Coronavirus Scotland: Exiting lockdown requires more than just speeding up our vaccine rollout

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PREMIUM

GLASTONBURY is cancelled for a second year.

A UK Government scientific advisor has suggested that it might be too dangerous to re-open pubs and restaurants in England “earlier than May”.

And release of the new James Bond film has just been delayed, for a third time, until October.

If we came into 2021 with a sense of ‘light at the end of the tunnel’ optimism, it is fair to say that has ebbed away somewhat with the dawning realisation that the journey back to genuine normality is going to be a long haul.

Why vaccinations will bring an end to lockdown – but an end to social distancing remains far off 

Vaccines, hailed a Holy Grail to end the pandemic, have become a source of frustration amid accusations that Scotland’s rollout is lagging behind other parts of the UK.

Is that fair?

The percentage of the population vaccinated in Scotland is the lowest of the four UK nations (Source: Travelling Tabby, data updated January 22)

On paper, Scotland’s progress looks slower. To date, 6.6 per cent of Scotland’s population has had a first dose, slightly behind of Wales with 6.7% and trailing England and Northern Ireland, who have reached 8.3% and 8% respectively.

The Scottish Government insists that it has rightly prioritised immunisations for elderly care home residents, with more than 90% having had their first dose compared to 63% in England.

Scotland began vaccinating in care homes a week earlier than England too, on December 14.

There will be no Glastonbury music festival this summer, for the second year in a row

There are signs that this strategy may be beginning to pay off, with Covid deaths in care homes in England up 46% last week to 1,260 – the highest level since mid-May – while in Scotland they fell by 16% from 116 (also the highest since mid-May) to 97 in the week to Sunday.

Vaccination is only part of the story, however.

Northern Ireland began vaccinating its older care home residents earlier than anywhere else in the UK, on December 8, and already three quarters have received first and second doses of the Pfizer/BioNTech vaccine after the country’s health authority decided to stick to the three-week timetable, which also applies to care home staff.

Care home deaths in Northern Ireland rose by 31 last week – the highest number since May

Despite this, care home deaths in the country are still rising, doubling from 15 to 31 last week.

More than anything else, Scotland is better placed by simply having the lowest virus rates in the UK: 208 per 100,000 compared to 290 in Wales, 353 in Northern Ireland, and 473 in England.

But that is unlikely to offer much consolation to over-80s in the community in Scotland, who are beginning to feel left behind compared to peers elsewhere in the UK.

Source: Public Health England

By last weekend, 13% of over-80s in Scotland had had a first dose of Covid vaccine compared to 60% of those in England, where GPs started inoculating this group back in mid-December.

In areas where the majority of over-80s have now been seen (in Glouchestershire, for example, 85% of over-80s have had their first jag), the over-75s and clinically extremely vulnerable have started to receive their invites, with Northern Ireland also expecting to begin offering jags to the over-75s as early as next week.

Warning ‘ridiculous’ bureaucracy for would-be vaccinators threatens 400,000-a-week jags plan

Dr Alan Stout, chair of the BMA ‘s GP committee in Northern Ireland said this week that “by the end of January we will definitely have everyone aged over 80 vaccinated”.

In Scotland, that timescale has slipped to end of February, with the Scottish Government insisting that it is moving as fast as it can with the stocks it receives from the UK Government: hundreds of thousands of doses are reportedly still in storage in, or in transit from, England.

GPs on the ground in Scotland are eager to get on with the job, and growing restless. Some have yet to receive any doses of vaccine at all, while other have had to cancel patients’ planned vaccinations at short notice because scheduled deliveries failed to turn up.

GPs in Scotland push for greater role in Covid vaccination scheme

This week, BMA leaders in Scotland called for the process to be “streamlined” to allow GPs to order supplies directly – as they do in England – instead of having to go via the health board.

There are other hurdles to come, however. Beyond the over-80s, GPs in many parts of Scotland are still in the dark about what their role will be (if any) when it comes to vaccinating the over-70s and over-75s, as the responsibility lies with health boards in Scotland.

Based on the wave one trend, hospital admissions would be expected to fall low enough to begin lifting lockdown by mid-March

Importantly though, our exit strategy from lockdown must be about more than vaccines.

In the first wave, Scotland waited more than ten weeks to begin easing lockdown on May 28, when hospital admissions for Covid were averaging 11.6 per day; right now we are averaging 162.3 per day, and can probably expect to remain in lockdown until mid-March.

When we do come out, we should look to the Asia-Pacific for a sustainable way of living with the virus until herd immunity is achieved, which is unlikely to come earlier than autumn.

In New Zealand, Australia and Taiwan the virus has been virtually eliminated and the economy is thriving, with hospitality and leisure venues open, friends and family able to socialise indoors, and hospitals and care homes open to visitors.

They are enjoying normal life – without a vaccine. We can have that, but it means not repeating the mistakes of last summer and reopening too much too soon.

If only ‘taking back control’ had also included our borders in a pandemic

Our borders should remain closed, and quarantine enforced using hotels as it is in Australia, New Zealand, and Taiwan for anyone arriving in the country – even UK nationals.

Travel restrictions may have to remain in place within the UK too (cases brought from England as well as continental Europe seeded the second wave in Scotland), and governments should do all they can in the meantime to compensate the travel industry for its losses.

International arrivals entering New Zealand are escorted from the airport into managed isolation in Government-appointed hotels. Those who test positive or develop Covid symptoms are moved into quarantine hotels

Cases must be driven back down to the lows of last July, but crucially much more has to be done to improve people’s ability to comply with self-isolation through better financial support (whether by blanket £500 payments as proposed in England or short-term furlough for those on low incomes) and practical support, such as putting infected people up in ‘isolation’ hotels where meals are brought to your door, as they do in New York.

In New York, Covid volunteers even walk your dog for you.

If this sounds costly, imagine the cost of a third wave lockdown. Because that is what we face if we get this wrong again.

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