 March 2020, who had been tested positive for COVID-19. 632 people are in delayed discharge in Scottish hospitals. This is 980 less than the baseline period (04/03 weekly return). A total of 6,227 staff (or around 3.8%) of the NHS Scotland workforce, are reporting as absent due to a range of COVID-19 related reasons.

Hospital-acquired infection[edit source | edit]

On the issue of hospital-acquired infections, Michael Griffin, president of the Royal College of Surgeons of Edinburgh warned coronavirus may be spreading in hospitals at twice the rate of its transmission in communities.[113] He said "we have to make our hospital environment as safe as possible. In the general population, the rate of reproduction of COVID-19 is less than one but in hospitals it is estimated at something like two."

A&E departments[edit source | edit]

The number of people attending Accident and Emergency departments in Scotland has fallen by more than 55% compared with 2019. NHS Scotland statistics reveal 11,881 people attended A&E in the second week of April 2020, down from 26,674 patients in 2019 and 25,067 in 2018.[113]

NHS staffing levels[edit source | edit]

As of 2 April, more than 14% of NHS Scotland staff were off work, according to Scottish government data and about 41% of those absences (equating to 9,719 people) were related to coronavirus. NHS Scotland's total workforce is about 166,000 people.[114]

As of 11 May 2020, [22] a total of 6,227 staff (or around 3.8%) of the NHS Scotland workforce, are reporting as absent due to a range of COVID-19 related reasons.

Personal protective equipment[edit source | edit]

On 2 April, new guidance on appropriate personal protective equipment (PPE) for healthcare hospital, general practice, ambulance and social care workers responding to COVID-19 has been issued by officials.[115]

On 26 April 2020, in response to a Sunday Times story that claimed the Scottish government failed to accept offers from six Scottish firms offering to supply PPE, a spokeswoman for the Scottish government said it had received 1,600 offers of help from Scottish businesses and individuals to supply or manufacture PPE and that a dedicated team and mailbox had been set up to focus on offers from local and global suppliers. The spokeswoman added: "we understand that potential suppliers will desire prompt decisions but our priority focus is to quickly identify those offers that can supply the largest volumes at the correct quality specifications and timescales necessary to meet the requirements of frontline services".[116]

Health secretary Jeane Freeman announced that PPE would be available to social care providers through a national network of hubs from 27 April 2020.[99]

Dundee University Professor of vascular medicine Jill Belch has spearheaded a Masks for Scotland six-figure fundraising drive to buy PPE for frontline workers.

Clinical research[edit source | edit]

Organisations in Scotland involved in COVID-19 related clinical research studies[117] include the Chief Scientist Office's Rapid Research in COVID-19 programme (RARC-19 programme),[118] Health Science Scotland, NHS Research Scotland,[119] Glasgow University,[120] Dundee University,[121][122][123] Edinburgh University.[124]

As of 22 April chief medical officer Dr Gregor Smith said nearly 800 patients have so far taken part in at least 10 clinical studies to develop coronavirus treatments, with another four being set up in hospitals, intensive care units and primary care facilities. One study is looking at whether existing HIV drugs including Lopinavir and Ritonavir could be used with results available in three months. Another study led by Dr Kenneth Baillie of Edinburgh University looks at the genetics of patients susceptible to severe illness by comparing patients' DNA with that of healthy people who show no or mild symptoms.

Dundee University is to lead a trial into brensocatib (formerly known as INS1007) a drug for lung inflammation (acute respiratory distress syndrome) to treat the worst symptoms of coronavirus and prevent the need for ventilation. Up to 20% of COVID-19 patients develop lung inflammation which can require them to be ventilated. The inflammatory response to the virus causes lung damage that can lead to respiratory failure and death in severe cases. It is hoped the treatment will also lead to patients spending fewer days dependent on oxygen and shorter periods of time in hospital, reducing the burden on healthcare systems. Funding and drug supply for the STOP-COVID19 (Superiority Trial of Protease Inhibition in COVID-19) trial is being provided by biopharmaceutical company Insmed Incorporated. The trial is to start in May and researchers plan to recruit 300 volunteers from 10 hospitals. The project is led by James Chalmers, professor of respiratory research at Dundee University and consultant respiratory physician at Ninewells Hospital, one of the trial sites. NHS Tayside research and development director Professor Jacob George is the study investigator.

