Our strategic intent remains to suppress the virus to the lowest possible level and keep it there, while we strive to return to a more normal life for as many people as possible.
We have six main tools for achieving this:
- the quickest practical roll-out of our vaccination programme
- the most effective use of Test and Protect
- applying proportionate protective measures (rules and guidance) to suppress transmission of the virus
- effective measures to manage the risk of importation of the virus
- supporting individuals, businesses and organisations to adhere to protective measures
- providing care and support to mitigate the harms of the crisis
All six of these need to be used together and it will take commitment from all of us to make them work effectively.
Due to the concerted efforts of people across Scotland, under the current restrictions case numbers are falling and the current published R number is between 0.7 – 0.9. In time, we hope that vaccination will also have a significant impact in reducing transmission and allow us to live much more normally. However, despite remarkable progress, it is still early days for our vaccination programme and the challenge in the weeks and months ahead is to be able to ease restrictions safely before the vaccination programme has reached its full extent. That is why we are continually striving to maximise the effectiveness of all the tools available to us to both suppress the virus and alleviate its broader harms.
We have strengthened restrictions on international travel and quarantine for people arriving in Scotland from outside the Common Travel Area. We will continue to liaise with the UK Government and the other Devolved Administrations in the hope of being able to adopt a common Four Nations approach to this issue.
We are also continuing to expand our testing capacity. Between them, NHS Scotland and the UK Government laboratories now have the capacity to process 80,000 tests a day for Scotland. We are using this capacity to provide additional testing for people in key public services and critical infrastructure.
We are also expanding the use of targeted community testing – where we make COVID tests available to people who do not have symptoms of the virus. This is especially useful in areas of high or stubborn prevalence.
The new variants of coronavirus that we are dealing with pose a significant challenge. In particular, the increased transmissibility of the now dominant B.1.1.7 variant makes it far harder to open up activities and settings while keeping the R number below one and the virus suppressed. Consequently, we expect that opening up after this current lockdown will be more gradual and more cautious than was the case last summer: this reflects the reality that we are no longer dealing with exactly the same virus.
This update to our Strategic Framework highlights our early priorities for gradually easing measures, when the epidemiological conditions allow us to do so safely. We are deliberately setting conditions for easing, rather than fixed dates, to reflect the ongoing uncertainties with the epidemic. However by outlining our early priorities and a suggested sequencing of easing, initially on a national basis and in due course with a return to geographically varied levels, we hope that people, businesses and other organisations can better understand the likely path back to something much closer to normality. The diagram below sets out how we intend to proceed illustrated through a series of stages.
The Scottish Government has always made it clear that we will prioritise education and a phased return for ELC and schools. That has already started and we hope that more young people will be able to return to school later in March.
However, achieving that, together with the opening up of care home visiting, means that any further easing of restrictions before mid-March is highly unlikely. Indeed, we envisage that the current requirement to stay at home, unless you have a reasonable excuse for leaving, will be in place until at least early April so that we can create sufficient headroom to get more young people back to school.
The timing of any changes will be driven by evidence and data, not predetermined dates. It is also important that we leave enough time between reviews to see the impact of changes.
However, if we manage to keep R below 1 as schools return and have room to ease further, we will start with a gradual easing of the current Level 4 lockdown restrictions where they apply. To ensure that we undertake this easing process safely, we will make use of the six conditions set out by the World Health Organisation.
In due course, we then expect to move back to a geographically differentiated levels approach until the virus is no longer a significant threat to public health in Scotland. Because vaccination roll-out will be important for reducing transmission as well as protecting health, our current plan is that we must have offered the vaccine to at least all of the JCVI 1-9 priority groups before it will be safe to return to fully variable levels across Scotland.
As we take these steps, continued testing, roll-out of the vaccine, border measures and support to people and businesses to help them adhere to protective measures will be key. We will strive to ensure these tools are as effective as they can be to suppress this deadly virus. This will work best if we all play our part.
Figure 1: Phasing of the Strategic Framework
The process of gradual easing of protective measures has begun with the return of early learning and childcare, children in Primary 1, 2 and 3, and secondary school pupils in the senior phase who have to be in school for essential practical work. We are also enabling a small increase in the provision available for vulnerable children – specifically those with the most significant additional support needs – where schools believe that this is essential. We will be monitoring the impact of these changes very carefully as any change could push the R number back above 1, in which case we would have to respond with appropriate measures. We have also announced some opening up of care homes from early March to facilitate meaningful contact between relatives/friends and residents.
Following this initial easing, when we are confident that it is safe to do so, we are planning for the ongoing reopening of schools to all children and young people, as well as a cautious, progressive lifting of some of the additional restrictions beyond education in Level 4 (for those in Level 3 areas, see the section: protective measures and levels system on what Level 3 looks like). These include: reopening places of worship with restricted numbers; allowing 12-17 year olds to take part in outdoor group non-contact sport; easing socialising rules to allow meetings between more than two people from two households outside the home; and opening of child contact centres. Before each new set of easings, we will check that it is safe to proceed further. In particular, we will use the six conditions for safe easing set out by the World Health Organisation. There is likely to be a gap of at least three weeks between sets of easings while we assess the impacts of earlier changes.
