“We need a clever, thought-through process of transition”, Sir Harry Burns

Scotland has proved to have been successful at keeping to a lockdown process but minds must turn now to gradually easing out of it. This is essential not just to help the economy but for the physical and mental well being of citizens.

Sir Harry Burns, gave evidence on Thursday 7th of May to the Scottish Parliament’s Covid 19 committee. This was a committee of MSPs set up by Holyrood to look at our response to the pandemic and the lessons to be learned from it.

Harry Burns, is Professor of Global Public Health at the University of Strathclyde, and  was Chief Medical Officer for Scotland from 2005 to 2014. He stressed the complexity of managing pandemics. He was Scotland’s CMO during the swine flu, H1N1 pandemic.

In 2007 The Scottish Government published its strategy for dealing with a pandemic flu outbreak.

“This framework is primarily about saving lives and reducing the impact on individuals, communities and our society that a pandemic will have.”

The strategy stated:

For frontline staff such as NHS and Local Authority staff, we need to ensure that arrangements are in place to cover alternative workforce arrangements, that pay agreements are in place, that appropriate protective equipment is provided, that counselling services are available and that relevant training is made available. It should be our aim to ensure that staff are, in every way, supported to continue to come to work.

You can read a report about the H1N1 pandemic in Scotland here:The Pandemic of Influenza A(H1N1) Infection in Scotland 2009-2010. A Report on the Health Protection Response.

People were eventually able to be vaccinated for H1N1, commonly known as swine flu. With Covid19 there is no immunity. There is no vaccine.

The  report, however, made recommendations for managing a future pandemic or like event.

These included :

• access to molecular testing facilities being  distributed more widely across NHS boards
• enhancing arrangements for teleconferencing
• looking at socioeconomic factors contributing to higher death rates
• a single UK centre for dealing with complex flight/travel contact tracing and guidance on Travel/Port Health/ Offshore issues
• expanding the role of web based information
• local flexibility
• producing a national list of prioritised public health programmes and activities to be maintained during a pandemic or like event.

The Covid19 committee meeting was focusing on the Scottish Government’s recently published COVID-19—A Framework for Decision Making

That document states:

Every individual member of Scottish society matters and our entire strategy is focused on preventing every avoidable death. There is no such thing as a level of “acceptable loss”. 

And it looks towards preparing for a transition and to an easing of the lockdown conditions.

Harry Burns stressed the importance on the quality of testing getting done and that ‘the critical thing is to test the people who are capable of spreading the virus.’

He said that everyone who has reported having symptoms needs to be tested – not to be told merely to go home and self isolate.

On wearing masks the Professor said that the evidence points to it limiting the spread of the virus. And he agreed with the First Minister that masks should be worn on public transport, in supermarkets and in shops.

“if we consistently do lots of things that have a small effect, they add up to a significant outcome.”

He continued to stress the importance of shared learning and of developing a much more caring and supportive society.

Important would be using the ideas of frontline staff to develop new thinking especially for children for whom the experience of lockdown will have been an extremely stressful, perhaps even violent one.

As Scotland moves into the next phase it is important ‘to establish areas within hospitals that are safe and secure and which are not subject to cross-infection’, he said, in order that other surgical procedures, cancelled or delayed, can happen.

And Harry Burns urged caution:

” We have struggled hard to get to where we are. Let us not throw away the gains that we have made; let us move forward carefully and sensibly.”

The committee also heard evidence from Professor Linda Bauld.

Professor Linda Bauld is the Bruce and John Usher Professor of Public Health and Co-Director of the Centre for Population Health Sciences at the University of Edinburgh.

Professor Bauld’s evidence to the committee raised the effect a long lockdown would have on young people and employment.

She said:

“The longer-term health impacts will take many years for us to realise. “

Professor Bauld referred to the huge drop in cancer referrals and the need to get the screening programmes back up and running.

“The only way to get out of the lockdown is if we take the test, trace, isolate, support approach and take it very seriously and ramp up the system. “

Linda Bauld also supported Harry Burns’ view on the need to wear masks/face coverings when in supermarkets etc but she also stressed the importance for people to be able to increasingly access outdoor spaces.

Looking to the future Linda Bauld felt :

“This is an opportunity for us to look ahead and ask—not only in general practice training, but in all aspects of clinical training and in other areas that feed into public health—whether we have the system that we need and how we can improve it.

“That way, when we face challenges in the future—which we will—about communicable and non-communicable diseases that are caused by preventable risk factors, we will be in a better position.”

The discussion on the Scottish Government paper COVID-19—A Framework for Decision Making   and the update  Coronavirus (COVID-19): framework for decision making – further information is open until 10pm Monday 11th of May to join in click on this link and register: Taking Part

You can watch the committee meeting here:

Reporter: Fiona Grahame