Covid Scotland: Health watchdog failed to follow own guidance around Nike Conference outbreak

Scotland’s health watchdog failed to follow its own guidance and made no recommendations on how to improve the response to Covid-19 outbreaks following the Nike Conference outbreak in Edinburgh, it can be revealed.

Public Health Scotland (PS) officials said no “hot debrief”, a key component of the watchdog’s immediate response to public health incidents, took place following the outbreak at the conference in February last year.

The long-awaited incident management team (IMT) report into the handling of the outbreak was published late on Tuesday and admitted that some asymptomatic infections caused by the Nike conference outbreak may have been missed due to the testing policy at the time.

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Official guidance for making recommendations about public health incidents was not followed by Public Health ScotlandOfficial guidance for making recommendations about public health incidents was not followed by Public Health Scotland
Official guidance for making recommendations about public health incidents was not followed by Public Health Scotland
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In June 2020, Nicola Sturgeon said the report would be published “as soon as possible”, but a deadline was only set following a Freedom of Information request from a member of the public.

The Covid-19 outbreak was not disclosed by the Scottish Government initially due to patient confidentiality concerns, but the details were later revealed in a BBC Scotland documentary.

This was previously criticised by Scottish Labour’s Ian Murray, who said the public should have been informed as soon as possible about the outbreak.

Mr Murray said on Tuesday in a fresh statement: “Had the Scottish Government taken urgent containment action after the first outbreak in Edinburgh, thousands of lives could have been saved from coronavirus.

“Instead, Nicola Sturgeon tried to cover up the outbreak, refusing to inform the public that more than two dozen people had been infected at a Nike conference in the capital.

“The SNP First Minister has consistently claimed the Scottish Government did all it could to respond to the outbreak, but we now know for a fact that isn’t true. This is yet more evidence of the SNP Government’s culture of secrecy."

The failure to undertake a “hot debrief” meant no early formal recommendations were made to ministers or councils about how to improve the handling of coronavirus outbreaks based on lessons learned from the outbreak.

The lack of a “hot debrief” also raises questions as to whether the-then health secretary Jeane Freeman misled Holyrood when she said a full report would be published within three to six months of a debrief which never took place.

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PHS guidance states that a “hot debrief” is considered necessary after any public health incident in Scotland which is considered to have any local or national impact.

The document asks officials to detail the incident, ask what went well and what did not go well, and note any lessons learned.

Guidance states it should be completed “as soon as possible” following the end of an incident before a full report from the IMT, which is a more detailed and comprehensive document, is produced.

Ms Freeman, the SNP’s health secretary at the time, told Holyrood in an answer to a written question in March the IMT report would be produced “in due course” and within “three to six months of the debrief”.

When asked in August, the Scottish Government refused to state when the debrief had taken place.

However, in response to a Freedom of Information request, PHS admitted a “specific hot debrief did not take place” for the Nike Conference outbreak, adding that “no formal recommendations from the IMT are available”.

In their response, officials blame the impact of the pandemic on the delay to the publication of the full IMT report.

In total, 39 cases – of which 23 were cases of those who attended or were directly linked to the conference and a further 16 which were secondary cases – were traced to the conference.

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Eight were in Scotland, but the country’s first official case was not recorded until March 1, five days after the conference, with England seeing 29 confirmed cases from the conference.

Officials became aware of an outbreak on March 2 following a positive case in the Netherlands, with the first positive Scottish case from the conference confirmed a day later.

In total, 68 contacts of primary cases were identified in Scotland, with a further 253 contacted in Scotland.

In June, a month after the outbreak was publicly revealed, the First Minister told journalists the outbreak did not spread Covid-19 across Scotland following genomic sequencing analysis.

However, the report admits some potentially asymptomatic cases of the disease may have been missed by the control measures due to the failure to test those without symptoms.

The report states: “It is possible that asymptomatic cases among conference delegates or close contacts of primary cases may not have been detected as a result of the testing policy in place at the time of the outbreak.”

It also concludes “dissemination of real-time learning about Covid-19 is crucial to inform subsequent management of incidents”, but makes no comment on whether the public should have been informed earlier.

Stating the specific lineage of Covid-19 linked with the conference has not been detected in Scotland since April 2020, the IMT said the measures around the conference outbreak had been successful in reducing the spread of the disease.

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The report states: “This suggests that the actions taken by the IMT to manage the outbreak were successful in curtailing onward transmission.”

IMT reports are intended to help public health officials learn lessons about how outbreaks were handled and provide recommendations to key public bodies

PHS said the guidance for “hot debriefs” was guidance and not mandatory, but refused to say if any informal recommendations were given to ministers prior to the publication of the IMT.

A Scottish Government spokesperson said: “As Public Health Scotland have made clear, the process of drafting the IMT report has been complex and lengthy as it has involved many international public health agencies. The former health secretary said in Parliament that the report would be published – and this has now happened.

“Learning around Covid-19 is a continuous process and findings such as this report will inform the wider response to the pandemic in Scotland.”

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