Impacts[edit source | edit]

Care homes[edit source | edit]

The Guardian's Libby Brooks reported that extra supplies of personal protective equipment (PPE) would be delivered directly to more than 1,000 care homes in Scotland.[when?]

Before the pandemic the care sector usually sourced its own PPE, but as extreme pressure was put on supply chains concerns grew that PPE manufacturers did not have capacity to deliver to Scotland in adequate quantities.

The Scottish government announced on 17/18 April that the NHS National Services Scotland would prioritise the delivery of stock directly to care homes where the virus is known to be present, although stock would still be provided to local hubs which supply PPE to other social care workers. [125]

Two of the worst suspected outbreaks in care homes occurred at Elderslie care home in Paisley, Renfrewshire and at Berelands House Care in Prestwick, Ayrshire.[126]

Thirteen residents at the Glasgow-based Burlington Care Home died in one week following a suspected outbreak of coronavirus. The Care Inspectorate has been made aware of the deaths and are in contact with the care service, as well as the local health and social care partnership.[127]

As of 10 May 2020,[22] 474 (44% of all) adult care homes had a current suspected COVID-19 case. This is a care home where at least one care home resident has exhibited symptoms during the last 14 days. 609 (or 56% of all) adult care homes in Scotland had reported at least one notification for suspected COVID-19 to the Care Inspectorate. 434 of these care homes have reported more than one case of suspected COVID-19. There have been 4,503 cumulative cases of suspected COVID-19 in care homes. This is an increase of 58 suspected cases on the previous day. 3,672 staff were reported as absent in adult care homes due to COVID-19, based on returns received from 822 (76%) adult care homes as of 5 May. This represents 8.5% of all adult care home staff (43,403) for whom a return was provided.

Construction[edit source | edit]

Royal Institute of Chartered Surveyors (RICS) said its headline statistic for workloads in Scotland fell into negative territory for the first time in four years, dropping by 4% in the first three months of 2020. Its quarterly survey of members found confidence fell sharply when the lockdown measures were introduced.

In Scotland, work was ordered to be suspended on all non-essential construction projects from 6 April.[128] By 17 April 79% of all housebuilding schemes had been suspended (according to a Glenigan survey of projects with a construction value of more than £250,000).[129]

Education[edit source | edit]

As of 19 March 2020, the Robert Gordon University, Edinburgh Napier University, the University of Dundee, the University of Glasgow, University of the West of Scotland, Glasgow Caledonian University, the University of Aberdeen, Edinburgh University, Heriot-Watt University, University of Stirling and University of Strathclyde had cancelled or suspended face-to-face classes. Scottish political parties (Green, Conservatives, SNP) also cancelled their spring conferences.[130]

Events[edit source | edit]

In early March, with Rangers vs Leverkusen being the last game played in Scotland on 12th March, football matches in the Scottish Professional Football League were cancelled until further notice, alongside a Six Nations game between Wales and Scotland. Radio 1's Big Weekend, which was due to take place in Dundee in May 2020 was cancelled in response to the outbreak.[130] On 7 May, The Royal National Mòd Inverness, scheduled for October was postponed to 2021. The next three Mods were also to the subsequent year.[131]

GDP[edit source | edit]

The Scottish Government's Chief Economist Gary Gillespie said Scotland's GDP could fall by as much as 33% from the lockdown crisis.

Police, court and prison systems[edit source | edit]

Scottish Police Federation (SPF) claimed new PPE for officers would not provide any “meaningful protection”, after Police Scotland announced staff would be given surgical face masks to wear when adhering to social distancing measures was not possible. But the SPF said that its new expert pandemic response panel refused to endorse the type two masks.[125]

From 27 March to 24 April 2020, police officers have made 78 arrests and issued 1,637 fixed penalty notices in Scotland related to lockdown violations.[132]

On 2 April, BBC Scotland said it found almost a quarter of Scottish Prison Service staff are absent from work amid the coronavirus outbreak. The SPS said 110 prisoners over 11 sites were self-isolating. At that time, two had tested positive for COVID-19.[133]

The first recorded coronavirus-related death of a Scottish prison officer was announced on 22 April. SPS spokesman Tom Fox confirmed where appropriate all prison officers are provided with PPE. It is not believed that the officer caught the virus while at work.

