Covid: Scotland should return to its policy of eliminating this virus, instead of 'learning to live with it' – Graham Checkley

The Scottish government has been accused of losing control of the Covid-19 pandemic.

When you look at the case surges, hospital admissions and cancelled operations, the accusers have a point. But there is a road back to control: the elimination road.

Everyone knows about zero-cholera Scotland, zero-polio Scotland, and of course the idea of controlling tuberculosis and typhoid. But when it comes to the current pandemic, and you mention a zero-Covid Scotland, you are told that “society will have to learn to live with Covid”.

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But we do not live with cholera, we do not live with polio, we do not live with tuberculosis, and we do not live with typhoid.

Campaign group Zero Covid Scotland takes the view that we need to manage this disease in just the same way that the diseases above were managed. Public health measures, such as vaccination, contact tracing, quarantine, and isolation of cases, can be combined with safety work in schools and workplaces to make life as hard as we can for this virus. Mitigate to eliminate while you vaccinate.

But why should we, they cry, when vaccination has broken the link between Covid, serious illness, hospitalisation, and death? Weakened yes, broken no. The British Medical Association is very clear on this point; you need to continue to mitigate while you vaccinate, particularly when you are dealing with the more infectious Delta variant.

No vaccine is ever 100 per cent effective for 100 per cent of the people that receive it, and the more cases, the more cases of Long Covid you are going to get, and more pressure put on an already overburdened NHS.

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Children wait to be vaccinated against polio in 1956 (Photo by Terry Fincher/Getty Images)

So, a zero-Covid, elimination approach allows you to keep control of the pandemic. It has even allowed countries such as New Zealand to live a nearly normal life, with 27 deaths, while Scotland has had over 8,000.

That we should be aiming at virus elimination is not even a new idea for Covid. This was the Scottish government policy until June of this year, when it was changed to “suppress the virus to a level consistent with alleviating its harms while we recover and rebuild for a better future”.

Why did they believe they could do this? Well, it was only from a subsequent analysis of the timeline of events that it appeared that, in many ways, the Scottish government was seeking to manage the Delta variant as they would have the Kent variant, not taking into proper account just how much more infectious the Delta one was. To misquote Winston Churchill, “politicians are always prepared to fight the last war”.

Look at their recent policy decisions. The disbanding of the Covid-19 (oversight) committee, the establishment of a Covid-19 recovery committee, and the appointment of John Swinney as the Cabinet Secretary for Covid Recovery, in May 2021, all indicated an underlying assumption that the pandemic was nearly over.

The Delta variant was identified by the World Health Organisation as a variant of concern on May 11, and the implications of its more infectious nature were clearly understood by July, but the Scottish government did not re-establish the oversight committee structures needed to manage this. In fact, their policy in the face of a more infectious virus variant was to relax mitigation controls.

This process of relaxation was to continue, in the face of some well-publicised warnings from eminent scientists published several days previously, culminating in “beyond level zero” on August 9.

Further, it is difficult to reconcile the recent air of surprise shown by Scottish government officials about schools and a surge in cases with what is known from the literature.

The risk of Covid transmission in schools had been highlighted in the Lancet in March, the British Medical Journal in June and in the Lancet again in July. The Scottish government was also aware that it was dealing with a new virus variant by June, and the increased infectiousness of the new variant was well established by July.

Also, as remaining in full alignment with the Joint Committee on Vaccination and Immunisation (JCVI) on vaccination of the 12 to 15-year-old population was the Scottish policy, then work on school ventilation safety was a clear and urgent priority. Such ventilation work was also the only current method of protecting the under-12s.

Despite warnings from organisations like Long Covid Kids, the Scottish government lost the opportunity to tackle this issue. Its eventual response that it “will request regular updates on progress from all local authorities” came ten days before the new term started and was too little management too late.

The initial vaccination programme was hugely successful, and a tribute to the NHS staff involved. But the rise of the Delta variant was a game changer, as it raised the required level of vaccination to relax other controls from 60 per cent to nearer 85 per cent.

This raised the issue of the vaccination of the young. If the policy of the Scottish government was to be vaccination-led, then it needed 16 and 17-year-olds to be vaccinated to approach that 85 per cent figure. However, its policy of staying in line with the JCVI recommendations meant starting on that work from August 4, even though it had declared its new vaccination-led policy on June 22.

Despite these contradictions and delays, relaxations in Covid mitigation continued. On September 20, the vaccination of 12 to 15-year-olds started in Scotland. In the USA this started in May.

To conclude: I grew up with kids with leg braces, and with kids with relatives in the “iron lung” ward. I also had a granddad die of tuberculosis. Do not ask me to “live with Covid”, let us regain control of the virus.

Graham Checkley is an independent researcher and a member of the Zero Covid Scotland, a campaign group lobbying calling for the reinstatement of the Scottish government’s policy of virus elimination

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