COVID-19 pandemic in Scotland
The COVID-19 pandemic in Scotland is part of the COVID-19 pandemic of coronavirus disease-2019, caused by the virus SARS-CoV-2. The first case of COVID-19 was confirmed in Scotland on 1 March 2020.[1] Community transmission was first reported on 11 March 2020, and the first confirmed death was on 13 March 2020.
For the COVID-19 pandemic in the UK as a whole, see COVID-19 pandemic in the United Kingdom.COVID-19 pandemic in Scotland
19 February 2020[2]
- 264 (active, as of 28 March 2021)
- 24,012 (total, up to 28 March 2021)
- 22 (active, as of 28 March 2021)
- 1,870 (total, up to 28 March 2021)
14,917 (total, up to 28 March 2021)[6]
- 7,584 (deaths within 28 days of positive test, up to 28 March 2021)
- 10,078 (deaths with COVID-19 on the death certificate by date of death, up to 25 April 2021)
- 137.6 (death rate per 100,000 who died within 28 days of the first positive test)
- 177.7 (death rate per 100,000 whose death certificate mentioned COVID-19)
COVID-19 became a notifiable disease in Scotland on 22 February 2020. The first cases were detected in Scotland in the following weeks. By 16 March and following the outbreak in Italy,[7][8] and based on forecasting by epidemiologists at Imperial College London[9]—the Scottish Government advised the public to avoid all "non-essential" travel and contact with others, and to remote work 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.[7] 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; this would come to be referred to as the UK lockdown.[10]
COVID-19 policies in Scotland began to diverge with those elsewhere in the UK as the first lockdown was lifted starting in April 2020. The Scottish government pursued a zero-COVID strategy aiming to eliminate the virus entirely in 2020, lifted lockdown rules more gradually than the rest of the country, and expanded testing capacity.[11][12] Personal protective equipment supplies and guidance were major issues early in the outbreak. A four-tier restriction system that applied to different regions of Scotland came into force later in 2020, and a lockdown applying to the whole country applied from early 2021 as the Alpha variant spread from elsewhere in the UK. A vaccination programme began in December 2020. As many restrictions were lifted later in 2021, the Delta variant and Omicron variant have since posed further challenges and prompted responses in Scotland.
Scottish healthcare service capacity was substantially reorganised in response to the outbreak[13] and clinical studies into COVID-19 have also taken place in the country.
The pandemic has had major impact across Scottish society. Care homes and healthcare were directly affected by the spread of the disease. Beyond that, it has caused major disruptions to education, law enforcement, and economic activities.
Background[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.[14] On 11 March 2020, the outbreak was declared a pandemic.[15][16][17]
Unlike the SARS outbreak of 2003, the case fatality ratio for COVID-19 [18][19] has been much lower, but the transmission has been significantly greater, with a significant total death toll.[20][18]
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.[21] The first case was detected on 1 March and by 23 March, the country went into lockdown.
Public healthcare infrastructure[edit]
Primary care network[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.[175][176][177][178] 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.[179]
Hospital capacity[edit]
Scotland has an estimated 3,000 hospital beds expected to be available for COVID-19 patients in hospitals across Scotland.[156]
ICU capacity across Scotland has doubled to 360 beds since the emergency began, 250 of which will be for the exclusive use of COVID-19 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.[156]
The NHS Louisa Jordan emergency COVID-19 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.[156]
Scottish hospitals plan to have around 1,000 ventilators by the summer for COVID-19 patients.[180]
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.[181]
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.[182]
On 30 March, First Minister Nicola Sturgeon announced the suspension of several non-COVID-19 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.[183]
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 COVID-19 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.[184]
As of 11 May 2020,[57] 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]
On the issue of hospital-acquired infections, Michael Griffin, president of the Royal College of Surgeons of Edinburgh warned COVID-19 may be spreading in hospitals at twice the rate of its transmission in communities.[185] 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]
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.[185]
NHS staffing levels[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 COVID-19. NHS Scotland's total workforce is about 166,000 people.[186]
As of 11 May 2020,[57] 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]
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.[187]
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".[188]
Health secretary Jeane Freeman announced that PPE would be available to social care providers through a national network of hubs from 27 April 2020.[168]
Also in April 2020 whistle-blowers in the NHS came forward to reveal that staff were being made to reuse dirty personal protective equipment (PPE) while at work. One nurse told STV, "[When we hear the government say supplies are fine] it's not frustrating, it's crushing. It is absolutely crushing. We feel we are being lied to."[189] Sturgeon told the Scottish Parliament in July, "At no point within this crisis has Scotland run out of any aspect of PPE. We have worked hard to make sure that supplies are there, we've worked hard overcoming challenges that we have faced along the way."[190]
A fundraising drive to buy PPE for frontline workers under the name of 'Masks for Scotland' was spearheaded by Dundee University Professor of vascular medicine Jill Belch.[191]