Scottish Government COVID-19 Advisory Group minutes: 20 April 2020

Attendees and apologies

Advisory group members

• Andrew Morris
• Angela Leitch
• Aziz Sheikh
• Chris Robertson
• David Crossman
• Devi Sridhar
• Jill Pell
• Mark Woolhouse
• Stephen Reicher
• Sheila Rowan
• Tom Evans
• Jim McMenamin

Invited attendees

• Mary Black

Scottish Government

• Roger Halliday
• Niamh O’Connor
• Richard Foggo
• Daniel Kleinberg
• Donna Bell
• Graham Ellis

Secretariat

• [Redacted]

Items and actions

• minutes
• summary notes

Minutes

Welcome and apologies

Chair welcomed all group members.

Apologies – [Redacted]

Minutes, action points, Chair update

Chair asked [Redacted] for an update on the modelling action from last meeting. [Redacted] confirmed work is ongoing on modelling different exit strategies, he may need assistance from HPS and will ask directly. Discussion of testing data required to inform the modelling work on options to ease restrictions. [Redacted] and [Redacted] will discuss directly. [Redacted] noted that very detailed modelling of different scenarios is being done by SPI-M. [Redacted] has access to this work, his team is scaling and adapting to Scotland. [Redacted] noted the need for work being done by Scottish Government on lockdown exit options to be shared with the group so that work isn’t going on in parallel.

Chair thanked everyone for their work on the Scottish Government request on Saturday, and noted the need to use the next three weeks strategically to provide the most useful advice possible.

Data taskforce update – [Redacted] leading – a proposal was considered by SG Directors earlier in the day. Update at next group meeting.

Action: Chair and Secretariat to discuss the potential implications of names of members of the group being in the public domain.

Action: [Redacted] to share the list from SPI-M of scenarios being modelled with the group, along with comment on what Scottish Government is considering.

CSA update

[Redacted] had engaged with SACC on robots for cleaning, will report back soon.

Deep dive – Schooling in Scotland

[Redacted] introduced the paper sent to the group. It was noted SAGE are also considering the schools issue and that communication is essential. [Redacted] had spoken to a number of teachers regarding different proposals, concerns were raised about PPE, safety of staff and children; also concern about widening attainment gap. [Redacted agreed and noted need for messaging around safety when schools do return. Should summer schools be considered as a targeted option for children disadvantaged by school closures? [Redacted] noted the need for a response plan when schools do go back and there are cases of COVID-19 diagnosed, and also a need for consensus on use of PPE. [Redacted] – we should be clearer on the role of children in transmission. [Redacted] – further evidence on this is imminent.

[Redacted] – equality is important to consider here, if a strategy includes some digital element then we need to consider families that don’t have devices and internet access. Free devices for school age children would have a positive impact beyond the end of the pandemic. [Redacted] requested further data on hospitalisation of children in Scotland, noting the potential for backlash if there is even one death as a result of schools going back. [Redacted] – in the paper circulated to the group, there have been no deaths so far in the 0-9 or 10-19 age groups, but HPS expects that there will be deaths at some point of children or young people with underlying conditions. Positivity rate is less than 5% in those age groups, older age groups have a far higher positivity rate.

Discussion on RAG / traffic light rating – does this obscure the complexity of the issues and advice sitting behind each one, or are they useful?

[Redacted] expressed concern about segmenting groups going back to schools, as there is potential for a severe impact on life chances and evidence doesn’t seem clear that a particular group should be prioritised. [Redacted] noted that the model from Warwick University suggested that schools are not a big cause of spread but there are some caveats and unknowns. Two risks to consider: to children in schools, and potential spread as a result of schools returning.

[Redacted] said that there doesn’t seem to be a consensus position in the group and also noted the fear surrounding school return which would need to be addressed as part of any plan.

Chair asked when policy makers will need advice on this, noting that perfect information on which to base a recommendation could take quite some time. [Redacted] noted that there is a need for clear messaging to all sectors about requirements for physical distancing, hand hygiene, etc as a condition for reopening. He will meet with FM on Thursday 23rd April and said that if the group had any advice by then, even if not definitive, this would be very welcome. [Redacted] asked if the 5 criteria from Dominic Raab applied in Scotland. [Redacted] stated that principles, values and progress would matter more than testing numbers in Scotland.

