NHS Grampian said both Aberdeen Royal Infirmary and Dr Gray’s Hospital in Elgin, Moray have been at code black status in recent days, with non-urgent elective operations postponed.
The health board blamed mounting pressure from rising Covid-19 cases in the north-east, both through the number of patients needing hospital treatment and staff absences due to self-isolation for the decision to postpone non-urgent procedures.
It comes as the First Minister said the situation was being kept under careful review, placing fresh doubts over the plans for Scotland to move to Level 0 as planned amid surging cases. And Scotland’s coronavirus contact tracing system has been under fresh strain, with new figures showing it was now falling below international targets. Close contacts of 1,628 people who tested positive for coronavirus were not instructed to isolate by contact tracers within 72 hours last week, leading opposition politicians to say it was now “completely overwhelmed”.
The move in Grampian follows an announcement from NHS Highland on Wednesday that Raigmore Hospital in Inverness had reached capacity and declared code black status – halting all non-urgent elective surgery. Meanwhile, NHS Lanarkshire today said it would hold a ‘Gold Command’ meeting in which the scaling back of elective care services was being considered.
NHS Grampian medical director Professor Nick Fluck said: “This is a dynamic situation, subject to change throughout each day. I can confirm that both Aberdeen Royal Infirmary and Dr Gray’s Hospital have been at black status (i.e. at capacity) in recent days.
“Choosing to cancel procedures or appointments is never a decision we take lightly; however it is our only option if we are to relieve some of the pressure and allow staff to concentrate on the most urgent and emergency care.
“I know it is distressing for people to have procedures or appointments postponed, sometimes at very short notice. I apologise to anyone who has been affected by this.
“We will work to reschedule these, but we cannot offer any guarantees at present about when this might happen.
“If you are accessing any healthcare services, please be aware delays are likely.”
Speaking to the BBC on Wednesday, the First Minister said case numbers were "much higher than we want them to be", but it could still be stabilising.
She said: "We are literally monitoring the data on a daily basis right now, as we head towards the review point next week where we will be able to say what our plans are for 19 July.
"We are looking at this very carefully. My biggest concern right now is that even though we are seeing a weakening of the link between cases and hospitalisations, if we have a high number of cases even a lower proportion of those cases ending up in hospital can put pressure on our NHS."
On restriction easing, she added: "Nothing, against a global pandemic of an infectious virus that has got more infectious and transmissible with the Delta variant, can be set in stone.
"I want as much as everybody does the certainty of 'by this date we will be free of everything and there will no longer be any restrictions'.
"Every part of me wants that and every part of me believes we are on a journey towards that and heading in that direction.
"But to set dates in stone while we still face that virus would not in my view be responsible. My job is to take hard decisions that get us as safely as possible to that end point."
Prior to the NHS Grampian announcement, BMA Scotland warned action is needed within days to tackle “a very high level of pressure” on the NHS in Scotland due to the surge in coronavirus cases.
The doctors’ trade union said hospitals may have to consider cancelling elective treatment unless measures are taken to ease pressure on staff.
Dr Lewis Morrison, BMA Scotland chair, said that decisions needed to be made quickly regarding staff absences due to the requirement to self-isolate.
He said: “Raigmore is an example of what might well happen in other places in the NHS in Scotland if we don’t take some action to deal with what is a very high level of pressure on healthcare, both in general practice and in hospitals, combined with rising Covid cases leading to a quite large number of staff having to self-isolate as contacts.”
Dr Morrison said any change in self-isolation policies for double-vaccinated healthcare staff would have to be safe for patients and staff themselves.
He said meetings were going ahead within the Scottish Government “with some urgency” on the issue.
Dr Morrison continued: “Within the next few days I think some sort of decision needs to be made to assure the continuity of healthcare services in areas under these kind of pressures.
“It’s as urgent as that I think.”
Health Secretary Humza Yousaf insisted that the NHS was not on the verge of collapse.
He said: “These claims are simply not accurate, and it is misleading to suggest the NHS is on the verge of collapse.
“We recognise the additional pressure NHS staff are facing as they work tirelessly to respond to the pandemic whilst continuing to provide vital treatment and safe patient care. We are in daily contact with boards facing the greatest challenges and are monitoring the situation closely. NHS Lanarkshire has provided assurances that those of most clinical urgency, including vital cancer treatment will continue during this challenging period.”