As of 23 April 94 people in custody across nine sites are self-isolating, 12 people have tested positive and staff absences are at 19.7% of the workforce.

The Scottish Courts and Tribunal Service has consolidated its work into 10 hub sheriff courts with as much work as possible done remotely.

It is estimated 300 to 450 prisoners will be released in phases starting at the end of April, and around 1,600 trials could be delayed if lockdown restrictions continue into the summer.

Deputy chief constable Will Kerr said the number of people in police custody has been significantly down during the pandemic and said changes during the lockdown such as virtual courts and digital evidence have helped minimise contact and time spent in custody and could be retained once the pandemic is over.

Retail[edit source | edit]

Retail sales in Scotland for March 2020 declined 13% in comparison to March 2019 Scottish Retail Consortium-KPMG Scottish Retail Monitor. Pre-lockdown the monitor recorded a 9% growth in the first three weeks of March but this was followed by a 44% decline in the last two weeks of that period. Total food sales were up 12.1% against the previous year while total non-food sales were down 33.6%. Adjusted for the estimated effect of online sales, total non-food sales decreased by 27.9%.[134]

Scottish Parliament[edit source | edit]

To comply with physical distancing rules, MSPs meet remotely by video link and have formalised virtual committee meetings during the pandemic.

On 23 April, a new dedicated Scottish parliamentary scrutiny committee on COVID-19 was created to question and report on the government's response, including its approach on PPE distribution, testing strategies, care home infection control procedures, and the management of a possible second wave of infections.

On 28 April 2020, Professor Hugh Pennington gave evidence to the Scottish Parliament's health committee by video link saying he did not think an effective coronavirus vaccine would be found and criticised the low number of tests that have been carried out. He said mass testing could and should have been rolled out faster and more effectively: "Prevention is the absolute paramount thing. The only way we know where the virus is by testing. And we have a very good test. We could have done a lot more to get that test rolling in many, many centres. We had the test, but we didn't use all the facilities available - not just in public health or NHS laboratories, but in research institutes and universities." And he said lessons must be learned for future virus outbreaks, warning: "There will be other pandemics. If we don't spend the money to have the capacity to cope with them then we'll have the same issues we're having now with COVID-19."[135]

Social security[edit source | edit]

During March and early April, there were around 110,000 Universal Credit claims in Scotland, up from an average of 20,000 a month in 2019.

Citizens Advice Scotland provides help to those who experience difficulties navigating the complex welfare system.

Transport[edit source | edit]

Glasgow Taxi Owners' Association urged taxi drivers to be careful during the ongoing COVID-19 pandemic, after hearing reports of drivers falling ill.[136] Chief Nursing Officer Fiona McQueen said good hand hygiene is vital along with physical distancing and wearing face coverings when in enclosed spaces such as shops and public transport.[137][138]

Statistics[edit source | edit]

Total cases and deaths[edit source | edit]

New cases per day[edit source | edit]

New cases per week[edit source | edit]

Cumulative cases by region[edit source | edit]

See also[edit source | edit]

Notes[edit source | edit]

  1. Cumulative total who have tested positive (as of 13 August 2020)
  2. This wasn't limited to these 3 establishments, also told to close was:
    • Nightclubs and other drinking establishments
    • Cinemas, theatres and bingo halls and concert halls
    • Spas, wellness centres and massage parlours
    • Casinos and betting shops
    • Indoor leisure facilities such as gyms and swimming pools
  3. Deaths in Scotland with COVID-19 mentioned as a cause:
    • 910 in hospitals (57%)
    • 537 in care homes (33%)
    • 168 in homes and other settings (10%)

References[edit source | edit]

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External links[edit source | edit]

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