Nicola Sturgeon indicates 'change in direction' to Covid-19 cases

Nicola Sturgeon is starting to make a “change in direction” away from a “maximum suppression” strategy as the Scottish Government reacts to rising Covid-19 case numbersnote-0, a public health expert has said.

Nicola Sturgeon has suggested the Scottish Government's response to Covid-19 may change in the coming months

At a Scottish Government coronavirus briefing on Tuesday, the First Minister indicated the number of people in hospital and intensive care rather than case numbers alone would begin to dictate the public health response to the virus.

Ms Sturgeon said early data around the vaccine showed it may lower the likelihood of serious illness or death among those infected by Covid-19 as she indicated a potential move away from a “maximum suppression” strategy.

This could see the Scottish Government response of strict lockdowns or restrictions “evolve”, Ms Sturgeon said, when case numbers rise in future.

The change in policy was described by public health expert Professor Linda Bauld as “appropriate” as she predicted Scots would likely receive a Covid-19 vaccine alongside a flu vaccine in future years as the country learns to live with the virus.

The chair of public health at the Usher Institute at the University of Edinburgh said the Scottish Government’s change in narrative was “reasonable” as the pandemic continues to develop.

Speaking at the briefing, Ms Sturgeon offered “cautious optimism” that case numbers in Glasgow appeared to have stabilised over the weekend despite test positivity “creeping up”.

The SNP leader said, however, that case numbers alone were no longer a good barometer of whether a region should consider harsher measures due to a potential drop in the number of hospitalisations and intensive care admissions linked to the progress of the vaccination programme.

Indicating the Scottish Government may move away from its existing policy of “maximum suppression”, the First Minister said the signs were good that vaccination may be lowering the risk of high case numbers necessarily leading to high numbers of hospitalisations and death figures in Scottish hospitals.

Ms Sturgeon said the traditional response to Covid-19 case numbers rising of strict lockdowns and restrictions on hospitality and other activities may not continue, with the Scottish Government planning to not react “quite so aggressively” in future.

She said: “Increasingly we are monitoring whether and to what extent vaccination might be breaking that link between rise in case numbers and significantly rising cases of serious illness and death.

"if that does prove to be the case – and we hope that it will – we hope that our response to this virus can increasingly evolve as well.

"While care will still be needed because there will always be people who require hospital treatment, it might mean that we don’t have to react quite so aggressively with tough restrictions in the face of rising case numbers.

"Instead we hope that we will be able to rely on enhanced public health interventions like testing and vaccination and, of course, on good public health practices on behalf of the public.

"This will be a key factor in our decision making in the coming days and indeed beyond that, both in relation to Glasgow, but also in relation to the country more generally.”

The First Minister said in the first day of the new registration system for 18 to 29-year-olds, a total of 22 per cent had registered for a Covid-19 vaccine.

In total, more than five million vaccine doses have now been administered in Scotland, with 3,138,366 first doses and 1,881,214 second doses.

This includes an additional 16,421 people who received their first dose of the vaccine on Monday, while 29,035 Scots were given their second dose.

Pushed on whether her comments meant the Scottish Government now favoured a policy of living with the virus rather than driving it to its lowest possible level, the First Minister said Scotland was at a point of transition.

She said: "I still think it is really important, taking everything into account, [that] we try to keep case rates as low as possible because the lower they are they less chance of transmission, the less chance of new variants developing, so that is important.

"But vaccination changes the game in some respects from last summer in how you deal with this.

"There’s got to be a point to us having a mass population-wide vaccination programme and that is it does allow us to change how we deal with this virus and deal with it in a way that has much less restriction on our day-to-day lives.

“We are in the position right now, we’re almost at what I would describe at a bit of a transition from how we were dealing with it to how we hope to be able to deal with it because we don’t yet know or understand the impact of vaccination as much as we want to, but I hope we can migrate to that.

"[it’s about] moving to a situation where we do get our normal life and operation of our country back to something much closer to what we all want it to be like.”

Speaking to The Scotsman, Prof Bauld confirmed the Scottish Government had made a subtle change to its overall approach to Covid-19.

She said: “It is a change of direction. In an ideal world they would like maximum suppression still, but it is difficult to sustain a zero Covid approach when your narrative all the way through has been to save lives and protect the NHS. It is appropriate to change tact.

"We are going to find cases. I am not surprised, but it is the first time I have heard it articulated. There are similar statements being made in many other developed countries. This is how we are going to live with it and I think that is reasonable.

"They are not rewriting any of their strategies. The narrative has had to shift because of the effectiveness of vaccines.

"If you are going to say to people ‘we still want to be testing’, they have got to recognise they are going to find cases, so it is the other indicators that become more important and that they are looking at.

"The question for me is ‘when do we get there?’ In Bolton, for example, there are a lot of people in hospital and they are very worried.”

Prof Bauld said caution was still key as the pandemic continues with particular attention to the demographics and numbers of those in hospital or in ICU.

The public health expert said the Scottish Government had a “duty” to protect individuals from serious illness.

She said: “The focus needs to continue to be on who is in hospital, what age they are and who is in ICU.

"It is not just about the deaths, you are also trying to prevent serious illness. You don’t want people to be on ventilators because the long-lasting effects of that are pretty horrific, and a long spell in hospital is very unpleasant and of course there is long Covid too.

"They have a real duty of protecting people from becoming seriously unwell from Covid.”

Asked whether Covid-19 would become similar to flu where it circulates each year with serious illness affecting many during the winter, Prof Bauld said it was possible flu and Covid vaccines could be administered together in the future.

She said: “We are always a bit resistant to the flu analogy, but it is highly possibly that we will be receiving a Covid-19 vaccine at the same time you get a flu vaccine.

"I think we will be seeing boosters for the more vulnerable groups and I think it will be delivered to this groups on an annual basis too.”

Prof Bauld added: "There is still a question mark around this [Indian] variant. It is definitely more transmissable and the dominant variant in some areas.

"I am not calm, but overall in Scotland it is going pretty well. If cases go down in Glasgow, that will be a real testament to the work there and a real positive.”

On Tuesday, Scotland recorded two deaths and 318 new cases of Covid-19, with the death toll reaching 7,666.

Daily test positivity rate was 2 per cent, the First Minister added, down from 2.8 per cent the previous day.

A total of 97 people are in hospital with recently confirmed Covid-19, up three, with six in intensive care, up one.

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