Self-isolation and testing changes: Scotland follows rest of UK and cuts isolation to seven days

Changes are being made to self-isolation rules in line with public health advice and testing requirements to help maximise testing capacity and ensure a speedier start to the process of contact tracing.

In a statement to the Scottish Parliament yesterday, First Minister Nicola Sturgeon announced that anyone who tests positive for Covid-19, regardless of vaccination status, must still self-isolate for 10 days.

However, from today, Thursday 6 January, new cases will be advised they can end self-isolation if they don’t have a fever and test negative on a Lateral Flow Device (LFD) on Day 6 and again at least 24 hours later.

Triple vaccinated close contacts of those who test positive, both household and non-household, or those under the age of 18 and four months, do not need to isolate as long as they return a negative LFD test result each day for seven consecutive days, and remain fever free.

The intention is for the public to be sufficiently reassured of a negative Covid-19 status during the potential incubation period.

Any close contact who is not fully vaccinated (three doses) will still have to self-isolate for the 10 days and take a PCR test.

Changes are also being made to testing after a positive LFD – people will no longer be asked to take a PCR test to confirm the result. 

Instead, anyone with a positive LFD should report the result online as soon as the test is done.  This ensures that people can get the advice they need as quickly as possible. After reporting their result, people should then fill in the online form they will receive, so that contacts can also be informed and rapidly given the correct advice.

First Minister Nicola Sturgeon said: “When the Omicron variant started to take hold, we strengthened self-isolation requirements, so that all household contacts had to self isolate for 10 days.

“That step was intended to slow the spread of the variant. It also reflected the fact that we knew less about the severity of the virus at that time, and that less of the population had protection from booster and third jags.

“We are now in a very different position – and so we can now adopt different rules.

“These changes are significant, but we believe they are also justified at this phase of the pandemic. They balance the importance of self-isolation – in slowing the virus’s spread and reducing the harm it can cause – with the wider harms to the economy that broader self-isolation rules can cause.”

If you have symptoms of Covid-19 (a fever, new continuous cough, or loss of sense of taste or smell) it is important to isolate and book a PCR test (even if you have already tested positive with an LFD) – that advice has not changed.

Getting a Lateral Flow Test:

People in Scotland who need a Lateral Flow Test can do so in the following ways:

  • By ordering online for home delivery.  A box of 7 lateral flow test will arrive within 24-48 hours.  Additional booking slots are added throughout the day.
  • At over 1,000 Community Pharmacies.  People will be able to collect one pack of 7 lateral flow tests. Pharmacies can receive a box of around 60 packs of lateral flow tests each day.
  • At over 60 Testing Sites.  People will be able to collect one pack of 7 lateral flow tests from any regional or local test site in Scotland.
  • At many other collect points established by Local Authorities.  Follow this link to find information on additional local sites in your community.
  • From where they learn or where they work if in education, health and social care or any workplace with more than 10 employees which have signed up for our workplace testing programme.

First Minister’s statement – 5 January 2022

Presiding Officer,

Firstly, I wish you, members and staff in Parliament, and everyone across the country a happy new year.

Today, I will report on the continuing rise in COVID cases.

I will outline our approach to managing this phase of the pandemic

As part of that, I will set out immediate changes to the requirements for self-isolation and testing.

And while we are not proposing any additional measures at this stage, I will confirm that existing protections and guidance will remain in place for the coming week, pending further review.

And finally, given that Omicron may not be the last new COVID variant that we face, I will also signal some longer term work to consider the adaptations necessary to enable us to deal more proportionately and sustainably with any future phases of the pandemic.

First, though, today’s statistics.

16,103 positive cases were reported yesterday – 26.9% of all tests carried out.

1,223 people are in hospital with COVID. That’s 71 more than yesterday – but it’s 544 more than at this time last week.

42 people are in intensive care – which is the same as yesterday.

Sadly, a further five deaths have been reported, taking the total number of deaths under the daily definition to 9,872.

Once again, I send my condolences to everyone who is mourning a loved one.

The surge of cases, driven by the extremely infectious Omicron variant, is continuing here in Scotland, across the UK, and indeed in many other countries around the world.

Here in Scotland over the past week, the total number of new reported cases has increased by 87%.

Tomorrow’s figures will almost certainly see us pass 1 million reported cases since the outset of the pandemic.

However, the rapid and very widespread transmission of Omicron is such that the daily recorded tally of cases – which has always been an underestimate of the true level of infection – now gives us an even less comprehensive indicator of how prevalent the virus is.

