- 23 Nov 2020
Good afternoon. Thanks for joining us again today.
I will start with the up to date today’s statistics.
The total number of positive cases reported yesterday was 949.
That is 8.6% of the total number of tests, and takes the total number of confirmed cases in Scotland to 89,310.
370 of the new cases were in Greater Glasgow and Clyde, 190 in Lanarkshire, 95 in Lothian, and 83 in Ayrshire and Arran.
With the remaining cases were spread across the 7 other mainland health board areas.
1,208 people are currently in hospital which is an increase of 38 from yesterday.
84 people are receiving intensive care just now, that’s 11 fewer than yesterday.
And finally, no additional deaths have been registered in the past 24 hours of patients who had tested positive over the previous 28 days.
I would remind you though that registration offices do tend to be closed at weekends, so the figures we report for deaths on Sundays and Mondays can be artificially low.
In total, since last Friday’s media briefing, 44 deaths have been registered.
And that means that the total number of deaths, under the daily measurement, is now 3,503.
And of course that reminds us, as this figure does every day, of the grief and heartbreak that this virus has caused too many families across the country and my thoughts condolences continue to be with them.
I have three issues I want to briefly update on today before the Chief Medical Officer and I take questions from the media.
Firstly, you may have seen some media coverage over the weekend, which has prompted some of you to email about the policy of testing people when they are being discharged from hospital to care homes. In light of that coverage I want to provide some reassurance on our because I know this an issue that can cause concern.
In particular, I want to emphasise that the policy is that anyone who has had Covid should have two negative tests before being discharged from a hospital to a care home.
Anyone who has been in hospital for reasons other than Covid should still have one negative test recorded before discharged to a care home.
That is the policy, and it is very clear and it has not changed since we introduced that earlier in the pandemic.
However, sometimes, there can be exceptional circumstances based on the clinical interests of a patient that mean something different will happen and again, this has not changed but I want to stress today that that would only be in exceptional circumstances and give some explanation of what that might be.
Sometimes, for example, a clinical care team looking after a patient in hospital, particularly if that patient is coming towards the end of their life, it might be clear that it would in the best interests of the patient to spend their remaining days at home, and in this context of course, for many older people home is a care home.
And the clinical team in judging might also judge that the patient, because of their overall condition, is unable to consent to a test or that a test might cause them harm or distress given the circumstances that they are in.
And it’s worth remembering that the Covid PCR test, which many of you watching may now have had the experience of, is quite an invasive test.
So it is only in these exceptional circumstances, driven by the clinical interests of an individual patient that someone could be moved to a care home without a test being done.
And it’s important to also stress that this would only happen in consultation with the patient, if that is possible, and with the patient’s family, and the care home.
It would follow a thorough risk assessment, with appropriate mitigating actions and support being put in place. And a 14 day period of isolation would also be applied to that patient.
Such a decision, and I think that is the key point I would want to make today, would be clinically led and driven by the clinical interests of the patient. It would be wrong, and I hope you can understand this, for any politician to seek to interfere with clinical decisions of this nature.
But the point that it is important for me to stress, is that what I’ve just outlined to you there are exceptional circumstances driven by clinical decisions and they don’t change the overall policy that we have in place.
That policy is clear, and it is one we expect to be followed, care home residents in hospital for Covid and being discharged to care homes should be tested before being moved.
I hope that that provides reassurance to people and explanation to people and especially to people who do have loved ones in a care home right now.
Now the second thing I want to do today is to briefly look ahead to the rest of the week. There are two significant statements about Covid that will happen in parliament this week.
On Wednesday, the Health and Sport will set out our plans for the further expansion of testing.
And tomorrow, I will make my weekly statement to parliament, setting out any changes to the levels which apply to different local authority areas.
Now we made significant changes to the levels system last week, including of course moving 11 local authority areas to level 4 for three weeks. That change came took effect on Friday.
In tomorrow’s statement, I do not expect much, if any change, to be announced. In particular, I am not expect any local authority areas to move up a level. Indeed, I would anticipate that the overwhelming majority of local authority areas will remain in their current level.
You will recall though that last week we indicated that East Lothian and Midlothian, if there was no deterioration in their positions, would from tomorrow move down from level 3 to level 2.
I can confirm that this will go ahead for East Lothian.
However, the National Incident Management Team has expressed some concern this morning about a rise in cases and test positivity over the past few days in Midlothian.
So we will be considering this further this afternoon and will confirm the position in relation to Midlothian later.
So it may be that Midlothian will remain at level 3 for a bit longer until the situation stabilises.
And white, if that is the decision, I know that will be disappointing, it is better than moving the area down a level only to possibly have to move it back up again in a week’s time.
What we are seeking to do with the levels system is to get as much stability as possible for people and for businesses.
Even though there is likely to be limited change tomorrow, that does of course mean that a significant proportion of the population will continue to live with level 3 or level 4 restrictions for now.
I would remind businesses who are affected to go to findbusinesssupport.gov.scot. That website details the help that is available and how to apply for it.
