New Our Scottish Future Report Urges Radical Acceleration of Coronavirus Testing

*WITH LESS THAN TWO PER CENT OF SCOTS TESTED FOR CORONAVIRUS, COUNTRY NEEDS TO RAMP IT UP, SAYS NEW THINK-TANK REPORT

*SCOTTISH GOVERNMENT’S 15,500-A-DAY TARGET BY END OF MAY ‘NOT NEARLY ENOUGH’, SAYS GORDON BROWN, WHO ADDS IT IS A SCANDAL AND TRAGEDY THAT CARE HOME RESIDENTS AND WORKERS ARE NOT BEING TESTED REGULARLY AS  MATTER OF ROUTINE 

*SIX-POINT PLAN CALLS FOR GOVERNMENT TO EXTEND ROLE FOR ARMY, DEPLOY SCOTLAND/UK-WIDE BULK PURCHASING POWER, REPURPOSE MANUFACTURING, UTILISE EMPTY LAB SPACE, SHARE EXPERTISE AND SET HIGHER TARGETS

*MASS PREVENTATIVE TESTING MUST BECOME THE NEW NORMAL IF WE ARE TO DRIVE COVID-19 OUT OF SCOTLAND AND UK ,SAYS PROFESSOR HUGH PENNINGTON 

*UK AND SCOTTISH GOVERNMENTS MUST WORK TOGETHER TO UPSCALE, WITH ROUTINE TESTING MADE POSSIBLE FOR 800,000 KEY SCOTS

The Scottish and UK Governments must agree a radical acceleration of testing for coronavirus in Scotland if the country is to secure a clear path out of lockdown, a leading think-tank says today.

In a new paper, Our Scottish Future says both Governments must plan to move from minimal to mass testing within DAYS  – warning that the current ambition set out by Scottish Ministers is too low for the country post lockdown.

The report calls for ministers to co-ordinate a plan to begin frequent and regular routine preventative testing for 800,000 Scots: key workers such as NHS staff, care home staff, police officers, transport and retail workers – plus old people’s homes residents and anyone coming into the country.

Both Gordon Brown and Professor Hugh Pennington, one of Scotland’s leading microbiologists who has advised both the UK and Scottish Governments, says that mass testing must become the new normal.

The paper argues that the new Scottish Government testing target announced this week, for 15,500 tests a day by the end of May, is wholly inadequate to meet such a large group.

The think-tank warns it would:

·  mean key workers in the NHS and in social care cannot get regularly tested and so would risk infecting patients if they go to work;

·  force many employees to go into self-isolation for the full 14 days without pay, because they can’t get tested to see whether they are infected or not;

·  leave contact tracers working below capacity because there would not be enough tests to process.

Current figures show just over 1.5% of the Scottish population have been tested since the start of the outbreak. The Scottish Government’s plan for 15,500 tests by the end of May points to just 0.3% of the population being tested per day.

Yet international evidence is that as in Germany Norway Denmark South Korea and down under a far bigger share the population should be tested every day if contact tracing is to be effective.

Scotland is starting from a low baseline: as of this week, just 19 tests per 1,000 people have been carried out, compared to 30 in Germany, 33 in Norway and 42 in Denmark.

The paper warns: “The Scottish Government’s plan to introduce 15,500 tests by the end of May is wholly inadequate and falls far short of the ambition we would hope to see at this stage. If not addressed, Scotland risks being forced to fight Coronavirus with one hand tied behind its back, with workers infecting others when they should be at home, while others trapped at home when they could be at work.”

Former Prime Minister Gordon Brown said: “Over the past month, we have seen our brilliant caring NHS and the whole country come together with self-discipline and self-sacrifice to fight this terrible disease. But the truth is we are only about to start stage two of this battle, and much, much more needs to be done.

“It’s now clear that mass testing across the community is the only way to give people the confidence to get back to work. But a maximum of 8,000 tests now and 15,500 by the end of the month is simply not good enough when we have 162,500 NHS staff, more than 130,000 adult social care workers,170,000 construction workers, 100,000 front line public servants from police and fire to teachers and 137,000 retail workers. Even on the Scottish Government’s most optimistic plan – 15,500 tested by the end of the month – we would be covering only 0.3 per cent of the people.

