COVID-19 statistics and testing methodologies: FOI release

Information requested

“1. If there have been any changes to how tests are being processed? I have confirmation for NHS Scotland that tests for each of the 3 genes are tested up to 40 cycles. This was from an FOI request response on the 29/12 which was originally requested at the start of December 2020. Has the cycle protocol been around the 23rd of December?”

“2. There are instances of hospital patients being tested 3 or 4 times within a hospital ward within the same 7 day period. What is the testing protocol for hospital patients who have been admitted for other matters?”

“3. Why does the Scottish Government not give a breakdown of the number of patients in ICU due to Covid and not with COVID? On today’s ICU figures in Scotland 06/01/2020 how many of those are in ICU because Covid put them there?”

“4. Is there any information to show whether a vaccination of health care workers and social care workers will impact on the number of positive tests?”

Response

I apologise for the delay in responding to your request for information. The delay has arisen as a result of the very high volumes of correspondence that we are experiencing in relation to the coronavirus outbreak. We are taking steps to ensure that FOI requests are processed timeously in future, and I apologise for the inconvenience on this occasion.

Question 1

Unfortunately, this request is invalid because it does not describe any specific information being requested. A request is not valid if it does not, in accordance with section 8(1)(c) of FOISA, describe the information requested. Point 1 of your letter sets out that you are looking to confirm a potential change in practice, however, it does not clearly identify the particular information you are looking for, we do not consider it to be a valid request under FOISA. Accordingly, we are not obliged to respond to it. However, if you wish to rephrase your request to clearly describe the information you are looking for, rather than simply setting out your aim, we would be able to consider your request and respond in accordance with FOISA. If you need any further advice and assistance to rephrase your request, please contact me. You may also find it helpful to look at the Scottish Information Commissioner’s ‘Tips for requesting information under FOI and the EIRs’ on his website at: http://www.itspublicknowledge.info/YourRights/Tipsforrequesters.aspx.

That said, I have included the following information that you may find helpful regarding the issue of testing.

The laboratory tests being used are real-time RT-PCR assays which are used to identify the causative agent of COVID-19 disease, known as SARS-CoV-2 virus. PCR tests use a highly sensitive and specific technique which is the gold standard for diagnosing viral infections. The tests detect the presence of the SARS-CoV-2 virus in respiratory secretions. Public Health Scotland have produced a frequently asked questions document on laboratory testing for COVID-19 which has further information on the tests in use and can be accessed here:
HPS Website - COVID-19 - laboratory testing frequently asked questions (scot.nhs.uk).

The Cycle Threshold, or CT value is the number of PCR cycles that it takes before the virus is first detected; the lower the CT value the higher the level of virus in the original sample. Each manufacturer of the RT-PCR test will recommend a differing maximum amplification cycle number when determining the presence of SARS CoV-2, but a maximum of around 40 amplification cycles is typically recommended by test manufacturers.

There are a variety of RT-PCR tests currently in use in Scotland to confirm the presence of the virus SARS CoV-2, all of which are regulated and approved by the Medicines & Healthcare products Regulatory Agency (MHRA), and thereafter validated for use by the Scottish laboratory performing the test. Furthermore, many of the commercial assays are used as the primary method for diagnosis by a number of other countries world-wide.

Public Health Scotland have produced guidance for sampling and laboratory investigations to minimise reporting of false positives occurring. This can be found at the below link:

• HPS Website - COVID-19 - guidance for sampling and laboratory investigations (scot.nhs.uk).

UK Government Laboratories (also known as Lighthouse Labs) also have similar quality procedure systems in place to minimise false positives but are unable to repeat test low positive results.

The Scottish Government is committed to using testing where it has a clear purpose and can contribute to reducing the risk of transmission. We will continue to adopt a flexible approach to testing which is based on the best available evidence to address the challenges where it can have the greatest impact and is guided by scientific, clinical and public health advice from our expert advisory structures.

Question 2

I have included the information you have requested, in Annex A and Annex B at the end of this document.

To be clear while our aim is to provide information whenever possible, in this instance we have redacted some of the information within the documents being released because that information is out with the scope of your request. Specifically, the FOI legislation provides you with the right to the ‘information’ and not the ‘document’, as a result information within the document which you have not requested is ‘out with the scope of your request.’

In addition, You can find published information on the below links :

• National Infection Prevention and Control Manual: Home (scot.nhs.uk)
• https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19/test-and-protect/coronavirus-covid-19-testing
• Clinical and scientific review of testing - gov.scot (www.gov.scot)
• Coronavirus (COVID-19) - testing strategy: Health Secretary's statement 25 November 2020 - gov.scot (www.gov.scot)
• Testing expansion update - gov.scot (www.gov.scot)
• https://www.gov.scot/news/scotlands-covid-19-testing-strategy/
• https://www.sehd.scot.nhs.uk/dl/DL(2020)32.pdf

Question 3

This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested.

The Scottish Government does not collect this information and therefore cannot publish it. However, I have set out below the definition we use when publishing information on patients in ICU.

NHS Boards provide Scottish Government with daily management information on the numbers of in-patients in Intensive Care Units (ICU) with COVID-19. A small number of NHS Boards have some combined ICU/HDU units and include information on patients in those units.

This measure (available from 11 September and first published 15 September 2020) includes patients who first tested positive in hospital or in the 14 days before admission. Patients stop being included after 28 days in hospital (or 28 days after first testing positive if this is after admission). Further background on this new approach is provided in this blog https://blogs.gov.scot/statistics/.

This is based on the number of patients in beds at 8am the day prior to reporting, with the data extract taken at 8am on the day of reporting to allow 24 hours for test results to be available. Where a patient has not yet received a positive test result they will not be included in the figures. Patients who have been in hospital or ICU for more than 28 days and still being treated for COVID-19 will stop being included in the figures after 28 days.

Question 4

This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested.

Although we do not have the information you request, I have set out below some information which you may find helpful.

It is important to note that not all vaccines prevent transmission and at this stage we don’t know if the vaccines will stop you getting Covid-19, or, importantly, stop you from passing it on.

We do know that it will reduce both mortality and morbidity. However, until we know more, restrictions will still be needed and it is critical that everyone continues to follow the FACTS guidance.

About FOI

The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at http://www.gov.scot/foi-responses.

FOI - 202100133761 - Information Released - Annex A and B

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