Publication - Research and analysis

Coronavirus (COVID-19): framework for decision making - assessing the four harms

Sets out the four harms process for assessment used to establish when coronavirus restrictions could be safely lifted after lockdown and the scientific evidence underpinning the decisions.

Coronavirus (COVID-19): framework for decision making - assessing the four harms
Footnotes

Footnotes

1. https://www.gov.scot/collections/coronavirus-covid-19-scotlands-route-map/

2. https://www.nrscotland.gov.uk/files//statistics/population-estimates/mid-19/mid-year-pop-est-19-report.pdf (page 3)

3. https://www.nrscotland.gov.uk/files//statistics/population-estimates/mid-19/mid-year-pop-est-19-report.pdf (pages 13-14)

4. https://beta.isdscotland.org/find-publications-and-data/population-health/covid-19/covid-19-statistical-report/

5. Scottish Household Survey

6. Scottish Census 2011 https://www.webarchive.org.uk/wayback/archive/20150218151549/http://www.gov.scot/Publications/2014/10/8378

7. This is determined on the basis of the bedroom standard as defined in the Housing (Overcrowding) Bill 2003, taking into account the number of bedrooms available in the dwelling and the type of household that occupies it

8. SHCS 2018 Key Findings

9. https://www.nrscotland.gov.uk/files/statistics/covid19/covid-deaths-report-week-45.pdf

10. PHS interactive dashboard shows a 7 day average of 529.7 cases for women and 431.9 for men as of 9 November https://public.tableau.com/profile/phs.covid.19#!/vizhome/COVID-19DailyDashboard_15960160643010/Overview

11. https://www.gov.scot/publications/fairer-scotland-women-gender-pay-gap-action-plan/

12. Beyond the data: understanding the impact of COVID-19 on BAME groups

13. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/
articles/coronaviruscovid19relateddeathsbydisabilitystatusenglandandwales/2marchto14july2020

14. This was true after adjusting for region, population density, socio-demographic and household characteristics, the relative difference in mortality rates between those disabled and limited a lot and those non-disabled was 2.4 times higher for females and 2.0 times higher for males.

15. https://www.nrscotland.gov.uk/news/2020/deaths-involving-covid-19

16. Data correct as of 3 December 2020

17. https://beta.isdscotland.org/find-publications-and-data/population-health/covid-19/covid-19-statistical-report/

18. https://www.open.edu/openlearn/science-maths-technology/biology/what-virus

19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173023/

20. https://coronavirusexplained.ukri.org/en/article/cad0003/

21. https://www.who.int/health-topics/coronavirus#tab=tab_1

22. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/907587/s0643-nervtag-emg-role-aerosol-transmission-covid-19-sage-48.pdf

23. https://www.gov.uk/government/publications/emg-role-of-ventilation-in-controlling-sars-cov-2-transmission-30-september-2020

24. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/933225/S0824_SARS-CoV-2_Transmission_routes_and_environments.pdf

25. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/923607/s0760-4a-duration-wearing-face-coverings-170920.pdf

26. https://www.nejm.org/doi/full/10.1056/NEJMc2004973?query=featured_home

27. https://www.nih.gov/news-events/nih-research-matters/study-suggests-new-coronavirus-may-remain-surfaces-days

28. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/887618/EMG_Environmental_transmission-_02052020__1_.pdf

29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543342/

30. https://www.gov.uk/government/publications/spi-bemg-covid-19-housing-impacts-10-september-2020

31. https://www.gov.uk/government/publications/sars-cov-2-transmission-routes-and-environments-22-october-2020

32. https://www.gov.uk/government/publications/principles-for-managing-sars-cov-2-transmission-associated-with-higher-education-3-september-2020

33. https://www.bmj.com/content/371/bmj.m3862

34. The UK Scientific Advisory Group for Emergencies (SAGE) are responsible for ensuring that timely and coordinated scientific advice is made available to decision makers to support UK cross-Government. SAGE in turn is informed by a group of academic experts [the Scientific Pandemic Influenza Group on Modelling [SPI-M]. SAGE meets two or three times each week. Following each meeting updated assumptions and modelling materials are released to Scottish Government. The Scottish Government Covid modelling team then apply these to Scotland.

35. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/weekly-and-monthly-data-on-births-and-deaths/deaths-involving-coronavirus-covid-19-in-scotland

36. https://www.gov.scot/collections/coronavirus-covid-19-modelling-the-epidemic/

37. This measure is included on the Scottish Government COVID-19 in Scotland: Indirect health impacts dashboard

38. https://informatics.sepa.org.uk/RNAmonitoring/

39. https://www.gov.scot/publications/coronavirus-covid-19-framework-decision-making-further-information/

40. https://www.gov.scot/publications/coronavirus-covid-19-daily-data-for-scotland/

41. https://www.cebm.net/covid-19/what-is-the-evidence-to-support-the-2-metre-social-distancing-rule-to-reduce-covid-19-transmission/

42. Douglas et al (2020) Mitigating the wider health effects of Covid-19 pandemic response BMJ 2020; 369 https://www.bmj.com/content/369/bmj.m1557

43. Scottish Government (2020) Equality and Fairer Scotland Duty Assessment of the Health and Social Impacts of COVID-19 https://www.gov.scot/publications/covid-19-health-and-social-impact-assessment

44. GOV.UK Guidance on shielding and protecting extremely vulnerable persons from COVID-19

45. GOV.UK Guidance on protecting older people and vulnerable adults

46. National Records of Scotland: "Winter Mortality in Scotland 2019/20." (Published 13 October 2020). https://www.nrscotland.gov.uk/files//statistics/winter-mortality/2020/winter-mortality-19-20-pub.pdf.

47. https://www.nrscotland.gov.uk/covid19stats

48. https://data.gov.scot/coronavirus-covid-19/detail.html#2_indirect_health_impacts

49. https://www.gov.scot/collections/scottish-health-survey/

50. The Scottish Government (2020) Scottish Health Survey 2019: summary report: https://www.gov.scot/publications/scottish-health-survey-2019-summary-report/pages/3/

SHeS data-tables provides breakdowns by age, gender and deprivation for cardiovascular disease and a wide range number of major health conditions. The latest SHeS data table are from the 2019 survey: https://www.gov.scot/publications/scottish-health-survey-2019-supplementary-tables/

51. https://beta.isdscotland.org/

52. Public Health Scotland publishes data on health service provision and use, much of it available for individual Health and Social Care Partnerships and Health Boards on this dashboard: COVID-19 wider impacts on the health care system

53. Scottish Government COVID-19 in Scotland: Indirect health impacts dashboard

54. Board level performance against cancer waiting time standards are detailed up to 30 June 2020: https://beta.isdscotland.org/find-publications-and-data/conditions-and-diseases/cancer/cancer-waiting-times/

55. https://beta.isdscotland.org/find-publications-and-data/healthcare-resources/waiting-times/ - Most measures are available at NHS board level.

56. ''NHS waiting times to end September 2020 - NHS waiting times - diagnostics 24 November 2020 - Data & intelligence from PHS. The eight investigations are upper endoscopy, lower endoscopy (excl. colonoscopy), colonoscopy, cystoscopy, CT scan, MRI scan, barium studies and non-obstetric ultrasound.

57. https://beta.isdscotland.org/find-publications-and-data/healthcare-resources/waiting-times/cancelled-planned-operations/

58. https://www.gla.ac.uk/researchinstitutes/healthwellbeing/research/generalpractice/deepend/

59. This weekly online panel survey is with around 1,000 adults and is representative of the adult population. Source: YouGov commissioned by the Scottish Government.

