COVID-19 Various questions: FOI release

Information requested

1. How many people and their age groups died only of covid-19 that had absolutely no other underlying health conditions or trauma or were presumed to have it?
2. Exactly how is covid-19 tested for?
3. Were any DNR's ( Do not resuscitate ) issued on Government / health authority orders?
4. Exactly how many patients needed treatment in the NHS Louisa Jordan, Glasgow?
5. Were any residents of care homes denied any medical treatments / medication due to or the presumption of covid-19?

Response

1. Figures for pre-existing medical conditions in deaths involving COVID-19 can be found in Figure S3: Pre-existing medical conditions in deaths involving COVID-19 in the Additional Analysis section on the National Records of Scotland website (https://www.nrscotland.gov.uk/covid19stats).
The Scottish Government does not hold figures on pre-existing health conditions of death involving COVID-19 broken down by age. Information on COVID-19 related deaths in Scotland is collected by the National Records of Scotland, therefore you may wish to contact statisticscustomerservices@nrscotland.gov.uk.

2. In Scotland, all Covid-19 testing for diagnostic purposes is ‘PCR (polymerase chain reaction) testing’. An appropriate sample is collected from an individual and PCR testing detects the presence of the causative virus in that sample - in this case SARS-Cov2. PCR testing is highly effective at identifying individuals with Covid-19 when they are symptomatic but cannot tell whether the virus is active or inactive.

3. Neither the Scottish Government, nor individual Health Boards, have ‘ordered’ the use of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms for any individuals or groups of patients and there has been no change to the Scottish Government guidance on the use of DNACPR forms during the Covid 19 outbreak.  
As with all other clinical treatments, decisions about CPR should be made by clinicians, based on the individual clinical circumstances and wishes of the patient, recorded appropriately and updated when medical circumstances change.

4. NHS Louisa Jordan was constructed to ensure Scotland’s NHS had the capacity and resources to treat a potentially unknown number of COVID-19 patients during an unprecedented global pandemic. To date, we have not needed to use NHS Louisa Jordan to treat any Covid-19 patients.

5. The Scottish Government is absolutely clear that we expect anyone who would benefit from medication or medical treatment including hospital care to receive this. This includes care home residents, when the treatment is clinically assessed to be in the best interest for their care. The Scottish Government first published guidance for care homes on 13 March and updated these thereafter, most recently on 15 May: https://www.gov.scot/publications/coronavirus-covid-19-clinicaland-practice-guidance-for-adult-care-homes/. The guidance has continuously stressed the importance of person centred care, including the need for the right healthcare support for care home residents, whether medication, medical treatment or hospital admission where necessary. This is a clinical assessment and decision made for each individual patient against a number of factors and not one that Government either directs or makes. The guidance also outlines the importance of healthcare support from community nursing and GPs practice teams within the care home.

Health Boards have been working closely with GPs, community pharmacists and community nursing teams to co-ordinate support for care homes, ensuring good pathways of care and management of any outbreaks. NHS 24 are putting all calls relating to Covid from care homes to Covid hubs to ensure appropriate pathways are followed. They have also developed a suite of content specifically for the care home sector to guide their staff to which resource is best for them. GP Practices continue to be critical in supporting care home residents. They remain the first point of contact for care homes and should continue to provide the same high level of care and medical treatment that they have always provided to their patients in care homes. The Chief Medical Officer (CMO) wrote to GPs on 17 April with guidance to support their work with care homes. In that letter the CMO asked GPs to reach out to these settings to offer reassurance and support during what is a worrying time for this sector. The Scottish Government has been working with the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP) on care homes and they fully support this guidance (they are joint signatories).

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