Insight: 24 hours at the heart of the Scottish Government’s virus fight

For more than two months, First Minister Nicola Sturgeon, Health Secretary Jeane Freeman and Interim Chief Medical Officer Dr Gregor Smith have spent every waking hour formulating the country’s response to the Covid-19 pandemic. They gave Dani Garavelli an hour- by-hour account of one of their exhausting days on Thursday, April 30

Nicola Sturgeon at the daily press conference - an empty room

6am-8am

Breakfast

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The sun is just up and everyone is awake and preparing for the packed day ahead. In her home just outside Glasgow, Nicola Sturgeon is drinking one, perhaps two coffees and perusing the morning newspapers with Good Morning Scotland on in the background to get a sense of the issues being raised. Jeane Freeman is grabbing a piece of date loaf and a banana and trying to remember to pack her make-up so she can reapply it before her appearance on BBC Question Time this evening. Dr Gregor Smith is tucking into a plate of porridge with nuts and honey. For the rest of the day, eating will be erratic and on the hoof, so it’s important to make sure they are fuelled up and ready to go.

7.30-8.30am

The daily commute

Before Covid-19, every day was different, particularly for the First Minister, who would move between her office in Bute House, Holyrood and St Andrew’s House as well as travelling across the country to meet schoolchildren, volunteers and businesses. Now St Andrew’s House has become their principal base (though she and the Health Secretary sometimes attend the Scottish Parliament when it is sitting). Today, however, they will all spend all day in St Andrew’s House, which is the only government building still open.

Work for Sturgeon and Freeman begins in the car. “I have a ‘box’ which in reality is a suitcase on wheels full of papers I need to take decisions on, so I work through some of those,” Freeman says. In the past few weeks, she has got used to cruising along an almost deserted M8. A journey that could take up to two and a half hours now takes just 60 minutes. She asks the driver to stop at Harthill so she can pick up a salad. She also has some tomato and chorizo soup her partner, Susan Stewart, has made for her and Sturgeon.

Sturgeon’s commute lasts around 50 minutes, as she checks her diary, starts to work through briefing papers and checks in with her special advisers and chief of staff.

8.30am-11am

Sturgeon catches up with her private office and looks at papers on test, trace and isolate – the approach which will have to be in place before any easing of the lockdown is feasible. The key tasks of the day include updates on the increase in Scotland’s testing capacity (to be announced the following day) and establishing where the country is with the RO – the reproductive rate of the virus, or the number of people, on average, an infected person can be expected to pass the disease onto. At the moment, the UK rate is thought to be between 0.5 and 1, which means infection rates are in decline, but one of the messages the First Minister will want to communicate is that the margins are so small an early easing of the lockdown could easily push it back up again.

Freeman catches up with staff from her private office. They give her a sit-rep on overall numbers of cases, number of cases in care homes, how the ambulance service is doing, what is happening with primary care. “It’s a lot of graphs and data,” Freeman says. “They also give me detailed information on how many weeks’ worth of PPE is in the national stockpile.” Today brings a piece of good news: an order of non-sterile long-sleeved gowns has arrived.

Jeane Freeman appears on Question Time

Smith too kicks off the morning with a conference call with the senior members of his team, including the chief pharmaceutical officer Rose Marie Parr, chief scientist Professor David Crossman, and interim deputy chief medical officer Dr Nicola Steedman to look back over the previous day’s work and prepare for the day ahead. Smith had to step up into this high-profile role earlier in the month when the previous CMO Catherine Calderwood was forced to resign after twice visiting her second home against her own explicit advice. But Smith has worked in St Andrew’s House since 2012, becoming deputy CMO in 2015 which, he says, has made the transition easier. Next up is the directors’ network meeting (also online) where the directors of the different policy areas come together. “There is a lot of discussion around emerging evidence, what people are seeing within their networks and the feedback they are getting from different clinical groups,” Smith says. During the calls, he looks out over Calton Hill and the City Observatory – a spectacular view which keeps him calm when things become fraught.