He added: “Although pandemic related pressures have eased over recent months, as restrictions relax we are seeing a rise in non-Covid attendances and admissions. We are encouraging people to consider options closer to home, by seeking medical advice online at NHS inform, by calling NHS 24, their GP practice, or by contacting their local pharmacy who can also help and prescribe treatment.
“While the increase in NHS staff absences over recent weeks is significantly lower than previous phases of the pandemic, this reflects the overall increase in infection rates across the population - and it is a reminder that each of us needs to continue doing all we can to slow the spread of the virus.
“The remobilisation of the NHS is one of our number one priorities and we will publish a national recovery plan for the NHS within the first 100 days of the new government.
“The exceptional care that all NHS and social care staff have delivered throughout the pandemic and their efforts on testing and vaccinations are the bedrock on which we will build our recovery.”
With the number of coronavirus cases rising, the Test and Protect contact tracing system set up to try to contain the spread of the virus has been coming under increasing pressure. However, at a briefing on Friday, First Minister Nicola Sturgeon insisted that the system was “coping well”.
The WHO criteria states that 80 per cent of new cases having close contacts traced and in quarantine within 72 hours of case confirmation. Meanwhile, updated figures for last week – to 27 June – also showed that the target was not hit during that period, with 34.9 per cent of cases not contacted within 72 hours. Over the past week, contact tracers interviewed just 28 per cent of people within 24 hours of their positive case being logged, while 37 per cent of people waited over 48 hours.
Scottish Liberal Democrat leader Willie Rennie said: “Test and Protect has been engulfed by this latest wave of the virus. It is not meeting basic international standards.”
The Lib Dem added: “People have sacrificed a huge amount to buy the Government time. This system should be able to withstand high case rates by now.
“Instead, some tracing activities have been turned off altogether and people are routinely waiting days for Test and Protect to show up.
“It’s evidence that SNP ministers once again just weren’t prepared and have lost control of the virus.”
He added: “We need to see Test and Protect reinforced, the vaccine rollout intensified and an end to the dithering around the current unsustainable self-isolation system which is proving a big challenge for key services and workers.”
Scottish Conservative shadow health secretary Annie Wells MSP, said: “It is clear that Scotland’s Test and Protect system is completely overwhelmed as a result of the recent surge in Covid cases.
“SNP Ministers need to be upfront about their failings and admit they took their eye off the ball. A robust Test and Protect System remains a critical tool in fighting the virus, but the SNP Government have failed to ensure it has all the resources it needs. It is hugely concerning that we are now falling well below WHO standards to close 80 per cent of cases within three days. That flies in the face of Nicola Sturgeon claiming that the system was coping well only a few days ago.”
She added: “That is all too typical of this SNP Government trying to continue to pretend everything is fine, rather than trying to address the serious problems the Test and Protect system is facing."
Scottish Labour health spokesperson Jackie Baillie said: "It's clear that the SNP has lost control of the pandemic. Test and Protect is in disarray and cases are spiralling. We cannot have the people of Scotland put in danger due to the failure of the SNP.
"The heroic efforts of our NHS and testing staff are being undermined by the incompetence of the SNP. It's time the SNP faced up to the scale of their failure and took action to mitigate the damage they have already caused."
Ms Bailie added: “This is an incredibly worrying situation in Lanarkshire. We can now see the direct impact that the SNP’s failure to control COVID is having on those in need of care and medical attention. If elective treatment is cancelled then waiting lists will grow ever longer.”
A Scottish Government spokesperson said: “The Test and Protect system has continued to operate well as case numbers have increased in recent weeks. Given rising case numbers, the system has been contacting unprecedented numbers of people.
“As we announced last week, we are using a variety of methods to contact people, including using digital methods like SMS messages for lower risk cases and prioritising calls for higher risk cases. These changes will ensure that people are contact traced, and begin isolation, as quickly as possible.
He added: “We will have to manage living with COVID-19 for some time to come, even when we are able to move beyond Level 0."
The Covid-19 Statistical Report also showed that in the last week from 26 June to 2 July, the seven-day rolling average of COVID-19 related acute hospital admissions increased from 32.71 to 46.86 admissions per day.
A total of five out of every 100,000 vaccinated people were admitted to hospital in the past week and had a positive PCR test 14 days prior, on admission, or during
their stay in hospital, compared to 13 out of every 100,000 unvaccinated individuals.
Meanwhile, in the last four weeks, 55.4 per cent of covid-related acute hospital admissions were in unvaccinated individuals, of which 71.3 per cent were under 40.