Coronavirus (COVID-19) update: First Minister's speech 22 April 2020

Good afternoon everyone. Thanks for joining us for today’s update.

I’ll start as usual with an update on some of the key statistics in relation to Covid 19.

As on the last two Wednesdays, this will have two parts – an update of the usual daily figures, but also a summary of the key points from today’s weekly publication from National Records of Scotland.

Now this inevitably means a bit more complexity, so please bear with me as I go through these statistics.

Let me turn firstly, to the daily figures.

As at 9 o’clock this morning, there have been 9,038 positive cases confirmed - an increase of 366 from yesterday’s figures.

A total of 1776 patients are currently in hospital with confirmed or suspected Covid-19 - that is a decrease of 90 from yesterday.

And a total of 155 people last night were in intensive care with confirmed or suspected cases of the virus. That is a decrease of 11 on yesterday.

Let me again say that these figures for hospital admissions and admissions to intensive care are really encouraging and there are a cause for optimism, still cautious optimism, but optimism nevertheless.

In addition, as part of a package of new information we are providing on our website from today I am able, for the first time, to give a figure for the number of COVID-19 patients who have been discharged from hospital – indeed, that is information some of you have contacted me to ask that we provide.

So I am able to confirm today that since 5 March, a total of 1,813 patients who had tested positive for the virus have been able to leave hospital, and I wish all of them well.

On a much sadder note though, I also have to report today that in the last 24 hours, 77 deaths have been registered of patients who had been confirmed positive through a test as having Covid-19 – that takes the total number of deaths in Scotland as of this morning under that measurement, to 1062.

Now I have spoken before about the different ways in which we record figures, but it might be helpful to very briefly recap on that.

For our daily update figure - the one you have just heard me give - we report on deaths which have been registered where the individual who has died has been tested and confirmed as having Covid-19.

Those figures are the most accurate ones that we’re able to provide on a daily basis. But obviously they don’t capture all deaths from the virus.

So National Records of Scotland now produces a report each Wednesday which captures all deaths registered within a 7 day period, ending on the preceding Sunday. It includes – not just those with a confirmed laboratory diagnosis of the virus - but also deaths which are presumed to be linked to Covid-19 and mentioned on a death certificate.

The number of deaths covered under this reporting system is therefore larger than under the daily system, when you compare the two figures according to the same date. But it is the comprehensive one.

NRS published the third of its weekly reports today, just around half an hour ago. It covers the period up to Sunday 19th April – three days ago. At that point, according to our daily figures, if I can remind you, 915 deaths had been registered of people who had tested positive for Covid-19.

However, today’s report shows that by Sunday, the total number of registered deaths linked to the virus - confirmed and presumed - was 1,616.

651 of those were registered in the 7 days up until Sunday the 19th of April. That is an increase of 41 from the week before, when 610 Covid-19 deaths were registered.

These figures are extremely difficult to report on, and I know they will be difficult for you all to listen to. They are higher than any of us would ever want to think about. But this information is really important because it gives us as full a picture as possible of the toll the virus is having and how and where it is progressing.

There are two further points I want to highlight about today’s report. The first is that it again provides a breakdown of deaths by age, sex, location and health board area.

It shows that almost three quarters of those who have died were aged over 75 – however it also shows that much younger people do sometimes die as a result of this virus. That is an important reminder that all of us are potentially at risk so it’s therefore important for all of us to follow the guidance.

The report also provides information about the location in which people died. So far, 56% of those who have died died in hospital, 33% - 537 in total - have died in care homes, and 10% have died at home or in some other setting. 

We know older people and care homes are particularly vulnerable to this virus.

But we must match that increased vulnerability with enhanced protection.

So I want to say a bit more today about the measures we have put in place to protect residents and staff in care homes.

Clear guidance on isolation in care homes has been in place now for some time and it is of course the duty of providers of care homes to make sure that guidance is followed.

The Health Secretary set out yesterday additional steps that we are taking.

NHS Directors of Public Health are taking enhanced clinical leadership for care homes.

A national rapid action group has been established, which will receive daily updates and ensure quick local action is taken to deal with emerging issues.

Testing for staff and residents is being expanded – as I set out here last week, all symptomatic residents of care homes will be tested. 