60. This measure is included on the Scottish Government COVID-19 in Scotland: Indirect health impacts dashboard

61. Public Health Scotland (2020b). "Insights in social care: statistics for Scotland. Support provided or funded by health and social care partnerships in Scotland 2018/19." https://beta.isdscotland.org/find-publications-and-data/health-and-social-care/social-and-community-care/insights-in-social-care-statistics-for-scotland/

62. https://www.gov.scot/publications/adult-social-care-winter-preparedness-plan-2020-21/

63. https://www.gov.scot/binaries/content/documents/govscot/publications/strategy-plan/2020/11/adult-social-care-winter-preparedness-plan-2020-21/documents/adult-social-care-winter-preparedness-plan-2020-21-evidence-paper/adult-social-care-winter-preparedness-plan-2020-21-evidence-paper/govscot%3Adocument/adult-social-care-winter-preparedness-plan-2020-21-evidence-paper.pdf

64. https://hselibrary.ie/what-is-the-impact-of-the-coronavirus-pandemic-on-the-mental-health-of-elderly-nursing-home-residents/ - for a review of literature on the mental health impacts of the pandemic on care home residents

65. Scottish Government (2019). "Scotland's Carer's – Update Release." https://www2.gov.scot/Resource/0054/00548776.pdf

66. Carers UK (2019). "State of Caring. A snapshot of unpaid care in the UK." http://www.carersuk.org/images/News__campaigns/CUK_State_of_Caring_2019_Report.pdf

67. Scottish Government (2015). "Scotland's Carers." https://www.gov.scot/publications/scotlands-carers/

68. Carers UK (2020). "Caring behind closed doors. Forgotten families in the coronavirus outbreak." https://www.carersuk.org/for-professionals/policy/policy-library/caring-behind-closed-doors-report

69. Scottish Government (2020) Equality and Fairer Scotland Duty Assessment of the Health and Social Impacts of COVID-19 https://www.gov.scot/publications/covid-19-health-and-social-impact-assessment/

70. Douglas et al (2020) Mitigating the wider health effects of Covid-19 pandemic response https://www.bmj.com/content/bmj/369/bmj.m1557.full.pdf

71. World Health Organization (2013). Mental Health Action Plan 2013-2020.

72. World Health Organisation (2019). The WHO Special Initiative for Mental Health

73. Coronavirus (COVID-19): mental health tracker study - wave 1 report: 12 Oct 2020

74. Scottish Government (2020) MENTAL HEALTH AND COVID-19: EVIDENCE AND ANALYSIS BRIEFING (2) 12 JUNE 2020

75. https://www.gov.scot/groups/coronavirus-covid-19-mental-health-research-advisory-group/

76. UK Chief Medical Officer' Physical Activity Guidelines (2019). Department of Health & Social Care, Welsh Government, Scottish Government & Northern Ireland Department of Health

77. See: https://www.publichealthscotland.scot/downloads/impact-of-covid-19-disease-control-measures-on-physical-activity-dietary-behaviours-and-weight

78. Sport England (2020) Sport England: Survey into Adult Physical Activity Attitudes and Behaviour

79. Editorial (2017). Life, Death and Disability in 2016. The Lancet; 390(10100): p1083-1464

80. Abdelaal M, le Roux, C and Docherty, N (2017). Morbidity and mortality associated with obesity. Annals of Translational Medicine; 5(7): 101: p.1.

81. World Health Organisation (2018). Fact Sheet Obesity and Overweight

82. Floriana, S, Luppino, MD, Leonore, M, de Wit, MS, Paul, F, Bouvy, MD et al. (2010). Overweight, obesity and depression: A systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 67;3;p229-220

83. Anstey, KJ, Cherbuin, N, Budge, M, and Young, J (2011). Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obesity Reviews; 12(5): 426-37

84. Public Health England (2020) Excess Weight and COVID-19 Insights from new evidence

85. Food Standard Scotland Covid-19 Consumer Tracker Wave 4

86. Food Standard Scotland Covid-19 Consumer Tracker Wave 4; and Obesity Action Scotland (2020) Lifestyle of Scotland's People Since the Coronavirus Outbreak

