Coronavirus (COVID-19): fertility services - winter 2020/2021 preparation plans

This document sets out the winter preparation plans for fertility services in Scotland.

11 Appendix 2: Tiers

Level 0 (baseline) and Level 1 - Within these levels, we would expect to see low incidence of the virus with isolated clusters, and low community transmission. Broadly, these levels are the closest we can get to normality, without a vaccine or effective treatment in place, before conditions will allow us to move to Phase 4 of the Route Map. They would be similar to the measures in place during the summer, once we reached Phase 3. The Baseline and Level 1 are designed to be sustainable for longer periods.

Levels 2-3 - Within Levels 2 and 3, we would expect to see increased incidence of the virus, with multiple clusters and increased community transmission. There would be a graduated series of protective measures to tackle the virus, focusing on key areas of risk – broadly, indoor settings where household mixing takes place with less, or less well-observed, physical distancing and mitigations. The measures would be intended to be in place for relatively short periods (2-4 weeks), and only for as long as required to get the virus down to a low, sustainable level.

Level 4 - Within this level we would expect to see very high or rapidly increasing incidence, and widespread community transmission which may pose a threat to the NHS to cope. It is likely that this level would see the introduction of measures close to a return to full lockdown. Measures would be designed to be in place for a short period, to provide a short, sharp response to quickly suppress the virus.

Tier Level 0 (baseline) and Level 1 1 - Living with Covid Tier 2 - Levels 2-3 Enhanced Measures depending on local virus prevalence Tier 3 – Level 4: Restricted Measures
Donor recruitment
Services resume to pre-COVID level but with new ways of working as highlighted in section 5. Continue with remote consultations Restrict face to face appointment Continue with fertility services where staffing permits as per HFEA guidance and restart plan already published Appropriate use of PPE both by patients and staff Low threshold for freeze all Remote consultations continue Face to face only when absolutely necessary Prioritisation of services as per section 5.2 Prioritisation for those at greatest risk of fertility decline Urgent fertility preservations to continue Staff encouraged to work from home wherever possible Consideration for freeze all for suitable patients to reduce ovarian hyperstimulation (OHSS) Appropriate use of PPE both by patients and staff

Road map agreed in restart strategy will be refreshed as needed.



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