Exactly six months today since full lockdown, Scotland is back in a mini-lockdown again. This time, only other people’s homes are off-limits. As in England, pubs will shut at 10pm. There are good reasons to be sceptical that these measures will be sufficient to contain the spread of covid-19. They appear suspiciously like applying maximum restrictions to non-commodified indoor activity, and then just keeping pace with England on everything that involves taking your wallet out. The Scottish Government say they are convinced that the household visitor ban has been effective in the west of Scotland and thus can be sufficient in containing an exponential spread for the whole country. The proof of the pudding will be in the eating – we will find out if they are right or not in a couple of weeks.
One specific area of concern is whether Scotland really has the contact tracing capacity it needs across the country. In early May, the Scottish Government outlined its “test, trace, isolate” plan, which included hiring 2000 contact tracers by June. Health Secretary Jeane Freeman said yesterday that there was just 874 contact tracers as of 10 September, less than half of a figure promised months ago. In Greater Glasgow & Clyde, there are 191 contact tracers, and yesterday there were 179 new cases there, so one tracer per case per day (following up on all of their contacts, informing them of what they need to know, carrying out checks, etc) is perhaps manageable, but if that increases to two, three or four times?
First Minister Nicola Sturgeon has insisted there is “no shortage” in contact tracers, with a “pool” of workers in local authorities that can be drawn on when needed. She said that over 90 per cent of cases are being traced, with the fallback of the National Contact Centre when cases flare up in one specific area. But the point of having localised contact tracers is to avoid a call centre-centric model. And what happened to using staff who aren’t busy contact tracing for carrying out randomised community testing? The Scottish Government said in April that “at full rollout the community testing approach will see 1,000 people tested a week”, but that seems to have disappeared. The picture we have of covid-19 in Scotland is primarily reliant on people who feel ill going to a testing centre themselves, which misses out people who don’t have symptoms, or don’t get checked because they are mild, and so forth.
The Scottish Government’s Test and Protect system is heavily reliant on UK testing labs, which provide the majority of the test results. Scottish NHS labs provide the rest. We have already seen how strain UK-wide in recent weeks means results in Scotland are being delayed. Over the past week, the number of Scottish results from the UK’s labs was below its population share, at 6.8 per cent. The number of test results coming through each day seems to be more about what the system can handle than the number of people getting tested.
It’s largely been taking at face value that Scotland’s Test and Protect system is fit for purpose, but it has been operational at a time when case numbers are low. There are at least question marks about whether it is resilient enough to handle exponential growth.
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