Coronavirus: Hundreds of new ventilators for hospitals as testing to be stepped up

The Scottish Government has commissioned hundreds of new ventilators for hospitals to prepare for more victims of the coronavirus, it was revealed today.

Nicola Sturgeon has said that sample testing for coronavirus is to be increased.

Health Secretary Jeane Freeman confirmed that "around 700" ventilators will be available after hundreds more had been commissioned as it was also disclosed Scotland's normal flu GP surveillance procedure was expanding to encompass 200 surgeries which cover 1.2 million people.

Prime Minister Boris Johnson is due to speak to engineering firms today about whether they can shift production lines to building NHS ventilators, as there is growing concern about a shortage of the life-saving equipment.

But Ms Freeman moved to assure the public that the Scottish Government was already addressing the issue and capaicty would be "around 700".

"We have already commissioned additional ventilators to ensure we have a full and proper supply," she said. "But we're also connected to the UK government four nation approach to look at ongoing supply of ventilators and other issues as well personal protective equipment and so on, but at the moment we have already instigated the commissioning of additional ventilators."

Ms Freeman was speaking at the first of two briefings due to be held by Nicola Sturgeon today - the second will be after her attendance at the UK COBRA meeting.

The First Minister said that the challenge in dealing with coronavirus was "unprecedented" but stressed it was not government policy to "achieve herd immunity" from the disease, and that all four UK nations were working closely together to ensure the same advice was being issued to people, to prevent confusion.

As a result, she said, the over-70s and those with pre-existing health conditions, were being advised to reduce social contacts by around 75 per cent but were not being told to self-isolate entirely. Schools would also remain open, despite them being closed in other European countries, based on the scientific advice the government was receiving.

TESTING TO BE STEPPED UP

However, she admitted that testing regimes may differ across the UK because the NHS structure differed. As a result, in Scotland, as of this week, the GP sentinel surveillance procedure - used to track normal flu every winter - is being stepped up.

She said: "Until now, and this has fed through to daily reporting, we have only been testing people if they fit a case definition, that is related to particular symptoms and particular travel history, and those admitted to hospital.

"It is likely that the numbers we have been reporting are under-estimates of the spread of the infection so far. As we ask people with mild symptoms to self-isolate it's not feasible, or best use of resources, to test everyone. It's also not necessarily adding to the protection of the public.

"That said, it is our intention to continue to test large numbers of people in order that we are able to monitor the spread and profile of how the infection is behaving. These are the same arrangements we had in place just over a decade ago with the swine flu pandemic.

"People with symptoms in hospital will continue to be tested, but also our GP sentinel surveillance system which we use routinely to monitor flu every year is being significantly expanded. Right now, that system consists of 41 GP practices across the country doing sample testing, these practices cover about 240,000 members of the population. We are extending and expanding that system to cover 200 GP practices that cover a population of 1.2m people."

She added: "The information we get from that will allow us to assess and report on the spread and profile of coronavirus. In many ways that will be a far more robust indicator than the figures we have been publishing so far.

"In Scotland it is also our intention to test key workers, including critical front line NHS staff to ensure people who are so essential to managing the disease and also to keep our physical infrastructure going are not self-isolating unnecessarily."

Scotland's Chief Medical Officer, Catherine Calderwood said using the GP practices to sample the population was a "well rehearsed epidemiological way of surveying population spread of disease", and would give more accurate estimates of how many people were infected.

She added: "So within that 1.2m people we will pick up x numbers of coronavirus. It is spread across different types of practice, some urban, some rural some remote, and will give a snapshot of what is happening across the population.

Asked if she expected the numbers to shoot up as a result of changing the testing system, she said "absolutely"

HERD IMMUNITY

The First Minister stressed that while she understood the comparison of government actions here to those in other countries, that it was "important not to lose sight of the significant actions being taken here in Scotland rest of UK."

"I'm not going to comment on other countries approach because I'm not privy to the advice and decision making in those countries. My response is to follow the scientific advice we are given, to apply judgement to it, but to follow that advice and that's what we are doing. There are some actions taken in other countries that may well be taken here, in Scotland and UK as a whole. But asking everyone who has a fever and cough to stay in their house for seven days is a significant behavioural change.

"These are not easy judgements, this is an unprecedented situation, which is why we have to act in a way that is as informed by the science as possible."

She said that developing a "herd immunity" to the virus was not government policy in Scotland or in the UK. "Herd immunity is a byproduct pf people getting an infection and it's not our policy to achieve that. Our clear aim in every step that we are taking, and will take, is to reduce the impact of this infection and crucially to save lives and reduce the numbers of people who will die from it in the weeks and months to come.

"That strategy is of course based on a realism that a virus like this cannot be stamped out completely or indefinitely. The key thing is how we manage the spread and reduce the peak impact. Protecting the public is the driving priority of everything we are, and will, do."

She said that those with symptoms of fever and persistent cough should stay at home, and self-isolate for seven days, and that government advice as of today was to cancel mass gatherings of more than 500 people.

"It is possible we will extend that in future to smaller gatherings, but those decisions have not been taken. General advice around hand washing remains just as important today as it has throughout this outbreak so far."

SCHOOLS

Asked if and when schools might be shut, CMO Catherine Calderwood said that data from other countries had shown that children are not severely affected, "so if we're talking about reducing pressures on the NHS, children having this virus are not going to be hospitalised in large numbers," she said.

"If you're going to introduce these types of measures (self-isolation and closures), we need to do that for months - a minimum of three months to suppress the spread of the virus. The thought that children will not mix together for three months is impossible, So there would be a risk of children congregating in other areas together and the virus is spread, so you have measures put in place that are not effective.

"And we have very significant numbers of health care workers, and others, with children and this will have an impact on childcare if our children need to be looked after elsewhere. I would not criticise what other countries are doing, but closing schools for two weeks, it's clear from the science, would not prevent the spread of the virus or protect those who are vulnerable."

Nicola Sturgeon added: "We will see ad hoc closure of schools, as we have today. We are not saying we are ruling out a more blanket approach if that is advised as something that would be effective."

COBRA MEETING

Actions to be considered at COBRA, today, she said will include social distancing for people over 70 and some vulnerable groups, such as those eligible for the normal flu vaccine.

"Scotland is not proposing a different approach to over 70s than rest of UK, that is not the case," she said. "The social distancing of these groups, not isolation, is the policy that COBRA has been discussing, and will discuss later today.

"There will also be discussion for those with compromised immune systems, and it would be our intention to proactively contact people in that group. There's the possibility of household isolation - where one member has the symptoms and we ask the household to self-isolate. And other possible steps include school closures, stopping smaller gatherings... all of these are under ongoing review on a daily basis and being informed by expert advice."