87. World Health Organization (2018) Alcohol Fact Sheet

88. Mathers C, Stevens G and Mascarenhas M (2009). Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization

89. Royal College of Psychiatrists (2020) COVID-19: Information for those who use drugs

90. Public Health Scotland (2020) Drug and Alcohol Treatment Waiting Times report

91. Alcohol Focus Scotland (2020) Alcohol Focus Scotland and Alcohol Change UK Polling Statistics Summary

92. UK Alcohol Duty Statistics, May to July 2020 Update. HM revenue and Customs

93. Drug Deaths Taskforce: terms of reference. 5 July 2019

94. Dickie E et al. (2017) Drugs related deaths narrative rapid evidence review: Keeping people safe. Edinburgh: NHS Health Scotland

95. Royal College of Psychiatrists (2020) COVID-19: Information for those who use drugs

96. Public Health Scotland, (2020) Drug and Alcohol Treatment Waiting Times report

97. Global Drugs Survey COVID-19 Special Edition: Key Findings Report

COVID-19 and drug markets survey – month one summary, Crew, May 2020

98. https://public.tableau.com/profile/sg.eas.learninganalysis#!/vizhome/VulnerableChildrenandAdultProtection/Introduction

99. https://www.gov.scot/publications/coronavirus-covid-19-domestic-abuse-forms-violence-against-women-girls-during-phases-1-2-3-scotlands-route-map-22-11-august-2020/pages/3/

100. https://www.gov.scot/publications/coronavirus-covid-19-domestic-abuse-forms-violence-against-women-girls-during-phase-3-scotlands-route-map-11-august-11-october/pages/1/

101. https://www.gov.scot/publications/recorded-crime-scotland-october-2020/

102. https://www.gov.uk/government/publications/coronavirus-covid-19-fraud-and-cyber-crime

103. https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/safe-at-home/rb_april15_only_the_tip_of_the_iceberg.pdf

104. https://www.gov.scot/publications/recorded-crime-scotland-2018-19/

105. https://www.scotcourts.gov.uk/about-the-scottish-court-service/scs-news/2020/11/17/monthly-information-on-criminal-case-throughput

106. https://www.parliament.scot/S5_JusticeCommittee/Inquiries/20200814LettertoJCfromCSJupdateJASCourtsModelling.pdf

107. https://www.gov.scot/publications/coronavirus-covid-19-children-and-transmission/

108. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/adhocs/12536coronavirusanduniversitystudents3to8november2020greatbritain

109. https://www.exeter.ac.uk/media/universityofexeter/collegeofsocialsciencesandinternational
studies/education/documentsfordownload/National_Tutoring_Service_April_2020.pdf

110. http://www.oecd.org/coronavirus/policy-responses/combatting-covid-19-s-effect-on-children-2e1f3b2f/

111. Data will be affected by public and school holidays, in particular the week beginning 12 October, where schools in 29 local authorities were closed for the October break and so were not included in these statistics.

112. https://www.ifs.org.uk/publications/14816

113. Office for National Statistics, 22 June 2020,
Coronavirus and the social impacts on young people in Great Britain: 3 April to 10 May 2020, available: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/coronavirusandthesocialimpactsonyoungpeopleingreatbritain/3aprilto10may2020#main-points

114. Respondents ages ranged from 11 – 25. 92% of respondents were aged 18 or younger; 46% were aged 15 – 17.

115. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/adhocs/12536coronavirusanduniversitystudents3to8november2020greatbritain

116. 12 – 18 October, smaller sample of universities, England only

117. As for 28th October – 1st November 2020

118. Where 0 is 'not anxious at all' and 10 is 'completely anxious'

119. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/households/household-estimates/2019

120. https://journals.sagepub.com/doi/10.1177/1745691614568352 Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review

121. https://data.gov.scot/coronavirus-covid-19/detail.html#loneliness

122. General information: https://shs.theapsgroup.scot/2019/key-findings/42/ and for additional information: https://shs.theapsgroup.scot/2019/supplementary-analysis/

123. https://www.carersuk.org/images/CarersWeek2020/CW_2020_Research_Report_WEB.pdf

124. https://www.gov.scot/publications/swf-monthly-management-information/

125. ONS Business Impact of Coronavirus Survey

126. Non-compliant actions relate to restrictions on meetings/gatherings indoors and outdoors, hugging/kissing, car sharing, travel and face coverings

127. https://www.gov.scot/collections/equality-evidence/


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