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Testing Times

“The COVID-19 pandemic is a tragic reminder of how deeply connected we are.  The virus knows no borders and is a quintessential global challenge.  Combating it requires us to work together as one human family.”  UN Secretary-General António Guterres


Testing for Covid19 in Scotland is to be expanded. The announcement by the Scottish Government on 1st of May follows the setting up of NHS Testing labs in every health authority. Added to this are the UK Government drive through testing stations and mobile units.

The capacity to test in Scotland is now at 8,350 a day. This capacity has so far been under utilised which is why the expansion of just who can be tested is taking place.

Who will now be tested in Scotland?

Care homes are a key focus for testing due to the appalling numbers of deaths occurring in them – now at over 50% of the total of all deaths in a week due to Covid19.

In a care home where there has been an outbreak of Covid19 – all residents and staff will be tested. If the same staff also work in other care homes – those facilities will also be tested.

In care homes without the virus there will be sample testing.

People with symptoms who are 65+ and those who are still leaving home to go to work will be eligible to book a test online: UK Government Self Referral Test

As part of a Scotland wide survey, anti-body tests will take place to try to understand how Covid19 is spreading in the population.

Testing in Scotland

At the start of the Covid 19 outbreak in Scotland there were 2 NHS labs set up to do testing – Glasgow and Edinburgh.

Test figures for Scotland for the day of 30th of April 2020

Tests done by NHS in hospitals/community/care homes: 2,537 tests
Tests done by drive-throughs/mobile/homes testing: 2,124 tests
Total number of tests done in Scotland on 30 April: 4,661

As you can see the full capacity (8,350)of the testing facilities now available has not been used.

In total for the whole of Scotland only 56,702 people have been tested (correct as at 1st May 2020): 45,048 were confirmed negative; 11,654 were positive.

A World Wide Public Health Issue

The pandemic Covid19 is a public health issue – one Scotland and the UK was not prepared for. The UK is the 5th wealthiest state in the world and yet it looks like it will have the worst death figures in Europe. Slow to respond and going its own way – the four nation strategy was  to not follow the World Health Organisation advice but to devise its own strategy. Over 40,000 people in the UK have now died.

As we have done clearly from the beginning we will continue to call on countries to implement a comprehensive package of measures to find, isolate, test and treat every case and trace every contact. WHO

The World Health Organisation has during this pandemic strengthened its ties with the EU and signed a Memorandum of Understanding with the European Investment Bank. This will be used to fund the development of vaccines (not just Covid19) and of supporting public health systems.

Coming out of lockdown

The advice from WHO is very clear on coming out of lockdown which cannot happen without the evidence to support it happening.

  1. Do you understand where the virus is?
  2. Is the infection rate falling?
  3. Are there measures in place to identify, test, trace and isolate ?
  4. Are citizens being kept well informed about physical distancing and personal hygiene?
  5. Is the NHS able to treat all those requiring it?
  6. Do our frontline workers have the required PPE to keep themselves and others safe?

The UK and within it, Scotland might be able to tick off one or two of these points but not all of them.

What can be learned?

Testing is one component of a series of elements which must be in place before lockdown can be eased. The way different countries have managed Covid19 will be studied in order that nations learn and improve their future responses to public health disasters.

For instance The Faroes were ready and able to test quickly. They did this by re-purposing existing testing facilities on its salmon farms.

In his evidence to the Health and Sport Committee of the Scottish Parliament, Professor Hugh Pennington commented on the failure to use the expertise and research labs in Scotland for testing from the start.

Professor Pennington said:

My main criticism is therefore not that we did not have the test—we did—but that we did not use all the available facilities, not just in Public Health England laboratories or other national health service laboratories, but in research institutes and university departments that do biomedical research.

“Biomedical research is one of the UK’s strengths, particularly in Scotland, and lots of labs have the RT-PCR equipment that is necessary to do the test.

“We also have well-qualified and competent people using such testing in cancer research, for example. They might not have been using it for diagnosing viruses, but for looking at other aspects of nucleic acid biology—although we do not need to go into details of that.

“Those are people on whom we could rely to run a sound and safe test. I am sure that, if they had been asked, they would have put up their hands and said, “I’ll do it by the middle of yesterday”, because this is a national crisis.”

The citizens of Scotland have been exemplary in their discipline of observing lockdown and limiting the spread of the virus. The ending of contact tracing and the limited testing that has taken place up till now means we still really do not know what the rate of transmission is within our communities (that is the R number). What we do know from the numbers of deaths in our care homes that it is extremely high in those settings – possibly as high as 10.

The R number needs to be between 0.6 and 1 in our communities- and preferably at the lower end of the scale – before we can come out of lockdown.

A long lockdown will have serious implications for : the economy;mental & physical health;education; other medical conditions (70% drop in cancer referrals from GPs) and poverty (A ‘Harsh & Uncaring’ UK – The Alston Report)

Coming out of lockdown before the steps advised by WHO are in place would result in a second wave of Covid19 in our communities and perhaps far more deadly than it currently is.

Over 40,000 deaths – in Scotland well over 2,000 – is shocking. The failure: to act swiftly; to not use and repurpose existing facilities;  and to  not provide frontline workers with enough appropriate Personal Protection Equipment (PPE) should never happen again.

Scientists can provide a range of advice but politicians make the decisions. The choices made at the start, dictate where we are now.

It is good to see the expansion of testing in Scotland starting to happen. It is good to find out that most of our frontline workers can now access PPE. It is good to know that on the whole most people are being responsible and protecting themselves and others by physical distancing.

And it is great to see the summer approaching, longer days, shorter nights and the air filled with bird song.

“At such times the universe gets a little closer to us. They are strange times, times of beginnings and endings. Dangerous and powerful. And we feel it even if we don’t know what it is. These times are not necessarily good, and not necessarily bad. In fact, what they are depends on what *we* are.”
― Terry Pratchett, I Shall Wear Midnight

Reporter: Fiona Grahame

Birsay 2

 

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