- 23 Apr 2020
Good afternoon everyone. Thank you for joining us for today’s briefing as usual.
Today I’m going to focus quite a lot on the paper we’ve just published about how we might, at the right time and in the right way, begin to restore some normality to our lives, while still containing the COVID-19 virus.
But before I do that, I will start as usual with an update on some of the key statistics in relation to the virus in Scotland.
As at 9 o’clock this morning, there have been 9,409 positive cases confirmed – which is an increase of 371 from yesterday.
A total of 1,748 confirmed or suspected COVID-19 patients are in hospital – and that is a decrease of 28 from yesterday.
And a total of 148 people last night were in intensive care with confirmed or suspected cases of the virus. And that is a decrease of seven since yesterday. Let me say again as I did yesterday, these figures on hospital admissions and admissions in to intensive care are very encouraging and do give us real optimism at this stage.
However in the last 24 hours, I am very sorry to have to report that 58 deaths have been registered of patients who had been confirmed through a test as having the virus – and that takes the total number of deaths in Scotland, under that measurement, to 1,120.
Once again, it’s really important for all of us to remember that each of these deaths represents a unique, loved and irreplaceable individual. And I want to again extend my deepest condolences to everyone who has lost a loved one.
I also want again to thank all of our health and care workers right across the country. This evening many thousands of us will, yet again applaud your efforts – we are all so deeply grateful to you for the extraordinary work you are doing.
So let me turn now to the paper we have published just a few moments ago about the decisions we will need to take as we seek to contain this virus while also restoring a semblance of normality to our lives.
And I want to be very clear with you at the outset - what we are publishing at this stage today is, by necessity, a first cut.
I am seeking today really, to start a grown up conversation with you, the public.
The decisions that lie ahead of us, of all of us, are really complex.
We will - as we have done all along - seek to inform those decisions with the best scientific advice possible.
But the science will never be exact, so we will also require to make very careful judgments.
And we are in uncharted territory – it’s impossible to know with absolute certainty what the impact of our decisions will be in advance.
That means we must also be prepared to adapt and change course as we go. We want to ease restrictions, of course we do, but we cannot absolutely rule out having to reapply some of them in future should we have evidence that the virus is again running out of control.
And I want to be frank with you every single step of the way about all of these complexities and uncertainties.
So while today’s paper is still quite high level, it is the start of a process.
It sets out the objectives and the principles that will guide us, the different factors that we will need to take into account, the framework in which we will take decisions, and the preparations we need to make now.
In the days and the weeks ahead, evidence, data and modelling will allow us to take firmer decisions.
As that happens, this paper will evolve into a detailed plan with metrics, actions, milestones and measurements attached to it.
And I give an assurance today that as we go through this process, we will share our thinking on an ongoing, iterative basis.
But let me briefly set out some of the key points today.
Firstly, and this is an obvious point, this virus causes real harm. And we see that every day in the statistics that we report, especially in the numbers of people who have died.
But the lockdown measures we are taking to contain the virus are also doing damage.
They’re doing harm to the economy and to living standards, to children’s education, to other aspects of our physical health, and to mental health and wellbeing. And the toll of all of that may also, in time, be measured in poorer health outcomes and lives lost.
So we must try to find a better balance than the one we have right now.
But my second point is that, as we do so, we cannot and we must not take our eye off the need to suppress the virus and minimise the damage that it does.
And let me be very clear about this, continuing to suppress COVID-19 is the central objective that we set out in this paper today.
Obviously, we cannot guarantee that no one will get this virus in the future - far from it - but an assumption that it is somehow safe to allow a certain proportion or a certain section of the population to get the virus is not part of the approach we will be taking.
Third, we are increasingly confident that measures we are taking now are suppressing the virus.
The key factor – and you may have heard this before - is what is known as the reproduction rate - the R number. And that needs be as far below one as possible.
Now before lockdown that R number was very likely above three. And that means everyone with the virus was infecting three more people, each of them was infecting three more people and so on and on. That is what is exponential growth.
Our best estimate now is that the R number is somewhere between 0.6 and one - though I should say that it is probably still higher in certain settings, such as care homes.
But we can’t yet be absolutely sure about any of that. That’s why we need more time to monitor the statistics we report every day - like case numbers, hospital and ICU admissions, and numbers of deaths. And we need to develop further our data through ongoing surveillance.
