Prevalence of COVID-19 has varied across Scotland. For example, in recent weeks some areas of Scotland have seen sustained periods of low or zero levels of the virus, whereas other areas have seen a rise in cases leading to community transmission. Being able to adjust local levels as local circumstances require is crucial as we move through the levels as a nation. This approach maintains the clarity of a national approach, while allowing us to respond flexibly and target measures at the appropriate regional or local level.
Moving forward, the intention is for most of Scotland to move to Level 1 on 7 June and Level 0 on 28 June, if the data remain supportive and the restrictions in the Levels remain necessary and proportionate. Consistent with the approach to national easings set out above, a general nationwide move down through the Levels should satisfy the WHO’s six conditions. For example, the general move down should be consistent with transmission in Scotland remaining controlled and NHS capacity sufficient to deal with expected levels of prevalence. However, the Levels approach also allows for differential treatment of areas where local conditions make that appropriate. Rather than pause progress for the nation as a whole, it may be appropriate to retain particular areas at their current level or potentially increase their level. In the event of a local COVID-19 outbreak showing signs of becoming more widely dispersed in the wider community, we will consider tighter restrictions in that area and potentially neighbouring ones if deemed necessary and proportionate, until the situation is brought under control. This would apply, for example, if an outbreak in a specific setting such as a factory spread more widely into community transmission. It is important that measures remain in place for as short a period as possible to suppress the virus, to minimise the overall harms caused.
We will continue to consider the most appropriate geography for restrictions, which might range from a town or individual island, through the basic building block of a local authority to a wider region, such as a health board area. However, we recognise the practical difficulties of applying travel restrictions between small areas. It is also possible that, following an outbreak, areas may move quickly down through the Levels once the outbreak has been suppressed – changes in Levels may not always be successive. For example, moving from Level 2 to Level 4 would be possible, as would moving directly back to Level 2 again, once an outbreak was addressed.
We recognise that smaller areas with smaller populations may show large proportionate changes in cases which are small in absolute value. For example, a week-long outbreak of 50 reported positive cases in a local authority with a population of 100,000 would present as 50/100,000 on the first core indicator (assuming no other cases in the area that week). In contrast, a similar 50-case, week-long, outbreak in a local authority with a population of 500,000 would present as 10/100,000. This might suggest quite different responses in terms of restrictions. This is why such numbers should not be considered in isolation but should be supported by local intelligence on the nature of the outbreak (e.g. whether the cases are in community transmission or centred on one particular setting). Where outbreaks are contained within single settings and where evidence of wider community transmission is not present, a different approach may be appropriate. Close liaison with local health protection teams can aid in establishing circumstances and the most appropriate response.
The identification of any new variants of concern in an area may also need a higher level of restrictions to contain the virus. Should vaccine-resistant variants emerge in the future, then this could require tackling in different ways to the current Levels approach.
There is a problem
Thanks for your feedback