- 2 Apr 2020
Good afternoon everyone.
I want to provide you with a further update on Scotland’s response to the Covid-19 epidemic and there are a few issues today that I want to address in detail.
First, I can confirm that, as at 9 o’clock this morning, there have been 2,602 positive cases confirmed - an increase of 292 from yesterday’s figures. As always, I want to stress that these numbers will be an underestimate.
A total of 162 people last night were in intensive care with confirmed or suspected cases of Covid 19. That is an increase of 15 on yesterday, and a total of 1282 patients, including intensive care patients, are in hospital.
Now, I’m going to take a bit of time today to talk about the figures of deaths that we are sadly reporting. And in doing so I want to firstly say that every single death from this virus is a tragedy and my thoughts are with the families and friends of all those who have lost their lives.
We know that one of the most difficult parts of having a friend or family member die from Covid-19 is that the nature of the virus means that family cannot be there at the time of death, and as we have announced, only limited friends or family can attend a funeral. It is a particularly cruel virus in that respect.
If I can turn now to the numbers of people who have sadly died from coronavirus since our last update. The figure for today, based on our method of reporting so far which, to be clear, comes from health board notifications of deaths with a laboratory confirmation of Covid-19 would be 10 which would have taken the total to 86.
However we’ve also been advised overnight of an additional 40 deaths that had not previously been notified due to delays in family liaison. That brings the total number to 126. However, it wouldn’t be accurate to add all of the additional 40 deaths to today’s total. They will require to be distributed over a number of days and we will seek to provide that further detail later today.
To reiterate, it does mean the total number of people with a confirmed Covid-19 diagnosis who have died in Scotland is now 126.
I can also confirm today, the numbers of deaths are unfortunately rising as the virus continues to spread. It is necessary to make some changes to the reporting system to ensure that as we go forward it is as robust and as up to date as possible and also as comprehensive as possible.
These two changes are as follows. Firstly, from now on, the daily figure of confirmed deaths reported by Health Protection Scotland (HPS) will no longer rely simply on notifications by individual health boards. Instead, HPS will use validated National Records of Scotland (NRS) figures. In short ,what that means in the daily figure reported will represent the number of laboratory Covid-19 cases confirmed through the NRS death registration process for the preceding 24 hours ending at midnight the night before.
The second changes is that as of next week, NRS will also start to report on deaths where Covid-19 is mentioned on the death certificate. This will include not just confirmed cases but also presumed cases and will cover all settings including hospital and community deaths.
Let me also say that as the number of cases and deaths rise, the issues of patient confidentiality associated with small numbers become less relevant. So from next week HPS will also be seeking to publish much more detailed breakdowns of these numbers and we will give more detail of what exactly that will entail over the weekend.
I appreciate that this is quite technical information, but as this situation develops we are determined that information continues to be as accurate, up to date and comprehensive as possible. And that we are being as transparent as we possibly can be. We intend to do a briefing for journalists over the next couple of days specifically focused on death reporting to ensure that any questions about these changes can be addressed and the basis of reporting as we move forward is fully understood.
The two other issues we wish to address today are also both subjects which, rightly, have attracted a great deal of attention.
The Cabinet Secretary will say more shortly about personal and protective equipment – or PPE – for those working in health and social care.
Over the past few days, we’ve taken significant action to improve the supply and distribution of PPE to frontline staff. Today, Health Protection Scotland will publish revised guidance on when - and how – that equipment should be used.
This revised guidance is intended to build confidence in the health and social care workforce that they are being properly protected. The revised guidance has been produced on a UK-wide basis, with input from Royal Colleges, and expert scientific groups. And it reflects the stage we’re now at, in the spread of Covid-19.
The second issue I want to talk about is testing. I want to briefly summarise the situation here in Scotland – and the ways in which we are working to enhance testing capacity.
At the moment, all NHS COVID-19 testing is what is called PCR testing.
