Coronavirus (COVID-19) update: First Minister’s speech 29 April 2020

Good afternoon everybody. Thank you once again to all of you for joining us for this daily update.

I want to start as usual with an update on some of the key statistics in relation to COVID-19 in Scotland.

Now as usual on Wednesdays, today’s update will have two parts – an update on the daily figures that you are used to hearing me present, and also a summary of the key points from today’s weekly publication from National Records of Scotland.

That means more complexity and a bit more length than normal - so please bear with me.

I also know and want to be upfront about this today that both speaking about and hearing about people dying is extremely upsetting. But I hope you understand that it is important that I do report these numbers and do so in some detail.

Let me turn firstly to the usual daily figures.

As at 9 o’clock this morning, I can report that there have been 11,034 positive cases confirmed – which is an increase of 313 since yesterday.

A total of 1,727 patients are currently in hospital with either confirmed or suspected COVID-19 - that is a decrease of 27 from yesterday.

A total of 114 people as of last night were in intensive care with either confirmed or suspected cases of the virus. And that is a decrease of 12 on yesterday’s figures.

Let me say again that these are encouraging figures.

I am also able to confirm today that since 5 March, a total of 2,521 patients who had tested positive for the virus have now been able to leave hospital.

However I also have to report that in the past 24 hours, 83 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 1,415. Although I’ll come on to the figures from the National Records of Scotland publication shortly.

Unfortunately there is a further group of deaths that I am able to report on today. Over the course of the pandemic, I can sadly confirm that 6 members of NHS staff and 5 members of the social care workforce have died from the virus. And my thoughts, and the thoughts of all of us in the Scottish Government are with their family and friends.

Now I should stress and it is an important point to stress that it will not necessarily be the case that all of these members of staff contracted COVID through their work – and in some cases, people may not have been in their workplace for some time.

However it is really important for us to understand how many frontline workers lose their lives from this virus, it’s also really important that we ensure appropriate investigation into the circumstances, and of course learn any lessons that we can from those circumstances.

Now the numbers that I have read out – for health and care workers, and indeed for all deaths - are not just statistics. And this is a point that is important for me to make every single day. Behind every one of these statistics is an individual an individual who is loved and cherished an individual who is now deeply missed by those that they’ve left behind. So once again, I want to send my deepest condolences and thoughts to everyone who has lost a loved one to this virus.

And finally I want to thank – as I always do – our health and care workers for the extraordinary work that you continue to do. The entire country owes you such an enormous debt of gratitude.

Now I have spoken before about the different ways in which we record figures, but I think it’s helpful if I briefly go through the key points again.

For our daily update figure – which is the one that you have just heard me give - we report on deaths that have been registered by National Records of Scotland, but where the individual has been tested and confirmed as having COVID-19.

These figures are the most accurate ones that we are able to provide on a daily basis. However, as you’ve heard me say before, they don’t capture all deaths associated with the virus.

So National Records of Scotland – or NRS – now produces a weekly report every Wednesday. It’s been published just over half an hour ago.

And this captures all deaths registered within a 7 day period, ending on the preceding Sunday. And it includes – not just those with a confirmed laboratory diagnosis of COVID-19 - but also deaths which are presumed to be linked to the virus.

So it includes cases where COVID is entered on the death certificate as a suspected cause of death, or as a contributory factor in the death, but where no formal test had been carried out.

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 more comprehensive, and it provides a fuller picture of how the virus is affecting our communities.

As I said NRS published the fourth of its weekly reports today. It covers the period up to Sunday 26th April – which is three days ago. At that point, if I can remind you, according to our daily figures, 1,262 deaths had been registered of people who had tested positive for the virus.

However, today’s report shows that by Sunday, the total number of registered deaths linked to the virus - confirmed and presumed - was 2,272.

656 of those were registered in the 7 days up to Sunday the 26th. And that is an increase of 5 from the week before, when 652 COVID-19 deaths had been registered.

Now, as I said a moment ago, these figures are difficult to hear – and they are of course very difficult and upsetting for me as well to report on.

But this more comprehensive information is vital, because it does help to give us as full a picture as possible of the toll the virus is having, and to see how and when it is progressing and where it is progressing. And that is important as we take decisions for the future.

Now because of the importance of this information, NRS once again provided breakdowns of these figures by age, health board area and setting. And I want to discuss briefly some of what these latest figures show.

First, the data says that in total, 52% of people whose deaths have been linked to COVID died in a hospital; 39% of people died in a care home; and 9% of people died at home or in another setting.

However in the past week, on its own more than half of all COVID-related deaths – 338 of the total - were in care homes. That partly reflects the fact that COVID-19 deaths in hospital do now seem to be declining.

