“Unite’s members particularly in those vulnerable sectors such as health and social care are extremely worried that we could see a new spike in hospital admissions, and it is the staff on the frontline having to deal with this.” James O’Connell, Unite
Changes being introduced by the Scottish Government over self isolation for key workers have been criticised by the trade union Unite Scotland who say that it could lead to a new spike in the pandemic.
As one of the nation’s leading trade unions in the health and social care sector, which has been significantly impacted by the pandemic, Unite has raised serious concerns directly with the Scottish Government over its approach to level zero.
The Scottish Government has removed the blanket requirement for close contacts to self-isolate as long as they’re double vaccinated and take a PCR test. This includes removing the requirement for those working in health and social care to self-isolate as had previously been the practice throughout the pandemic.
The Scottish Government state that those who work in critical roles where staff shortages are in danger of putting essential services, such as health and social care, transport and the provision of food supplies at risk can voluntarily exempt themselves from self isolation. Those who do so must be double-vaccinated and in receipt of their second dose at least two weeks previously. They will also require to have a negative PCR test and to agree to undertake daily lateral flow tests.
Explaining the decision, First Minister Nicola Sturgeon said:
“It is essential that lifeline services and critical national infrastructure are maintained and we are implementing these changes now – ahead of possible changes to self-isolation rules for close contacts that may apply more generally in future – to ensure staff shortages do not put key services at risk.
“We have seen significant staff shortages in a small number of organisations in recent days and we have worked with them to protect services. Applications for exemptions are being considered from today and we will consider applications as they come in.
“Clinical evidence tells us we can safely and effectively release some critical staff from self-isolation, with appropriate safeguards. However, this is a very limited change at this stage, to be applied on a case by case basis and only where absolutely necessary.
“We will not allow key services to be threatened by staff shortages but equally we must continue to protect public health.”
Figures published on the 23rd of July in Scotland show:
- 1,505 new cases of COVID-19 reported
- 25,795 new tests for COVID-19 that reported results
- 6.4% of these were positive
- 6 new reported death(s) of people who have tested positive
- 57 people were in intensive care yesterday with recently confirmed COVID-19
- 502 people were in hospital yesterday with recently confirmed COVID-19
In the week ending 20 July, on average 2,109 NHS staff, or around 1.2% of the NHS workforce, reported absent each day for a range of reasons related to COVID-19.
James O’Connell, Unite industrial officer, said:
“There has been a growing number of cases of the delta variant in Scotland and we can’t allow this to spiral out of control.
“While we understand there is a need and desire to return to normality, we have got to remember that vaccination is not immunisation.
“Unite’s members particularly in those vulnerable sectors such as health and social care are extremely worried that we could see a new spike in hospital admissions, and it is the staff on the frontline having to deal with this.”
“If you’re identified as a close contact it potentially takes 48 hours minimum for the virus to be detected through a test so there is a potential for staff to be asymptomatic without knowing they are positive for a period of time.
“Using the hierarchy of control risk should be removed or at least minimised as much as it can be, therefore, in order to remove or minimise the risk of spread you should isolate not gamble using health and social care staff as the test. They look after the most vulnerable people in our society, is it worth it?
“The Government is putting a lot of emphasis on double vaccination which does not stop contraction of the virus, however, why are they not looking at reducing the time between vaccine?”
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This is really a tricky one… on one hand essential health services are difficult to provide when a large proportion of staff is absent, especially since staff shortages have already been a general issue since long before the pandemic (austerity, staff exodus after Brexit etc.).
But the risks are high for patients who would not seek medical treatment if their health was not compromised already… by illness, long-term condition, accident or injury.
I believe the government’s plan is somewhat flawed (but could be significantly improved for better mitigation): A PCR test only gives an indication whether the staff member is infected at this point in time. If the viral load has built up yet, so that it can be detected which can take a few days (or even longer) from exposure to being infectious. This has rightfully been outlined in the article above.
Relying on lateral flow tests afterwards could result in a considerable number of false negatives because if the virus is contracted after vaccination, the viral load could be significantly reduced, so that it cannot be detected. Whilst this will also reduce the transmission risk to patients some extent, it will not eliminate it. I would also assume (this is so far a hypothesis only) that some patients, for example the ones with a compromised immune system, unvaccinated (for a variety of reasons) or with an insufficient immune respose to the vaccine, could be at risk even from low level spread.
One could perhaps at least mitigate risks by making sure that staff under the isolation exemption rule (which by the way must remain a voluntary decision of the staff member because noone should be forced to work if they would rather isolate) must wear FFP3 masks without valves at all times in healthcare settings, if possible only care for patients which have been vaccinated themselves and are tested for their antibody levels (which is easily done), and that staff members undergo a second PCR tests after 3 – 5 days in addition to the daily lateral flow tests.
Obviously, in times of a pandemic also all patients (in-patients as well as out-patients) should be offered at least FFP 2 masks of which I can only hope the NHS stock has been built up over the course of the last months; there was definitely time and opportunity to do so.
Also: Urgently (before the winter!) the government has finally to undertake what is necessary to safeguard adequate ventilation. Many of our hospitals and other healthcare setting are in some poor state and the ventilation systems insufficient or inadequate. This issue can make healthcare settings hotspots for disease spreading as we have seen in the high numbers of nosocomial infections, for example south of the border.
Open windows won’t be a solution anymore once we get towards colder spells or the autumn… the windy winters…