As we continue to roll out the vaccination to priority groups and enhance testing, we will maintain protective measures and border controls will remain in place to limit the spread of the virus and particularly to prevent new variants entering the country. This includes the need for arrivals from overseas to quarantine in specific locations.
Following the re-opening of schools and the other limited easings within Level 4, as the state of the epidemic permits, we expect to return to a situation where the level of restrictions is variable across different parts of the country, depending on the levels of the virus, and consistent with our aim to suppress the virus while returning to greater normality for as many people as possible. Before returning to variable Levels across Scotland, we will make sure that it is safe to do so. In particular, we intend that at least the first 9 JCVI priority groups should have been offered the vaccine. That will be important not only for their protection, but because we expect this vaccination roll-out to help reduce transmission, giving us the headroom to ease restrictions safely. The effects of vaccination on transmission remain uncertain, so we will continue to keep the required vaccine coverage under review.
More generally, this process of easing restrictions and allocating areas to levels will be informed by data to give us confidence that it is safe to make changes. For example, we want to be confident that there will be no resurgence of the epidemic or overwhelming of the NHS. This conditionality is key, given ongoing uncertainties both about the status of the epidemic and the impacts of making any changes to restrictions. As a result of this data-driven approach, we will generally seek to avoid announcing forward schedules of dates beyond those required for short-term planning purposes. We intend to re-align some of the indicators that inform judgements about allocating areas to levels in light of current World Health Organisation (WHO) guidance, to ensure that we can safely open up while continuing to suppress the virus, including the new variants.
Ultimately we want to progress to the stage where, although COVID-19 is unlikely to have disappeared entirely, it stops having such a disruptive impact on our daily lives and is no longer considered a serious threat to public health. This stage is Phase 4 from our original Route Map and remains our goal. However, to get to this stage, a strategy of maximum suppression is essential.
As a society, we are likely to have to live with COVID as a permanent feature. It will not have been eradicated, and we will always have to be vigilant because of the risk of new variants, or further outbreaks.
But if we suppress it as far as we can - as close to elimination as possible - we will get life back to something much closer to normality.
At every stage in our management of the epidemic, we will recognise the wider harms that the virus brings, to people, their communities and to businesses. We will continue to support people and businesses by providing clear guidance, access to information and advice and financial assistance where required and we will redouble our efforts in working with employers, trade unions, Local Authorities, the third sector and others to make workplaces and public spaces safe. The UK Government also needs to play its part, with continued support through the furlough scheme, which this strategy assumes will continue beyond 1 April. Without adequate support for businesses and workers, we cannot mitigate the worst economic harms.
This updated Strategic Framework has been informed through engagement with Parliament and also by the views of business organisations, trade unions, third sector bodies and others. It sets out a targeted and coordinated approach which brings together the many measures required for us to take our next steps forward. The following pages set out our phased approach to easing restrictions and the key actions within each element of this Strategic Framework.
Figure 2: planned easing of restrictions
The quickest practical roll-out of vaccination
- continuing the roll-out of our vaccination programme at pace, in line with advice from the Joint Committee on Vaccination and Immunisation (JCVI)
- prioritising second dose for our most vulnerable and moving on to vaccinating Cohort 6 - all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality and unpaid carers. We will move quickly to bring forward Cohorts 7, 8 and 9 in line with our Vaccine Deployment Plan.
- taking a strategic approach to how under-50s will be vaccinated, potentially on a Four Nations basis
- progressing work to encourage high uptake amongst all these groups, building on the strong support for vaccination shown by older age groups
- working to ensure vaccine uptake amongst hard-to-reach groups
- continuing to issue clear public health messaging around the benefits of vaccination
- developing plans for on-going seasonal vaccination, if required
- maintaining and developing robust surveillance of emerging variants/mutations and the likely effectiveness of vaccines against them.
- monitoring data in relation to the vaccinated population over time, to consider immune responses and the potential for re-infection.
- maintaining reliable vaccine supply chains and developing mechanisms for delivering large-scale vaccination programmes in future.