These PCR tests are effective at identifying people who have the COVID-19 infection at the time when they are symptomatic. However, they cannot reliably detect the virus during the incubation period – before the person has symptoms - and they cannot confirm whether a person has had the infection once they have recovered.
In the future we also hope to be able to offer a different type of testing - antibody testing, which would indicate if a person has had the infection. These tests are not yet available in a reliable form, but the Scottish Government is working with the UK on this, and we hope that validated tests will become available soon.
That means, that as of now, we have three priorities for testing.
As you would expect, we test those who are most seriously ill – to support their care.
We undertake testing so that frontline health and social care staff can return to work. However, when a health care worker is self-isolating because a family members has symptoms but they don’t yet have symptoms testing the health care workers would not be effective. So in some cases this strand of testing will involve testing family members of health care workers who have symptoms and if they don’t have the virus then they can go back to work.
I can confirm today that we have tested a total of 3,400 NHS workers or family members and we expect that figures to rise considerably in the days to come.
And thirdly we need to use testing to assess, monitor and report on the spread of the virus across the country – surveillance testing – that is in a way that is similar to what we do for flu every year.
To enable us to test in these priority areas, rapid increases in testing capacity are taking place.
Initially, we were able to test 390 samples a day. That capacity has now increased to up to 1,900 tests daily. And we are building towards being able to carry out 3,500 tests per day, by around the end of April.
From next week we seek to publish daily information on what tests have been carried out.
Now there are two issues in particular I want to address.
Firstly – while testing key workers is important – and we have so far tested 3,400, in many cases testing simply confirms that the individual does have Coronovirus. So while we will continue to expand testing and to expand key worker testing, it does not of itself mean staff will be able to return to the workforce.
In the coming weeks – it will become more likely that a person with symptoms has Covid-19, than that they do not have the virus.
Secondly, procurement of tests and capacity. The capacity I have described is within Scotland’s NHS.
We continue to look at ways to expand that capacity ourselves and with other organisations – and we are also taking part in four country initiatives with the rest of the UK which will further add to that capacity. This is in addition to, not instead of building our own capacity in NHS Scotland.
We are very grateful to every organisation that has offered laboratory space.
However, we need to be sure the testing is done in a way that is safe and meets high quality standards so we can be confident in the results.
There are therefore important due diligence issues that need to be addressed before any new laboratory can be used.
That is why National Services Scotland has so far prioritised the expansion of NHS capacity but are engaging as a priority with the external laboratories that are better placed to meet these criteria more quickly.
We are also considering how we use more extensive testing – including antibody testing - as part of the strategy to take the country out of lockdown – though I must remind people that may not be imminent.
I want to close by once again acknowledging the extraordinary contribution of our health and social care workforce.
This evening I – along with people across this country – will again take the time to applaud the fantastic work they are doing. As a further show of appreciation, this Scottish Government building – St Andrew’s House – will light up in blue. That will happen this evening - and every subsequent Thursday – in the weeks ahead.
It’s one small way of expressing our respect and our gratitude for those on the frontline.
But – as I’ve said before - the single most important way we can show support for health and social care workers, is by staying at home.
By doing the right thing and by limiting contact with other people as much as possible, we can all do our bit to slow the spread of the disease; to protect our NHS; and to save lives.
This is not a quick fix. We all want this phase of our lives to be over as quickly as possible. But much as I’d like to stand here and say otherwise, this unlikely it is going to be in just a few weeks, we are in this for the long haul.
As we gather more hard data on how the virus is spreading in Scotland and on what impact these lockdown measures are having we will be able to more precise about when and how we can start to get back to normal. We will share as much of that analysis as soon as we can. But I want at every stage to be giving you our most informed analysis rather than just telling people what we all want to hear and then having to downgrade that later.
I know who tough this is, but please stick with it. You are helping us save lives.
So I want to again thank everybody – across the country – who is playing their part. Your efforts will continue to be vital in the weeks ahead as we fight this battle against coronavirus.