And to everyone in the 11 council areas now in the first full week of the three week level 4 restrictions, I want to thank you for following the rules over this weekend. The anecdotal evidence is that everyone did comply with these rules.
I know that the level 4 restrictions are hard for individuals and for businesses, but we do believe they are necessary, and that they will have an impact if people abide by them.
The levels system, we think, is already helping us, in most parts of the country, although we continue to see some volatility as I’ve just outlined in relation to Midlothian, but it in most parts of the country it is helping us to reduce the number of new Covid cases.
The additional restrictions that came into force on Friday in many areas will, we hope, help to bring cases down further and faster, and help to ease pressures on the NHS in the coming weeks and into January, and also of course, to save lives.
Reducing the prevalence of the virus is also what will allow us to consider a slight and careful, and I want to stress today those words slight and careful, easing of the rules for a few days over the festive period.
That is something which, as you may have read in the media, we have had discussions about in recent days, and most recently on Saturday, with the UK Government, the Welsh Government and the Northern Irish Executive. We are making progress towards arriving at a common position across the UK, which we think is important because of family patterns, but it’s important for me to be clear that the details of this approach are still to be finalised.
We hope that we will be in a position to confirm our conclusions later in the week.
I know there is a lot of, understandable, speculation at the moment about what may be allowed, but I would urge everyone to wait until we make reach a final conclusion.
I’m going to be pretty frank with you here in saying that this is in a time where every decision seems as if it’s difficult to get the right balance. This is a particularly different balance to strike, and if my email inbox is anything to go by, public opinion on this is quite mixed as you perhaps would expect it to be.
There is an obvious desire to see loved ones at Christmas, I think we all feel that very strongly, but also a lot of anxiety about the potential risks associated with that, particularly we are at a time when we are starting to see, perhaps, the end of this pandemic loom on horizon.
So we are trying as hard as we can to reach a sensible balance.
So it is possible, likely in fact that some households may be able to form slightly larger bubbles with each other for a short period over Christmas, and we are considering this because we recognise that isolation and loneliness can hit people particularly hard over the Christmas period.
And so for some people, doing the right thing at Christmas, will mean taking time to care for and be with loved ones who might otherwise be on their own.
That said we cannot ignore that any relaxation of the restrictions carries additional risk.
I’m afraid the virus won’t take Christmas off. And so if we provide it with opportunities to spread from household to household, it is likely to take those.
That would be a worry at any time, but perhaps more so when we could be within weeks of being able to vaccinate a significant proportion of the population.
And so it’s for these reasons we need to be sensible and careful.
And it is also why that when we do set out the rules which will apply over the festive period, we also the Scottish Government intend to set out the precautions that we are advising people to take.
We will remind families that, just because you might be able to mix a bit more indoors over Christmas in a limited way, that doesn’t mean you have to do that if you don’t think it is necessary or you can get through Christmas without it.
We will ask people to think very carefully about if you really need to travel and visit indoors, or if there are other ways, for example through technology or by meeting outside, in which you can ensure our loved ones are well, without taking risks.
It’s maybe worth asking yourself now, do we need to visit family or friends over Christmas? Because if we feel we don’t have to, then delaying a visit until the spring, especially if that visit involves travel, might be the better option.
And it may leave more space for those who really do need to are able to care for a vulnerable elderly relative, for example, to do so.
So I know this sounds very complicated and it is very complicated. I could try to stand here and over simplify but that wouldn’t be fair to anybody.
These are really difficult balances to strike and really difficult decisions to arrive at. But we need to try to reach them and strike them in the most sensible way possible.
And of course, the discussion about Christmas, reinforces one fundamental point.
The best way of making life as safe as it can be right now, is to reduce the number of people who are infectious, and that means continuing to abide by all the rules as they stand right now.
The existing rules and restrictions are intended to achieve that.
So I ask you please to, continue to stick to them.
If you are in any doubt what the rules are in your own local authority area, go to the Scottish Government website and use the postcode checker there to find out.
But in summary, everybody, right now, outside of Orkney, Shetland and the Western Isles should avoid visiting other people’s houses, except for essential purposes. You should avoid travelling outside of your local authority area if you live in a level 3 or 4 area. And you shouldn’t travel into these areas if you live elsewhere in Scotland that, of course is now the law.
Meeting outside or in indoor public places, the limit is six people from a maximum of two households
You shouldn’t care share if you can avoid it.
Work from home if you can.
Download the Protect Scotland app.
And finally, remember FACTS, the key things that help us all to limit and reduce the risks of transmission. So,
· remember to wear a face covering when you are out and about
· avoid any place that has crowds of people
· clean your hands and clean hard surfaces regularly
· keep a two metre distance from people from other households
· and self-isolate immediately, and get tested, if you have any of the symptoms of COVID.
It is by sticking to these rules that we will reduce the number of people with COVID, the number of people who have their health adversely affected. It’s how we will reduce over the piece the impact of businesses and get us more safely to that point on the horizon that we can now see of an end to this pandemic through scientific developments.
Thank you very much for joining us and for listening for a few minutes and I’ll now go straight to questions.