The proportion of deaths in Scotland in care homes - while obviously deeply distressing - is however broadly in line with the proportions being reported now for many other countries. And that demonstrates again how crucial it is to make care homes as safe as they can possibly be during a pandemic of this nature.

Care homes have had strict guidance to follow since 13 March. And it is incumbent all care home providers, whether they are in the public or private sector to follow and to implement that guidance.

Our NHS Directors of Public Health are also playing a lead role in assessing how each care home in their area is managing infection control, staffing, training, physical distancing and testing.

Patients being discharged from hospital should provide 2 negative tests before being admitted into a care home, and all new admissions to care homes should be tested and isolated for 14 days.

All care home residents with symptoms of COVID-19 are tested.

Social care staff with symptoms or their families should be tested and we have worked with the care sector and continue to work with the care sector to ensure appropriate provision of PPE.

We know that care homes – due to the age and often the frailty of their residents, and because many people are living together in the same setting - are very, very vulnerable to this virus, not just here in Scotland but across the UK and other countries too. The steps we have taken so far are designed to ensure that they are as safe as they can possibly be. And we will continue to take whatever steps are necessary and appropriate to make sure that is the case.

The second issue I want to briefly cover is that we have again today in this publication provided information on what is sometimes called “excess deaths” – that is the difference between the total number of deaths last week, and the average number of deaths, in previous years, for that particular week.

Today’s figures show that there were 743 excess deaths last week. That is actually lower than in the previous two weeks – by more than 100 - but it is still a much higher number than we would want to see. The overwhelming majority of those excess deaths – 85% of them - can be and are attributed to COVID-19. But there are 112 additional deaths which cannot be attributed to the virus.

That figure - for unexplained excess deaths - is actually also lower than in previous weeks, but it is of course still a source of concern.

The figures published today show that a significant proportion of these additional deaths are due to Alzheimer’s or dementia, or circulatory conditions such as heart disease or stroke. The other point I would make about the excess deaths overall is that they are high and far too high but on the most recent comparable data we have in Scotland, the proportion of excess deaths is slightly lower at this stage than in England and Wales.

Now I know there have been questions raised about whether all deaths thought to be from Covid are recorded in that way. And I want to be very clear that in reporting and analysing all excess deaths, I hope the NRS report provides some reassurance on that point. And we of course continue our work to understand what lies behind these increases and in particular to understand the excess deaths that are not attribute to the virus.

Thirdly, in terms of the points I want to cover, these figures again demonstrate that this virus disproportionately affects the elderly and that is not just elderly in care homes, the vast majority – nearly all – of deaths from this virus are in the over 65 age group. However they also show that anyone can get this virus, and that people of all ages have died or become seriously ill from it. So for all of us, strict hand hygiene and sticking to social distancing rules is still the best way of protecting ourselves, as well as protecting our loved ones and our communities.

And that brings me to my final point – and it is one which you hear me make every day but I think it is more important than ever to make it during these Wednesday briefings than perhaps at any other time.

I know how upsetting these numbers are to listen to, because I know how upsetting they are to report on. And there’s a danger of feeling – when you hear numbers like this - dispirited, certainly very sad but also powerless, as a result of the fact that the death toll is still so significant, given all of our efforts in recent weeks.

But every one of us does have power to protect ourselves, our loved ones and communities. And not withstanding these figures, deeply distressing figures of numbers of people dying. Some of the earlier statistics that I have sighted today show that we are making progress.

So by exercising the power that each of us as citizens have, we have already all of us helped protect the NHS, we’ve helped to push transmission rates in the community to a much lower level now than was the case several weeks ago.

So please, I ask you, continue to stick to the rules.

Stay at home – except for essential purposes such as buying food or medicine, and exercising.

If you do leave home for essential purposes, don’t mix with people from other households - stay more than 2 metres away from other people. If you have to be in an enclosed space with other people, like a food shop or public transport, please consider covering your nose and mouth with a face covering like a scarf.

If you have symptoms of the virus, you and your household should isolate completely.

And everybody must still wash their hands regularly and thoroughly and follow all of the other hygiene guidance.

These measures are tough for all of us, and as I say every day because it’s true they are getting tougher. But they are having a positive impact. Notwithstanding some of the upsetting news I reported today. But the converse of that point is equally important and equally as stark, easing up on them now would also have an impact but it would be a negative impact - and that impact would be felt very rapidly.

So we do need to stick with it. These restrictions are the ways in which all of us, together, will slow the spread of the virus even further, continue to protect our NHS, and save lives. So thank you once again to all of you who are doing that. And please, please keep doing that because you are making a difference.