[Redacted] – this is an issue of equality. Do we know if there is a difference between private and state provision for children at the moment. [Redacted] - no evidence, but anecdotally there is a big difference. Noted that there is a need to articulate the reasoning behind any advice clearly.

[Redacted] – the group is likely to be asked for its opinion on a range of different scenarios – can they provide a broad set of principles in order to keep the work focussed?

Action: the group will provide interim advice to the First Minister, building on SAGE work and [Redacted]’s paper.

Deep dive – Outdoor occupations

[Redacted] spoke to the paper submitted to the group. [Redacted] – segmentation by worker type seems acceptable to the public good. [Redacted] – there is an enforcement issue as it won’t be obvious to the police what people in white vans are doing. [Redacted] – public health guidance on this would have to be very clear if we want people to maintain physical distancing. [Redacted] – transmission seems likely to be low, but how can the group’s advice minimise this? [Redacted] – developing new social norms on physical proximity will be challenging. Need to consider who benefits from people going back to work, as the self employed may be keen to return to work but some employees will see this as being put at risk for someone else’s benefit.

Action: the group to consider the key scientific principles and evidence relevant to the argument and discuss further on Thursday.

Public engagement

[Redacted] thanked the group for their input to the paper circulated on Saturday and noted that there is an opportunity for the group to comment further before the document is finalised. In terms of direct engagement with the public, the group’s advice would be welcome. Chair – should the group wait to see the next draft from Scottish Government before discussing [Redacted]’s paper further? [Redacted] agreed, this would give time for engagement with the group.

Action: [Redacted] to liaise with group members and incorporate their comments into a further draft for Thursday.

Remit of the group

As agreed at the inaugural meeting, the group undertook a review of its remit after four weeks (eight meetings).

Chair noted that the work of the group seems to be valued and is working well. There is however a need to guard against scope creep and maintain close engagement with SAGE. It was agreed that the health and biomedical scientific expertise of the group was its distinctive contribution, providing advice on the basis of evidence. Ministers then decide policy.

Is working in sub groups the best way to operate? How do we ensure against scope creep?

General comments – CMO hasn’t been present on recent calls, what advice does Gregor need? [Redacted]has been feeding back key themes, hopefully [Redacted] can attend going forward. Chair will send [Redacted] an email about the group. [Redacted] – should we coordinate more with SAGE? Chair – SAGE is UK-wide, but we should offer support where appropriate.

[Redacted] – the group’s expertise is medical but the advice sought impacts other areas, e.g. economic. How does the group make its advice clear and coordinate with others were needed? Noted a need for wider engagement – can this be done through sub groups? [Redacted] – the group should not aim to bring all expertise into the group, coordination happens elsewhere – e.g. the Scottish Government has a Chief Economist and an economic advisory group has been convened. The group should be clear on the perspective of its advice and the evidence on which it is based.

[Redacted] – it would be useful for have more behavioural expertise / clinical psychologist.

Action: Secretariat to share a note of discussions with SAGE every Thursday

Action: Chair to produce a new draft remit, clarifying points such as the scientific focus of the group.

Summary notes

1. The Advisory Group noted the work of SAGE and had ‘deep dive’ discussions on potential options for re-opening schools in Scotland and allowing some outdoor workers to return to work.

2. Regarding schooling in Scotland, the group noted that there are still a number of uncertainties in the evidence base, including the likelihood of children transmitting the virus. The group agreed on a number of points.

• the risk posed by the virus to children is low but not zero
• if schools were to return, clear advice would need to be given on safety measures for staff and children
• a policy would need to be developed to deal with suspected and confirmed cases amongst teachers and pupils in advance of schools going back

3. Regarding outdoor workers, the group agreed that with appropriate physical distancing the risk of transmission is likely to be low. The group also agreed that clear public health guidance will need to be given on precautions to be taken in order to keep the risk of transition to a minimum. The Chair will convene further discussion on this topic on Thursday 23 April.