“It is a scandal and a tragedy that care home residents and workers are not being tested as a matter of routine. Reactive testing – when the disease breaks out – is not good enough when people can carry the disease for days and infect others without showing symptoms. Nor is random testing enough although we welcome dedicated teams who will test everyone in a home. We need routine preventive testing of all residents and workers on a regular basis to stop the disease.

“Nor can we tolerate a situation where – as our report suggests – key workers will be unable to get tested routinely and regularly and bread-winners will have to stay off work,

losing pay, for lack of a test, telling them whether they are infected or not.

“We need the Scottish and UK Governments to come together on a war footing with a  mass mobilisation of people resources and equipment  and we need to ramp up our ambition with a plan which takes advantage of the UK-wide networks we have to accelerate testing at a much more rapid pace. Mass testing – not minimal testing – must become the new normal.”

Professor Hugh Pennington CBE, emeritus professor of bacteriology at the University of Aberdeen added: “Mass preventative testing is essential if we are to drive COVID-19 out of Scotland and the UK. This practical evidence-based plan shows why, and how, it can be done. As a virologist I endorse it without reservation.”

Jim Gallagher, of Our Scottish Future, said: “The proposals are based on the international evidence and the emerging academic consensus about just how much more testing will be needed to get Scotland and Britain safely back to work.

“Scotland can’t do this on its own. It requires an unprecedented mobilisation of manufacturing and scientific resource at a UK level and testing infrastructure across the whole country. Both UK and Scottish governments should commit to it now.”

The paper makes in total six recommendations for the UK and Scottish Governments – which, between them, are sharing responsibility for the roll out of testing in Scotland:

* to commit to a far more ambitious antigen testing target;

* to use the whole weight of the UK’s NHS demand pool to buy lab resources including unused labs and repurpose manufacturing capacity;

* to integrate the testing network so it is seamless for Scottish patients

* to work together across the UK to share technological advances on testing, and back a UK wide trace and trace approach;

* to deploy the army, military vehicles and logistics to support mobile labs in more remote parts of Scotland – and source empty lab space;

* to put Scotland and  the UK on a war footing -exchanging data and f telling people to get tested ,  until testing  is the new normal

It also warns that a lack of strategic thinking risks reducing the effectiveness of the Scottish testing plan. Figures this week show that under 5,000 tests were performed in Scotland across both the NHS Scotland and UK Government facilities – just 45% of capacity available.

Closer joint working could increase this percentage, the report concludes.

The 800,000 Scots who should get access to routine preventative testing are made up of the approximate 30,000 people who are likely to be forced into quarantine after lockdown (because they have symptoms or have been in close contact with an infected person), 300,000 health and social care workers, 130,000 teaching professionals and police officers, and 350,000 key workers in critical areas to the Scottish economy. from construction to retail where there is direct contact with the public.

According to academic evidence, routine testing can only be effective in cutting infection rates if it is available regularly  – thereby giving key workers up to date information on whether they are safe to work, or whether they need to isolate.

The 15,500 testing target was set by the Scottish Government earlier this week and would be an increase on current levels of testing, which are less than 5,000 a day.

However, it is likely to fall short of UK-wide plans for testing, with plans being prepared to increase testing to 200,000 or more above and beyond the current 100,000 a day figure.

Read the full report here.

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Coronavirus and the Constitution

Is devolution problematic to crisis management? In this guest blog, Jim Gallagher provides an overview of the UK and devolved governments’ approach to COVID-19 and discusses how the pandemic is likely to impact upon devolution in the UK.

With the UK’s united approach to managing the coronavirus crisis apparently fraying at the edges, questions are being asked about whether devolution is problematic for crisis management, and even whether the Scottish government is “playing politics” in the midst of a pandemic. Some commentators appear surprised the UK government cannot simply instruct the devolved administrations; others claim the Scottish government is doing better than the UK government and has “attracted commendation from … both at home and abroad”.

Such claims mainly display the preconceptions of those making them. The constitutional allocation of powers cannot just be overridden. Scotland is, however, doing no better than the rest of the UK in controlling the virus. Excess deaths are typical of UK levels; the “reproduction number” is possibly slightly higher than the UK average, and the gap between virus testing in Scotland and England is apparently increasing. It is nevertheless worthwhile reflecting on how coronavirus and the territorial constitution affect one another.

