Coronavirus (COVID-19) update: First Minister's speech 19 October 2020

Good afternoon, thanks for joining us again today. I will give you the usual report on the COVID statistics first of all.

I can report that the total number of positive cases yesterday was 993.

That represents 17.1% of people who were newly tested and 6.4% of the total number of tests that we carried out and I am going to come on later to say a little bit more about these different measurements.

The total number of cases now stands at 47,708. 362 of today’s cases were in Greater Glasgow and Clyde, 294 in Lanarkshire, 122 in Lothian and 57 in Ayrshire and Arran. 

The remaining  cases are spread across the other seven mainland health board areas.

754 people are currently in hospital which is an increase of 40 from yesterday and 61 people are intensive care, that’s two fewer than yesterday.

Now for the eagle-eyed amongst you who  follow these figures very closely day-to-day and might have spotted that yesterday’s hospital and ICU figures and today’s don’t exactly tally, I can tell  you there has been a small revision made to the figures reported by Ayrshire and Arran yesterday and that will be shown in the publication that will appear on the website later.

I also regret to say that in the last 24 hours 1 additional death has been registered of a patient who had tested positive over the previous 28 days.

We also reported 15 deaths on Saturday. So since I last stood here to give the daily update on Friday, 16 additional deaths have been registered. And the total number of deaths, under the daily measurement is now 2,610.

That figure is a reminder of the heartbreak that this virus is capable of causing and once again I want to pass on my condolences to everyone who has lost a loved one.

Now I have got a few things I want to briefly update on today.

I am going to highlight two points about the daily figures that I have just reported and at the end of my remarks I will look forward to the week ahead and some of the decisions that lie ahead of us.

But briefly first of all, let me just look back. It seems clear from anecdotal reports that people overwhelmingly stuck to the rules over this weekend, including the rules on household gatherings.

And that’s really important – stopping households meeting up indoors is, as you know, crucial to slowing the spread of Covid.

But I am aware that it is also really tough, and it gets tougher with every week that passes.

I just wanted to take the opportunity today to say thank you  to everyone who has  played a part by following the rules and guidelines. You are making a difference and please be assured of that.

Let me now cover a couple of issues relating to the daily statistics.

We reported only 316 new cases yesterday and as you can see that’s far lower than the numbers we have been reporting on previous days.

Now, we are still exploring this with the UK Government but we think this might be because from Friday onwards, quite a large number of tests were diverted from the Lighthouse laboratory in Glasgow, to  be processed in other laboratories in the Lighthouse network.

Our understanding  - although we do not control this process -  is that this was to ensure that the Lighthouse lab in Glasgow didn’t handle more tests, from across the UK, than it had the capacity to deal with promptly.

We also understand that the tests diverted included those of people with symptoms, who had gone to drive-through or walk-in testing centres. 

And it stands to reason these people are more likely to test positive than asymptomatic people who are being tested as part of routine care home testing, for example. And that might help to explain why yesterday’s number of positive cases was probably artificially low.

The rerouting of cases was due to stop yesterday and  my expectation is that any new cases which we would have expected to see yesterday, will be included in the figures for today and tomorrow, although we continue, as I said earlier, to explore whether there might be any other issues at play here.

Of course this is one reason why – when we consider the number of positive cases – we always look at the trends over a number of days, rather at any single day at a time.

And of course our Test and Protect teams will be working to identify contacts of positive cases as soon as the information about them comes into our case management system.

And I would remind anyone who may be waiting for a test result, that you should of course be continuing to self-isolate while you wait for that. That is a really important part of our collective effort to control the virus.

Now, the other point about our statistics that I want to cover, relates to the percentage of people who test positive for Covid.

And I’m afraid that – as occasionally happens – I’m going to discuss an issue now which is quite technical, but which is important, so please bear with me as I always like to try and give you an understanding of what lies behind our statistics and the reasons for any change in how we are calculating any aspect of them.

For some time now, as you know, I have reported here a daily figure for the proportion of people who test positive for Covid - that’s an important metric that allows us, amongst other metrics,  to determine whether the virus is spreading more rapidly  or going into decline.

To arrive at that figure what we have done so far is measure the number of people

testing positive, as a percentage of the total number of people being tested, who had never been tested before. That’s why you hear me say every day that it is a percentage of people newly tested.

That ensures that we don’t count people who are tested twice in a very short period of time - for example if a test result needs checked, or perhaps some days tested both on admission to hospital and then a few days later.

Now the current measure has been helpful so far in assessing how the virus is spreading.

All of you will have seen in recent weeks in the percentage of positive cases that we have reported the rise in that has been consistent  with the rise in case numbers, in hospital admissions and increasingly, unfortunately, in people dying.

However the way in which we currently calculate  this becomes less reliable over time as more and more people in the population have been tested.

We are now more than 7 months into the pandemic and already more than 1/7 of the population of Scotland has already been tested for Covid. Under our existing measure, none of those people will ever count again as a newly tested person - someone who has not been tested before although if they test positive their positive result will be counted.

