Publication - Transparency data

Coronavirus (COVID-19): Route Map - supporting evidence for the 15 October review

Supporting evidence to inform decisions about timings of changes within Phase 3 as set out at the review point on 15 October 2020.

Coronavirus (COVID-19): Route Map - supporting evidence for the 15 October review
WHO criterion 1: Evidence shows that COVID-19 transmission is controlled

WHO criterion 1: Evidence shows that COVID-19 transmission is controlled

  • R is consistently low
  • Number of infectious cases is showing a sustained decline

These criteria are not met. SAGE's consensus view, as of 8 October, was that the value of R in Scotland was between 1.3 and 1.6. The various groups which report to SPI-M use different sources of data in their models (i.e. deaths, hospital admissions, cases) so their success at capturing recent changes varies from group to group, leading to increased levels of uncertainty at this point in the epidemic. However R in Scotland is now above 1. The SAGE consensus is updated weekly on a Thursday.

Supplementary measures

The number of new confirmed COVID-19 cases by specimen date showed a sustained decline since peaking in late April 2020, based on the 7 day moving average, up until 9 July, even in the context of increased testing and expanded eligibility. In early July there were fewer than 10 new cases a week and at the last review we reported 232 per day in the week to 19 September. Since then the weekly average number of new cases per day has increased to its highest ever level of 988 on 10 October.

Daily New Positive COVID-19 Cases – 7 Day Moving Average:
This figure shows the moving average number of new positive cases, since the start of March 2020. There is a first peak at 400 average new positive cases in the last week of April, before a sustained decline throughout June and July. Cases begin to increase, rising to above 200 a day in mid-September, and increasing quickly to nearly 1,000 a day in the first week of October.

Source: Public Health Scotland daily dashboard, 12 October 2020

The number of hospital admissions per day for those with a positive COVID-19 result showed a sustained decline from 7 April 2020, based on the 7 day moving average, but has recently started to increase. In the week ending 8 October there were 46 admissions per day, compared with under 5 per day in early September and fewer than 1 per day in mid-July.

Hospital Admissions with confirmed COVID-19 – 7 day moving average
The graph shows the 7-day moving average of hospital admissions with confirmed COVID-19. Since March 2020, hospital admissions grew quickly to a peak of just over 180 per day in the second week of April, before declining quickly to below 20 a day in mid-May. They remained below this level, before beginning to increase again in the last week of August. There were over 40 new admissions each day in the first week of October.

Source: Public Health Scotland daily dashboard, 12 October 2020

The number of new daily ICU admissions showed a sustained decline from 4 April based on the 7 day moving average, and while still low has shown signs of increasing again recently. In the week ending 11 October, there were 21 confirmed COVID-19 patients admitted to ICU compared with 8 in the week ending 21 September.

ICU Admissions with confirmed COVID-19 – 7 day moving average
The graph shows the moving average of the number of new ICU admission with confirmed COVID-19. There is a quick rise to over 20 admissions per day at the start of April, before a rapid decline to below 5 admissions on average each day from May to the 9th of October. The number of admissions has increased marginally during September, but remained below 5 new admissions to ICU per day.

Source: Public Health Scotland daily dashboard, 12 October 2020

After peaking at 661 in the week ending 26 April (week 17), the number of deaths involving COVID-19 reduced to less than 1% of the peak level but has started to increase slightly again.

As of 4 October, there have been a total of 4,276 deaths registered where COVID-19 was mentioned on the death certificate. In the latest week (to 4 October) there were 20 deaths, which was double the previous week's number and 3% of the peak level. The previous review reported 5 deaths in week ending 13 Sept.

Deaths involving COVID-19
The graph shows the number of deaths where COVID-19 was mentioned on the death certificate. After rising to a peak of over 600 during April, the number of deaths declines steadily to below 100 during June. The number of deaths per week remains low, but begins rising slowly at the end of September.

Source: https://data.gov.scot/coronavirus-covid-19/detail.html#1_direct_health_harms

The proportion of those who have a positive test for COVID-19 out of those who are symptomatic of COVID-19 in community healthcare has increased in recent weeks. There were no swab positives for three weeks, week 27 (29 June to 5 July) to week 29 (13 to 19 July) but 36 positive swabs in the most recent week (28 September to 4 October) which represents 7.6% of swabs.

In conclusion:

A significant increase in case numbers has been observed over recent weeks and the weekly average number of new cases per day has now increased to its highest ever level. Hospital and ICU admissions and deaths have increased over recent weeks and continue to rise.

The estimated range on R has been above 1 in Scotland for the last three weeks.

On the basis of the evidence summarised above the assessment is that these criteria have not been met at this review point


Contact

Email: craig.gibson@gov.scot