Questions concerning scientific evidence, guidelines and statistical information related to COVID-19: FOI release

Information requested

1. Scientific evidence for face covering guidelines in schools, shops and on public transport;
2. All medical risk assessments associated with face coverings for adults and children;
3. Scientific evidence for all imposed lockdown guidelines since February 2020.
4. Medical risk assessments associated with lockdown measures (social distancing, 2m rule, isolation, furlough, shielding);
5. Scientific references to the isolated COVID19 virus using Kochs postulates.
6. The R0 data from the beginning of lockdown to the current date;
7. The latest overall Case Fatality Rate (CFR) in Scotland for COVID19 (based on total population size);
8. Any lockdown guidelines prescribed to the NHS for receiving and discharging patients with AND without COVID19 (from the beginning of lockdown to date).
9. A breakdown of the funds spent on the research of COVID19; and
10. A breakdown of the funds spent on Public Relations specific to COVID19.

Response

1. The Scottish Government has made clear in ‘Scotland’s Strategic Framework’ that it takes a 4 harms approach to decision making in relation to the pandemic. The Scottish Government considers a wide range of evidence before reaching its conclusions and will continue to make decisions informed by the available scientific and medical evidence. Regarding face coverings, decisions were based on scientific evidence and advice from the World Health Organisation (WHO) and Scientific Advisory Group for Emergencies (SAGE) and the Scottish Government Covid-19 Advisory Group.

The Scottish Government Covid-19 Advisory Group interprets and applies advice from SAGE and other appropriate sources of evidence and information and uses it to advise Ministers in order to inform decisions in Scotland. The Advisory Group has published advice on Physical Distancing and Superspreading which provide general advice on the risks of transmission of covid-19 and possible mitigations, including face coverings, but has not published advice on face coverings.

The face coverings guidelines in schools, retail and transport was based on the following evidence:

• On 4 June 2020, SAGE discussed mitigation measures which included the use of face covering. You can find further information in the meeting minutes which are available on the UK Government website here.

• The World Health Organisation released update advice on face covering on the 5 June 2020. The guidance advised that to prevent Covid-19 transmission effectively in areas of community transmission, governments should encourage the general public to wear face coverings in specific situations and settings as part of comprehensive approach to suppress Covid-19 transmission. You can find a copy of this guidance on the WHO website here. And their recent guidance on children wearing face coverings can be found here.

• The UK Government released a summary of the relevant SAGE reports for this topic. This can be found on the UK Parliament website here.

• The Scottish Governments guidance on face coverings, including exemptions, can be found here.

We continue to review our policies on a regular basis in light of the emerging evidence on coronavirus and so we would urge you to continue to use the hyperlinks to find the latest position.

It is important to note that physical distancing, hand hygiene and respiratory hygiene are the most important and effective things we can all do to prevent the spread of coronavirus. The wearing of face coverings must not be used as an alternative to any of these other precautions.

2. The Scottish Government does not hold the information you have requested on all medical risk assessments associated with face coverings for adults and children because these assessments are done on an individual basis. This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested in this part of your request.

3. While the Scottish Government consistently follows the latest scientific and medical advice, it is important to emphasise that the approach which is guiding decision-making on lockdown restrictions is informed by a balanced assessment of the four harms caused by the COVID-19, namely, the direct impact on people’s health and lives, as well as wider non-COVID health, economic and social impacts. This means that the Scottish Government is required to balance these various, inter-related harms so as to minimise the overall harm. Further information on the Scottish Government’s Framework for Decision-making is available here.

Some of the information you have requested is available on the Scottish Government’s website. This collection details Scotland’s phased approach through and out of the COVID-19 crisis and transitioning out of lockdown, including the framework and supporting evidence that guides decision making.

In relation to the scientific aspects of COVID-19, the Scottish Government is advised by the COVID-19 Advisory Group, whose remit, meeting minutes and papers are available on the Scottish Government website here. The Advisory Group benefits from access to the extensive scientific and technical advice considered by the Scientific Advisory Group for Emergencies (SAGE), which can be found on the UK Government’s website here.

Under section 25(1) of FOISA, we do not have to give you information which is already reasonably accessible to you. If, however, you do not have internet access to obtain this information from the website listed, then please contact me again and I will send you a paper copy.