Let me illustrate that with an example - if you had a fever in August, if you got a test then and you didn’t have Covid – and then you have a cough now, you get tested again, and it turns out you do have Covid - your positive test will be counted, but you will not count as a “newly tested person”, when we work out the percentage.

So, as you can see, over time as more and more people who have already been tested go for further tests – and remember almost 40,000 care home workers are tested every single week – what happens is that the percentage of positive test that we report is artificially high and gets more and more artificially high as time goes on.

So we have been discussing this issue in some detail with the UK’s Office for Statistics Regulation. We have taken their advice into account in deciding a new measure, and will continue to engage with them on future improvements.

Instead of relying only on people who have been newly tested, we will now calculate the percentage of positive tests, based on the total number of test results which have come in on that day.

Now that measure is simple to calculate. And it does come closer to matching the methodologies used by the World Health Organisation, for determining whether the virus is out of control.

It is worth stressing though that although it is a better measurement for this stage in the pandemic for the reasons I have tried to set out as clearly as possible , it’s still not perfect so we’ll continue to look at further improvements. And the imperfections are these – if you need to be tested more than once in the same day or the same week, all of those samples will now be counted.

And in addition, the new measure – to a much greater extent than the old measure – combines test results from different groups of people.

The majority of our tests are of people who have symptoms of Covid.

But we also test lots of asymptomatic people every week as well, principally people who work in care homes.  And those tests are much less likely to be positive than tests of people with symptoms, so in a day-to-day basis that could lead to some fluctuations in the daily percentage.

But on a weekly or monthly basis that the trend in test positivity will be clear.

And our view is that the new measure will give us a better picture of the course of the virus over the weeks and months ahead. The old measure was the most accurate for the early phase of the pandemic, we think this one is more accurate for the next phase.

Now, as you have just gathered, that is quite a technical change, and thanks for bearing with me if you have managed to do so. But we also want to give you a bit of time to see the effects of the change in methodology. So, for that reason, and also to be completely transparent, to avoid any suspicion, what we are trying to do here is change methodology to result in a lower  number, every day  for at least the rest of this week I will am going to give you both our old and our new measurements  when I give you the daily figures. Eventually though, I will start to report the figure under our new measurement only.

So to remind you of what I said earlier on, on the old measurement taking people just newly tested, our test positivity rate today was 17.1%, on our new measurement taking  all tests it was 6.4%.

The final point I want to cover is to look to the week ahead as I indicated last week  we will publish this week detail of our new strategic approach to tackling the virus. I hope to discuss the outlines of this tomorrow with leaders of the other parties in the Scottish Parliament.

And we will then publish a strategic framework at the end of the week, before debating it in parliament next week.

One of the things the framework will set out are the different tiers or levels of intervention and restrictions which may be applied in future – either locally or nationally across Scotland - depending on how the virus is spreading.

We will also indicate -  based on the latest advice from the National Incident Management Team and our clinical advisers – what levels should apply to different parts of the country or potentially all of the country once the current temporary restrictions on hospitality come to an end on 26 October.

The framework will also summarise our work to improve the effectiveness of existing measures to curb Covid – for example how we will work to improve compliance with FACTS advice and all of the other guidelines; the review of our testing strategy and how we will continue to support Test and Protect; and also how we will provide support for businesses and individuals so that they can comply with all that they are being asked to do, either now or in the future.

Publication of the framework is an important step, as we look ahead to the winter and prepare to manage the virus over, what may well be and I would expect to be, a very challenging period.

We hope that the framework can command broad support both politically in parliament and across wider society.

But this is where I will end, it is worth stressing that - although the strategic framework will update our approach to tackling the virus – many of the basic elements of that approach will not change.

In particular, it will continue to be vital that to slow the spread of the virus, all of us as individuals stick to all of the essential rules and guidelines on hygiene, physical distancing and limiting contact  with other households.

Let me just briefly remind everyone of what those current general rules and guidelines are.

As I said earlier, except for very specific purposes – such as childcare – none of us should be visiting each other’s homes right now.

When we do meet - outdoors, or indoor public places that are open like cafes –  we shouldn’t meet in groups of any more than six people from a maximum of two households.

Only car-share if it is essential to do so

Work from home if you possibly can and again I would appeal to employers to facilitate that for your workers.

Download the Protect Scotland app, if you haven’t done so already.

And finally, remember FACTS.

• Wear Face coverings, it is now the law, as of today, to wear them in communal areas in work places, like corridors
• Avoid crowded places.
• Clean your hands and hard surfaces
• keep two metres distance from people in other households.
• and Self isolate, and get tested, if you have symptoms.

These are the basic things, no matter the other rules in place at any given time,  these are the basic things  that if all of us do all of them all of the time  then we give ourselves the best chance of keeping the spread of the virus  under control

It’s the best way to look after ourselves, to look after our loved ones and our communities.

And ultimately it is the best way to protect our National Health Service and save lives.

Thank you again for listening today and thank you particularly for bearing with me through quite a long, laborious and technical update on how we will calculate the percentage of people testing positive.