11am-11.30am

Freeman and Smith make their way upstairs to the First Minister’s Office, stopping to sanitise their hands along the way. This meeting is their opportunity to update Sturgeon with all the information they have gathered from their own teams, and to agree a strategy for the daily press briefing in an hour’s time. They space themselves out across the office and top up their caffeine levels.

All three are concerned because it has emerged traffic levels on UK roads have risen to the highest level since lockdown began. They agree Sturgeon must be clear that, while infection rates appear to be in decline, the situation is still fragile and people should still not be making unnecessary journeys. There is also a discussion on what is being done to increase testing capacity to prepare for test, trace and isolate. “We spend a lot of time checking facts and figures,” Freeman says “We don’t use a figure unless we are certain about it – and that means it gets lots of interrogation. The reason for this is, I think the more open you are and the more what you are saying is accurate, the better the chance people will trust what you are saying, and we need people to believe what we are saying because, at the end of the day if people don’t comply with what we are asking them to do, this isn’t going to work.”

Freeman says the fact every decision taken about the virus has the power to affect so many people means she is gripped by a sense of responsibility and worries a lot about decisions. “The First Minister and I read World Health Organisation papers and papers of scientific evidence from other places. It can be overwhelming because there is a great deal of information. Some scientists are, at times, uncomfortable because the pace is so fast. They are used to what they write being peer-reviewed before it is published and that’s not always possible now because the virus is moving so fast.”

12.30pm-1.45pm

The press briefing

As far as journalists and the general public are concerned the press briefing is the centre-point of the day. Sturgeon, Freeman and Smith take their place behind lecterns on a stage in the media centre and speak to an empty room before fielding questions from journalists whose heads appear on a screen when it is their turn to talk. A BSL interpreter stands behind them.

Today, Sturgeon makes her plea on unnecessary journeys and announces a £34 million hardship fund for newly self-employed Scots, a £20m fund for small and micro enterprises in the creative, tourism and hospitality sector and a £45m pivotal enterprise resilience fund to support vulnerable small and medium-sized enterprises (SMEs) which the government deems as vital to Scotland’s economic future, or to the economies of local areas throughout the country. Smith announces £5m of funding to Scottish universities and research institutions for 55 coronavirus-related projects before Sturgeon takes questions.

To outside observers, the daily briefings can occasionally feel a bit repetitive as the same issues are brought up again and again.

“It’s tough, if people are asking the same questions slightly differently phrased, for the response not to sound pat,” Freeman says, “but it’s difficult for the journalists too because these briefings happen every day and they have to think of questions to ask”.

Everyone agrees the experience is slightly surreal. “You are gazing out towards an empty room with nothing but tech kit and lighting,” says Smith. “I love the ability to interact with people, but it is very difficult to interact when the person asking the question is on a screen at a slight angle to you. You are aware of the face to the side, but in order to continue speaking to the camera, and therefore to the public, you have to ignore them. Freeman says she amuses herself by working out which journalists have the camera angle on their iPad spot-on while Sturgeon likes to see inside their houses. “I’m not saying whose the messiest is though,” the First Minister says.

2pm-5pm

Freeman is briefed for her Question Time appearance by special advisers while snacking on oatcakes and cheese. The health questions ought to be straightforward. “We assume it will be mostly on the pandemic and let’s face it, I ought to be on top of that,” she says. So most of the prep time is spent going over what the Scottish Government is doing on the economy and what it wants from the UK government. “We talk about what we are doing in the communities portfolio to help people who may be furloughed at the minute and about the extra money being put into food banks,” she says. There follows a phone conference call with Cosla where the main topic of conversation is a 63 per cent reduction in delayed discharge. “There are a number of things that, as a consequence of the pandemic, we have achieved a lot quicker than we would otherwise have done,” Freeman says. “One of those is the use of online consultations between GPs and patients, another is the decrease in delayed discharge. We need to concentrate on sustaining that position, but also look at the ‘front door’ – in other words, whether or not there still are admissions to hospitals where we think clinical care in the community would have been better. If, as we go through the pandemic, we can improve both ends, that would represent a huge dividend for patients.”

