Section 1 – National Framework and balancing multiple harms
The Scottish Government documents 'COVID-19 – A Framework for Decision Making' and 'Covid-19: Framework for Decision Making Further Information' set out the way in which Scotland is planning for a managed transition away from current restrictions that enables the suppression of transmission to continue. This will include ongoing physical distancing, the continued need for good hand hygiene and public hygiene, and enhanced public health surveillance.
The supporting evidence paper recognises that the crisis is impacting differentially on subgroups of the population and different parts of the country, and highlights that equality will be at the heart of our decision-making. It reiterates the four harms:
1. The virus causes direct and tragic harm to people's health.
2. The virus has a wider impact on our health and social care services in Scotland.
3. The restrictions which have been put in place affect our broader way of living and society.
4. The impact on our economy, with a damaging effect on poverty and inequality.
There are two key factors underpinning the framework:
1. Implementation is conditional upon scientific and medical advice confirming that it can be done so in a manner that is consistent with wider efforts to control the reproduction rate and protects the health of staff and pupils alike.
2. Comprehensive implementation of complementary public health measures, including adherence to 'test, trace, isolate and support' (TTIS) practices, the use of PPE where appropriate for all staff, and a range of other hygiene measures such as:
- Increased hand-washing facilities/hand sanitisers and use thereof.
- Regular and enhanced cleaning of surfaces (e.g. surfaces such as sinks, toilet seats and door handles disinfected twice a day).
- Protocols for what to do if a child/members of staff has suspected/confirmed COVID-19.
- Ongoing risk assessments on the operational parameters of re-opened centres.
The framework highlights that our first objective and absolute necessity is to contain and suppress the virus. Beyond that, our challenge is to minimise broader harm to our health, society and economy and to restore as much normality to everyday life as possible. There is a recognition that these harms are related: health harms impact on society and the economy, just as the societal and economic effects impact on physical and mental health and wellbeing.
Children and young people are likely to be impacted most, and for longer, by the unintended consequences and other factors attributable to actions taken to control the pandemic. We understand that school closures are having a negative impact on all aspects of children's progress and development, including wellbeing. The anticipated consequences include impacts on mental health, socialisation and attachment (particularly for younger children). Impacts of 'hidden harm' may lead to additional cognitive, emotional and behavioural need and are likely to require significant intervention over the medium and longer term. Navigating the right course through the crisis will involve taking difficult decisions that seek to balance these various, inter-related harms so as to minimise overall harm.