Covid-19 patients discharged from hospital, should only be admitted or readmitted to a care home once they have had 2 negative tests.

In addition, other new admissions to care homes should be tested and isolated for 14 days - let me stress that this is in addition to and not a substitute for the clear isolation and social distancing measures the guidance sets out.

We are also helping to recruit students, and people who previously worked in social care, to work in the care sector as soon as possible. Nursing staff are also supporting care homes, where that is needed.

And we are increasing access to NHS personal protective equipment to care homes.

For example this week, and let me stress this is in addition to our other supply routes, we are delivering supplies of aprons, gloves and fluid-resistant surgical masks direct to care homes. In doing that, of course, we are giving priority to those with known outbreaks of the virus.

Finally, the Scottish Government, from today, is making more information publicly available about how the virus is affecting care homes.

The statistics that we publish at 2pm today will include

• the total number of adult care homes that have reported a suspected COVID-19 case at any time;
• The total number of suspected cases in care homes so far; and
• the number of care homes that have current suspected cases. On this last point, I can tell you the figure today will show that 384 care homes have a current outbreak, but let be me clear what that means. It means that these are care homes that have at least one resident who has exhibited symptoms of the virus in the last 14 days.

We must remember, difficult though this is, that it is not unusual for people to become sick in care homes.  Residents are often frail and nearing the end of their lives.

But that does not mean we consider any of these cases to be inevitable or that we don’t do everything we can to prevent them. Older people in care homes require as much – if not more – support and protection as anyone else in our society.  We are working with care homes and other partners to provide that.

In doing that, we are helped hugely by the expertise and dedication of those who work in the sector, who are doing a remarkable job in incredibly testing circumstances. We are grateful to all of them.

The second point I want to briefly cover about the statistics is that the overall number of deaths registered last week is again much higher than the average for the same week in previous years - something that seems to be reflected in other countries at this time.

And while around three quarters of that difference this week can be attributed directly to Covid-19, more than 200 deaths cannot be explained in this way.

The data the NRS published today provides some explanation of that and indicated that some of the difference appear to be a result of more people dying of cancer, and dementia and Alzheimer’s. However clearly, this is an issue that we need to do further work on to make sure we understand it fully.

Now, I focus on the statistics in these updates because they are important.

And I set the reasons why they are important to us in understanding the spread of this virus and informing decisions about the way forward, and I’ll say more about the principles that will underpin our decision making tomorrow.

But I want to emphasise again that these death are not just statistics.

They were all people who were loved and cherished and who, for their family and friends, are irreplaceable. We should never forget that.

Just as we shouldn’t forget those left behind, grieving for their lost loved ones. My condolences are with all of them.

The final point I want to acknowledge is that listening to numbers like this is really horrible – reporting these numbers is really horrible, certainly the most difficult experience I’ve had as First Minister.

And I know listening to this might leave you with a feeling of powerlessness as well as an acute and deep feeling of sadness.

But I want to stress again that none of us are powerless, we all have some power against this virus. By following the rules, by staying home and by self-isolating when we have symptoms, we are all making a difference.

I know it’s hard to see progress when numbers of deaths that we are reporting are so grim.

But the other statistics I’m reporting on daily right now, particularly on hospital and intensive care admissions, do show that we are making progress – they are a source of optimism - and soon I hope a fall in the numbers of people dying will show that progress too.

By complying with the lockdown, we are protecting ourselves and others, and we are saving lives.

But even a very small easing up in that right now could send all of that progress very quickly into reverse.

So please, keep sticking with it.

Stay at home except for essential purposes. When you do go out, stay 2 metres away from other people, and do not meet up with people from other households. And wash your hands thoroughly and regularly.

By doing this, we are all helping – and we are helping - to slow the spread of the virus, we are protecting the NHS – which has not been so far overwhelmed in the way we feared just a few weeks ago and despite these figures I am reporting to you today - and we undoubtedly all of us saving lives. So thank you once again to all of you for doing that.

So thank you once again for all that you are doing. This is hugely appreciated not just by me, and by the government, but the collective community. It is appreciated by everyone. Thank you very much for bearing with me though what I know was a complicated update today with lots of different statistics.