Easing lockdown

Without much more regular testing, steps to ease lockdown are still making a journey into the unknown, claims Alison Johnstone.

There was a collective sigh of relief on Sunday at the news that for the first time since the start of the coronavirus outbreak, Scotland had recorded no deaths from the virus in a 24-hour period.

But before we start making plans to get together with friends and family again, there are good reasons why we need to continue to act with great caution. Because while this was welcome news indeed, it comes with some fairly sizeable caveats.

The daily figures announced by the First Minister or Health Secretary only include deaths from those who have been tested positive for COVID-19. Because so few people in Scotland have been tested for infection, we must wait for excess mortality statistics or the NRS figures which show all deaths which mention COVID-19 on the death certificate before we can get the full picture.

If that sounds confusing, it’s because there is a distinct lack of clarity about the real impact of COVID in healthcare settings and our communities. At the weekend it emerged that a total of 908 patients who had been in hospital for other reasons had acquired the infection and 218 of them have died.

The evidence that hospitals, like care homes, can be places where the virus spreads quickly has been well known since before coronavirus reached these shores. It’s why on March 16 the World Health Organisation (WHO) head Tedros Adhanom Ghebreyesus said there had not been an urgent enough escalation in testing, isolation and contact tracing.

“We have a simple message for all countries: test, test, test,” he said. I’ve been pushing the Scottish Government to take this on board ever since.

Sadly, this pandemic has seen Scotland and the UK report some of the worst death rates in the world. Ten of thousands of families are grieving at the loss of a loved one, often denied the rituals that help us share and come to terms with this grief such as a funeral or wake.

It is a source of frustration that from the beginning both governments have been slow to act with the urgency required, when the WHO has been clear and consistent throughout.

My questions of government are longstanding. I first proposed introducing regular testing for all health and social care frontline staff over five weeks ago and it was backed by the Royal College of Nursing and the Royal College of Emergency Medicine. Frontline staff are still contacting me to say how vital this is.

The Health Secretary finally confirmed this for care home staff more than two weeks ago. Scotland has built a greater capacity to test, but for those five weeks since I wrote to ministers, only around half of the capacity has been used, in spite of enormous demand and when those working on the front line are crying out for more testing.

Clearly the UK Government’s ‘drive-through’ testing centres, which are mostly located at Scotland’s biggest airports, are not appropriate for those who don’t drive or have just worked a 12-hour shift on the front line.

It beggars belief that regular and routine testing of those on the front line in the fight against COVID-19 still isn’t happening, when we know the virus is at great risk of spreading in our care homes and hospitals. Concerns also remain about which PPE is appropriate in different settings, and whether what is being used will be effective. Where is the urgency so clearly requested by Tedros Adhanom Ghebreyesus in March?

If lockdown restrictions are to be lifted safely, it’s vital we have a clear picture of where the virus is and where it is being spread.

Without that we are walking into the unknown.