Sturgeon has a steady stream of in person and online meetings, including a press conference debrief, a review of upcoming marketing campaigns and an update on economic packages of support. She also has to record a short video message for the VE Day commemorations.

Smith is on hand to support Deputy First Minister John Swinney as he answers detailed questions from the leaders of the other political parties. “I am impressed by the maturity of the conversation – these meetings are not confrontational in that traditional sense you sometimes see in the chamber, but actually seek to get into the detail of the information,” Smith says.

5pm to 7pm

Sturgeon’s meetings continue apace with an update on public services and community/welfare support and a review of the economy Cabinet papers ahead of the following day’s meeting.

A conference call with the BMA/RCN, involving both Freeman and Smith, is postponed because other things have overrun, but Freeman still has an online meeting to update her on work the directors of public health have been asked to do with care homes. There are just under 1,100 care homes in Scotland, 70 per cent of which are private. The Scottish Government wants to ensure those homes understand and properly implement infection protection and control measures and that they have the necessary PPE. After this, the health secretary has just enough time to touch up her make-up and put on more lipstick before Question Time.

7pm to 9pm

Freeman’s UK-wide TV appearance proves frustrating. Just as Freeman is doing a technical check on the computer screen connecting her with Fiona Bruce, she discovers the other guests – Transport Secretary Grant Shapps, shadow chancellor Anneliese Dodds, former chancellor George Osborne and geneticist Sir Paul Nurse are not, as she had been led to believe, on a video link like her. They are all in the studio with Bruce. She is the only one who is being beamed in from afar. This puts her at a disadvantage. Freeman can only see the one person who is speaking at any given time and cannot chip in. “I hope I am experienced enough to do what needs to be done despite this, but if the same thing were to happen another time I’m not sure I would be willing to take part.”

The others are still working too. Smith joins a conference call with senior clinicians from England, Wales and Northern Ireland before grabbing a quick dinner at the St Andrew’s House canteen, while Sturgeon has taken papers home with her. At 8pm, she and husband Peter Murrell stand outside to Clap for our Carers. “It’s quite emotional, particularly as I have family working in frontline services,” she says.

9pm-midnight

After Question Time, Freeman is driven back to Glasgow in her ministerial car. She looks at the papers in her box but decides she is too tired to make any decisions. She has hardly eaten – the salad she bought at Harthill on the way over this morning remains in the fridge in Edinburgh, but she is past the point of being hungry. She is also too late for the walk she likes to take with her partner. When she gets in, she has a bagel and cheese. She is often too stressed to sleep so she reads. Tonight, she is finishing American Dirt, a novel about a Mexican who flees to the US as an undocumented migrant. Then finally shortly before midnight she goes to sleep.

Sturgeon works on until 11pm and then goes to bed. She has not been getting out on walks either, but says she gets her exercise walking up and down the stairs at St Andrew’s House. “It doesn’t look much, but there are six floors from my office to the media centre so you’re definitely out of breath by the top.” One imagines it is even more difficult to do it in heels. Usually she too would read. “Normally I can quite easily get completely absorbed in a good novel, but just now I’m finding it pretty difficult to switch off.” Like many people she is spending more time getting in touch with family members. “I am also enjoying seeing the many funny TikTok videos appearing across social media – it’s good to see how creative people are becoming while stuck at home.”

Smith too sits at his laptop answering emails. He loves exercising but has not done any for weeks. He longs for the day he can get back to the gym. But he is so exhausted he has no trouble winding down. He closes his laptop, drinks a cup of tea, and falls asleep as soon as his head hits the pillow.

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