It’s only when we are sure that the virus is under control that we can even start to ease any of the restrictions.
And it’s my next point really that takes us to the hard part.
When we do reach that stage, the virus will be under control only because of the severity of the restrictions we are all living with just now. But the virus will not have gone away.
So as we start to lift the restrictions, the real risk – and it is a very real risk - is that COVID-19 runs rampant again.
So a return to normal as we knew it is not on the cards in the near future. And it’s really important that I am upfront with you right now about that.
What we will be seeking to do is find a new normal - a way of living alongside this virus, but in a form that keeps it under control and stops it taking the toll that we know it can do.
Social distancing and limiting our contacts with others will be a fact of life for a long time to come - certainly until treatments and ultimately a vaccine offer different solutions. So that means possibly for the rest of this year and maybe even beyond.
And that’s why talk of lifting the lockdown - as if it’s a flick of a switch moment - is misguided.
Our steps – when we take them - will need to be careful, gradual, incremental and probably quite small to start with.
We will need to assess them in advance and monitor them in action. Sometimes, as I said a moment ago, we may even need to reverse things.
As we go, we will apply our judgment to the best scientific advice possible, we will continue to collaborate closely with the other governments across the UK, and we will learn from international experience. The fact is that different countries are at different stages of this pandemic - but none of us are anywhere near through it yet and we all face the same challenges.
So as we make these decisions here, careful balances will have to be struck.
For example, it may be that be that certain business in certain sectors can re-open - but only if they can change how they work to keep employees and customers two metres distant from each other.
Similarly with schools - classrooms may have to be redesigned to allow social distancing, so maybe not all children can go back to or be at school at the same times.
Some limited outdoor activity might be able to restart earlier than indoor activity. But let me be clear, big gatherings and events are likely to be off for some months to come.
We will also consider whether different approaches would make sense for different areas - though our preference, not least for ease of understanding, will be for as much consistency as possible.
And of course given how severely this virus is affecting older people and those with other health vulnerabilities, some form of shielding will almost certainly be required for the foreseeable future.
Now let me stress that what I have just set out there are not firm decisions - but they do illustrate the kind of options we will be assessing.
And as we do so, we will consider not just the health imperatives, but also issues of practicality, sustainability, fairness and equity, ethics and human rights.
And lastly, as well as changes to how we live, we will use public health interventions and technology to the maximum possible to help us control this virus.
In the next phase, extensive testing, tracing of those who test positive and the isolation of symptomatic people to break the chain of transmission will be a central part of the approach that we will take. And the preparations to make that possible are already under way.
We will also discuss with the UK government - for this is a reserved responsibility - the need for stronger surveillance measures for those coming into the country from elsewhere.
So in short, this paper sets out the difficult decisions we face and the way in which we will go about preparing for them, making them and also assessing their impact.
I want to stress again because it’s important that I am frank. The path ahead is not an easy one - it is paved with complexity and uncertainty. But with openness, transparency and frankness along the way, I believe that together we will be able to navigate it. It is for me and for government to work through and lead that process. But this is about all of us - hence this discussion that we are opening up with all of you today.
The paper we have published is available on the Scottish Government website. I will post a link to it on Twitter, later this afternoon.
So, please, even if - like I suspect most of the population - you are not in the habit of reading government documents, have a look at it. And if you have views on it please let us know. These views are important and will be helpful.
As I said earlier, I will continue to share our thinking with you as it develops.
But let me now end now on a vital point and one that you have become used to hearing me make each day. Moving on from where we are now as all of us want to do as quickly as it is safe to do will only be possible if and when we do get this virus properly under control.
And that means sticking with the current rules that are in place just now.
Stay at home except for essential purposes.
Stay two metres apart from others when you have to be out.
Do not meet up with people from other households.
And isolate completely if you or anyone in your household has symptoms.
This is tough, this is the toughest set of circumstances that the vast majority of us have ever lived through - and I can’t stand here and promise you it is going to get a whole lot easier soon.
But as I hope we have started to set out today, if we keep doing the right things, and if we consider all of the options carefully and with the right objectives in mind, I do believe there will be a way through.
And we will find that way through. So thank you for all you are doing to help. And please if you can, engage with this discussion as we go through the days and weeks to come.
Thank you very much for your patience right now in allowing me to go through that in detail.