Devolution and Emergencies

Devolution always assumed an integrated UK approach to emergency planning and management. Scottish Ministers became members of the UK Government’s Civil Contingencies Committee, like territorial Ministers before them, not from institutional inertia but because emergencies need operational responses more quickly than normal political processes allow for, potentially cutting across the business as usual boundaries of responsibility.

Like so much of the British constitution, these arrangements are based on administrative practice and have no specific legal, still less constitutional, underpinning.  They seem to have served well enough for the last 20 years, but are under unprecedented pressure from a pandemic which obviously requires swift action across the whole of the UK, coordinated across the constitutional allocation of powers.

Government actions were generally taken in lockstep for the first couple of months. Inevitably, the UK government brings more capacity to this work than the devolved administrations do (eg the technical expertise of Porton Down, or fiscal capacity to support furloughs), but critical parts of the response are in devolved control, not just legally, but in practical terms, eg the operation of the NHS, or responsibility for care homes. 

How successful this joint approach has been is open to question. UK excess deaths are among the world’s highest, and the emphasis on saving the NHS may have put the vulnerable in care homes more at risk. With the crisis far from over, judgements may be premature. Higher mortality might reflect the openness of the UK economy and society rather than government failures. But the UK government and the devolved administrations share responsibility for the decisions and outcomes.

Political Games?

The handbrake turn from politics as usual to crisis management is bound to create tensions: intergovernmental differences have been evident in Germany and the US.  Some divergences may be driven by different objective circumstances, such as the trajectory of the virus, but others perhaps by the different priorities of political leaders. The UK entered the crisis with mistrust between London and Edinburgh and, despite governments working closely together, relations have strained.

This was mostly about presentation rather than substance. Nicola Sturgeon was perceived to steal a march on the UK government by announcing schools policy before them, and Boris Johnson let the devolved governments find out about policy changes on television.

Maybe not surprising, under great pressure, institutions and people revert to their default behaviors. Whitehall still instinctively regards itself as a unitary UK government, even when it knows it is not (after all, 85% of the UK population is unaffected by devolution). Boris Johnson defaults to studiedly ambiguous communications.  

Nicola Sturgeon reverts to her defaults too. She finds it easy to present in a more orderly way than Johnson (their personae could hardly be more different). But it is also easy for SNP politicians to present Scotland as disempowered or disrespected in the management of the crisis (they would say the UK does that normally) and claim Scotland is doing much better, even though halting epidemic spread, protecting care homes or providing tests in Scotland is a Scottish, not a UK government, responsibility.

Differences have come to head over moving out of lockdown. At different times, each government has accused the other of being premature and sending mixed messages. At present the UK government is taking a slightly more forward stance. Governments explain their similar, but not identical, approaches in different terms. Objective differences justifying different approaches are hard to identify. They may reflect different views on the balance of risk or different pressures on governments. But earlier presentational divergence will have made policy divergence more likely.

The underlying problem

Rattiness between politicians under pressure is to be expected. But the resultant mixed messages are unhelpful in managing an almost insoluble policy problem. Emergency lockdown cannot be sustained indefinitely; public behaviour is changing by itself. No government in the UK has an easy to understand strategy that will command public confidence for returning to anything like normal economic activity while continuing to suppress virus transmission. Divergent approaches will worsen that, and create awkward mismatches between devolved and reserved aspects of policy. Just now, the most important gap is a shared one: having enough testing capacity to run an effective “test, track and isolate” approach, routinely testing those most at risk having and passing on the disease.

Filling that policy gap is critical. We need our political leaders to hammer out a credible joint approach, laying aside any mistrust and resisting the temptation to default to the tropes of normal politics, amidst a medical crisis. Those can come back along with rest of normal life.

Professor Jim Gallagher is a Visiting Professor at University of Glasgow, Honorary Professor at St Andrews University and an Associate Member of Nuffield College, Oxford. This article first appeared at: https://www.centreonconstitutionalchange.ac.uk/news-and-opinion/coronavirus-and-constitution

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