- contributing to the World Health Organisation Safer Vaccination programme which is examining the technical details, ethical and equality issues, and privacy standards of vaccine certification
- keeping vaccines under review as more clinical and scientific information on new variants emerges
Most effective use of testing and contact tracing
- increasing accessibility of testing, by expanding capacity, infrastructure and geographical reach
- regularly testing healthcare workers, expanding to cover primary care workers in patient-facing roles and staff who work directly with patients in hospices
- delivering a schools asymptomatic testing programme in support of a safe return
- expanding workplace asymptomatic testing to support the safe maintenance of essential services and critical infrastructure
- working with businesses in high transmission risk sectors, such as in food production and distribution, with a view to introducing routine testing for their workforces
- expanding targeted community testing in areas of persistently high infection
- enhancing our contact tracing approach to advise close contacts of those who have tested positive to get tested themselves, as well as to self-isolate - to identify more positive cases and close contacts
- continuing surveillance of outbreaks and increasing the use of real-time genomic sequencing for priority areas such as international arrivals, cases of vaccine failure and where there is high risk of new mutations
- utilising wider data sources, including wastewater data, to support targeted interventions
Applying proportionate protective measures (rules and guidance) to suppress transmission of the virus
- proportionate and necessary regulations are currently in place across Scotland to address the ongoing public health emergency
- continue to emphasise the importance of a package of non-pharmaceutical interventions - including the use of face coverings, avoiding crowded places, hygiene and physical distancing
- cautious and gradual easing of protective measures will take place when it is safe to do so, starting with the phased schools return and reopening of early learning and childcare
- further easing within Level 4 (for mainland Scotland and some islands) will continue when it is safe to do so
- increasing roll-out of the vaccine programme is anticipated to provide headroom for easing further restrictions in the future
- when epidemiological conditions permit, we will begin to vary levels across the country to ensure proportionality and ongoing suppression of the virus
- the levels will remain a valuable tool to respond rapidly and decisively to any emerging outbreaks
- over time, we hope to reduce restrictions to the lowest levels prior to the epidemic being judged to be no longer a serious threat to public health
Measures to reduce importation of the virus
- prohibiting non-essential international travel to and from all areas of Scotland
- making it a requirement for passengers travelling to Scotland from outside the Common Travel Area (the UK, the Republic of Ireland, the Channel Islands and the Isle of Man) to have a valid negative COVID-19 test result before they travel, and they must self-isolate for ten days on their arrival, during which time they must take two further tests
- making it a requirement for all direct international arrivals to Scotland from outside the Common Travel Area or those arriving from the Republic of Ireland if they have been in or passed through a “red list” country in the last 10 days to go into managed isolation for 10 days on arrival in Scotland
- continuing to work with the UK Government, the Welsh Government and the Northern Ireland Executive and to press for a comprehensive pan-UK approach to managed isolation
- ceeping international travel restrictions under review and will consider further measures necessary to protect public health.
- committed to working on a Four Nations basis as part of wider international consideration of ways to assist the recovery of international travel, consistent with WHO advice, not as a replacement for managed isolation but as a means by which elements of international travel might be safely opened up
- restricting travel within Scotland and to and from other parts of the UK and the wider CTA to limit transmission of the virus and opportunities for any new variants to spread
Best possible support to adhere to protective measures (guidance and regulations)
- improved support for those who need to self-isolate:
- widening the eligibility for payment of the Self-Isolation Support Grant
- working with Public Health Scotland so that letters may be sent out to employers of those required to self-isolate, asking for their co-operation and support
- listening to and giving clear messages to the public:
- encouraging appropriate ways of thinking, both short-term and long-term: to avoid complacency as the vaccines roll out; continued adherence to NPIs (non-pharmaceutical interventions); a culture change of hazard awareness and new behaviours
- continued use of polling and focus group research to understand current public attitudes and behaviours (e.g. restrictions, FACTS, Test and Protect) to inform communications and marketing campaigns
- engaging with the business community:
- reviewing our sectoral guidance to ensure its continued relevance in changing circumstances
- developing a cross-sectoral tool to help workplaces ensure they are compliant with guidance and regulations
Care and support to mitigate the harms of the crisis
- record funding to support NHS Scotland. The Health portfolio will receive more than £16 billion, with a further £869 million for tackling Coronavirus.
- ongoing delivery of the Winter Preparedness Plan for NHS Scotland which sets out the key priorities for the NHS and their delivery partners until April 2021
- continuation of support, including for those most at risk of COVID and its wider impacts. Our £100 million Winter Support Package has invested nearly £6 million in promoting equality and tackling social isolation and loneliness - including through digital inclusion.
- more than £375 million to support schools and families, particularly with safety mitigations aligned to published guidance, support to accelerate learning recovery, including recruitment of additional staff, additional digital devices and the provision of family support, and the on-going provision of free school meals.
- additional support for students facing hardship (£20 million will help to alleviate the financial burden and stress facing our students and we are supporting institutions with £10 million for the revenue lost by providing rent refunds or rebates to students.)
- the recent Budget includes £68 million for the Scottish Child Payment, supporting awards for eligible children under 6 in 2021-22.
- as well as a further £100 COVID Hardship Payment for children and young people receiving free school meals on the basis of low income, which will be paid around Easter. The funding offered will also enable support to be extended to children who receive free lunches within early learning and childcare settings.
- allocated more than £3 billion to support businesses across Scotland. The Strategic Framework Business Fund will continue to provide support for businesses beyond this financial year and we will continue to review wider support for businesses. The latest information and updates on available support can be found on findbusinesssupport.gov.scot website.