Scots will struggle to comply with complex new restrictions, claims public health expert

Pub closures and other new restrictions set to be imposed on Scotland from Friday evening will only work if the Scottish Government’s testing strategy is improved while measures are in place.
New restrictions will work but need simultaneous improvements of Scotland's testing strategyNew restrictions will work but need simultaneous improvements of Scotland's testing strategy
New restrictions will work but need simultaneous improvements of Scotland's testing strategy

Public health expert Linda Bauld, professor of public health at Edinburgh University, said the new restrictions may see low compliance from the public due to the complexity of the measures but added that while she was not enthusiastic about the closure of hospitality, it was likely to reduce the spread of Covid-19.

She said: “This is very complicated and I think the public are really going to struggle to understand the details of this in terms of different rules again for different parts of the country and some of it is voluntary.

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“I don’t think this is a set of measures which the public are going to be able to easily comply with except for things like not being able to access something which is shut.

"The more complex it gets, the more voluntary it is from a behavioural perspective, the more you see non-compliance.”

She added the restrictions would give Test and Protect a chance to learn how to better deal with high case numbers, which she said had seen the system come under strain.

Prof Bauld said: “I think what the restrictions will do is reduce the number of cases eventually and they will reduce at which the speed cases are increasing.

"The system is good, but the more cases, the harder it is for Test and Protect to operate so these measures will help to just settle down that system and then they have got to get the testing strategy right.

“Using this period of closures to really pin down with their expansion of testing is important.”

Prof Bauld’s comments came alongside calls from Muge Cevik, a clinical lecturer in infectious diseases and medical virology at the University of St Andrews and co-author of a study calling for transmission data to be used to inform policy, for the underlying cause of low compliance with self-isolation to be examined.

She said: “Many people with infection either do not infect anyone or infect a single person, and a large number of secondary cases are caused by a small number of infected people.

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"Overwhelming evidence suggests that a majority of these infections are linked to indoor settings (rather than outdoor activities), especially family/friend gatherings, and group activities such as dining together.

"Importantly, evidence suggests that prolonged contact in a crowded and poorly ventilated indoor settings (particularly without mask) transmission could lead to large clusters or super-spreading events – in these settings, transmission could also occur beyond the two metre guideline, because small droplets could linger longer due to poor ventilation.

“So new restrictions target these environments. Going forward, we need to help the public differentiate between low versus high-risk settings, and public health messages could convey a spectrum of risk to support engagement in alternatives for safer interaction.”

She added: “Another important issue is to support people with symptoms and positive tests to self isolate. As seen in the report yesterday, only one in five people self-isolate fully in Scotland

“We need to explore underlying reasons for this and especially provide financial support to enable cases and their contacts to self isolate without financial concerns.”

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