With regard to evidence supporting the closure and subsequent re-opening of specific sectors and activities on our route out of lockdown, decisions are guided by the principles set out in our Framework for Decision Making: Coronavirus (COVID-19): Scotland's Strategic Framework. Proposals are technically assessed using the best available evidence and analysis of their potential benefits and harms to health, the economy, and broader society to minimise overall harm and ensure transmission of the virus continues to be suppressed. This assessment process includes oversight of the assessed health risks in different settings by the Chief Medical Officer and input from the other Chief Clinicians as appropriate.

Further information about the Scottish Government’s decision-making framework can be found in the paper Coronavirus (COVID-19): framework for decision making - assessing the four harms published on 11 December. This paper provides an overview of key analysis and evidence in support of COVID-19 decision-making. 

In this document, we describe how the four harms approach works in practice and present evidence under each of the four harms to illustrate how we used the four harms to make decisions about levels, activities and restrictions through the Route Map process.

A subsequent publication will explain the four harms approach to the recent development of local protection levels. As the Scottish Government is currently preparing to publish this information in due course, this is a formal notice under section 27(1) of the FOISA, that the information is intended for future publication. We consider that it is reasonable to withhold the information rather than release some of this information before the planned publication date.

This exemption is subject to the ‘public interest test’. Therefore, taking account of all the circumstances of this case, we have considered if the public interest in disclosing the information outweighs the public interest in applying the exemption. We have found that, on balance, the public interest lies in favour of upholding the exemption. We recognise that there is some public interest in the release of this information now but we believe the public interest is best met by our planned publication. There is greater public interest in taking the time necessary to ensure the information has been properly collated and checked before it is published as planned. Also, we see no public interest in disrupting our programme of work to release the information ahead of the future publication date.

4. The Scottish Government does not hold the information you have requested on medical risk assessments associated with lockdown measures (social distancing, 2m rule, isolation, furlough, shielding) because these assessments are done on an individual basis. This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested in this part of your request.

5. The Scottish Government does not hold the information you have requested on scientific references to the isolated COVID19 virus using Kochs postulates. This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested in this part of your request.

6. The Scottish Government uses epidemiological modelling to estimate the reproduction rate Rt which is a measure of the average number of people that would be infected by one individual with Covid-19. If Rt is 2, then two people would be infected by one person on average. If Rt is above 1 then it shows that the virus is spreading in the population, and if it is below 1 then it is declining in the population.

All the information you have requested is available from:

• Prior to 8 May 2020, the reproduction rate Rt used by the Scottish Government in its epidemiological modelling is reported by Imperial College London, a mean Rt of 3.28. You can find it in page 6 of the Supplementary Information of Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe | Nature.

• From 8 May onwards, the Scottish Government’s has been publishing a collection of reports, including findings on modelling the COVID-19 epidemic in Scotland including the spread of the disease through the population (epidemiological modelling) and the demands it will place on the system. These cover, among other data, the estimation of the reproduction rate Rt. They are available on the Scottish Government website here.

Under section 25(1) of FOISA, we do not have to give you information which is already reasonably accessible to you. If, however, you do not have internet access to obtain this information from the website listed, then please contact me again and I will send you a paper copy.

7. The Case Fatality Rate (CFR) is the ratio between confirmed deaths and confirmed cases. As at 7th January 143,715 people have tested positive for COVID-19 and 4,779 have died. This gives a case fatality rate of 3.3%. More information on the figures used to calculate this rate is available here.

8. The Scottish Government does not have the information you have asked for because it is not directly responsible for the subject. However, Health Protection Scotland (HPS), which is part of Public Health Scotland (PHS), has published guidance and protocols for secondary care, including how to deal with discharging COVID-19 patients from hospital to residential settings. You can find the latest available version of their guidance here. If you are interested in older versions of the guidance and protocols, you can make an FOI request to PHS here. This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested.

9. On 25 March the Chief Scientist Office of the Scottish Government launched the “Rapid Research in Covid-19 (RARC-19)” funding call. This resulted in support of £5.2m being committed to 15 health research portfolios.  While the total final expenditure will not be known until all the portfolios have concluded the Scottish Government, has so far advanced £4.4m in grant funding to the 15 organisations involved. Further Information on the research supported by Rapid Research in Covid-19 RARC-19 can be found online here. I am attaching a breakdown of the funds spent on the research of COVID19 in the format your asked for. This is named Annex A.

10. I enclose a copy of breakdown of the funds spent on Public Relations specific to COVID19 in the format your asked for. This is named Annex B.

 

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