The weekly survey published by the Office of National Statistics (ONS) gives a better indication. In the week to 23 December, it suggested that one in 40 people in Scotland had COVID.

The results of the most recent ONS survey – published just a few minutes ago – suggest that in the week to 31 December that had risen to one in 20.

The proportion of people with COVID is though likely to be even higher than that now, a few days later – and I would anticipate that we will see continued growth in the level of infection as work and school resume after the holiday period.

In short, COVID is significantly more widespread now than at any stage in the pandemic so far, and will almost certainly become even more so in the days to come.

This, of course, has extremely serious implications for the NHS and social care.

But it also has a severe and increasing impact on the economy and other critical services.

This is primarily due to very high numbers of people off work with COVID – but it is of course compounded by the wider requirements for self isolation.

As I said last week, we have been considering very carefully the risks and benefits of changes to self isolation requirements and I will update on that shortly.

More generally, as I said a moment ago, we are not proposing any new protective measures today.

However, with the virus so prevalent, we do consider it important to continue to apply some brake on transmission, particularly in settings posing the highest risk.

Accordingly, I can confirm that the restrictions on large gatherings, the requirement for distancing between groups of people in public indoor places and for table service in hospitality venues serving alcohol on the premises will remain in force for now and indeed, I expect, until 17 January.

In addition, while this is not a legal requirement, we are continuing to strongly advise the general public to limit contact with people in other households as far as possible, and to limit the number of households in any indoor gathering that does take place to a maximum of three.

After two long years of this pandemic, I know that asking people to cut all social interaction is just not feasible – and it would be damaging of course to mental health and wellbeing.

However, limiting contacts insofar as we can, and thinking carefully about the interactions that matter most to us, is important just now.

It helps stem, at least to some extent, increases in transmission – and so has a collective benefit.

But it also helps protect us as individuals.

When at least one in 20 of us have the virus – as is the case now – the risk of getting it when we mix with others is significant.

So if we limit the occasions on which we do mix, we also reduce our own risk of catching a virus that we know could have a nasty impact on our health.

Trying to stem transmission – at least to some degree – is also important for the NHS which is under increasing pressure.

On the upside, the evidence that Omicron causes less severe illness than previous variants – at least amongst the under 60s, where the virus is most prevalent at the moment – does appear to be strengthening.

Indeed, the fact that the numbers here in intensive care are so far remaining stable while the numbers in hospital generally rises quite sharply, may be indicative of this.

We also know for certain that a booster jag provides strong protection against serious illness for people of all ages.

However, notwithstanding the success of the booster programme and indeed the apparent lower rate of hospitalisation from Omicron, the sheer volume of people becoming infected means more people with COVID are being admitted to hospital.

There is also remaining uncertainty about the impact on hospital admissions if Omicron continues to spread from younger age groups – where the risk of falling seriously ill from COVID has always been lower – to those in older age groups.

As I reported last week, work is also underway to better understand the detail behind the headline hospital numbers.

I can advise Parliament that the first results from analysis to differentiate those who are in hospital because of COVID from those in hospital with COVID but who were admitted for different reasons will be published on Friday.

Work is also being done to assess whether the average length of hospital stay resulting from Omicron is any different to that associated with other variants.

So, in short, our understanding of the precise nature and extent of Omicron’s impact on hospitals and the wider health and social care system is still developing.

However, what is beyond doubt is that it is already having a considerable impact.

The number of people in hospital with COVID has increased from 679 to 1,223 in the last week. That’s a rise of 80%. That is putting significant additional pressure on the NHS.

Indeed, the NHS is now facing increasing pressure on three related fronts.

First, from dealing with non COVID backlogs built up over the course of the pandemic.

Second, many NHS staff are absent and self-isolating either because they have COVID, or are close contacts of people with it.

This means the increasing pressure on the NHS is being managed by a depleted and ever more exhausted workforce. Let me say at this stage we owe each and every one of them an enormous debt of gratitude.

And third, as we keep saying, even with a lower rate of hospitalisation, the sheer volume of cases caused by the much greater transmissibility of Omicron will lead, is leading, to more patients with COVID ending up in hospital.

And, with reference to the analysis that will be published on Friday that I spoke about a moment, it’s important to remember, even if COVID is not the primary reason for someone’s admission to hospital, the fact they have COVID means enhanced infection control measures are required, and that further constrains NHS capacity so exacerbates that pressure.

We continue to support health boards and staff to manage this pressure – this includes working with councils to reduce delayed discharge and targeting additional capacity where possible.

Work is also underway importantly to develop alternative patient pathways for people with COVID, enabling them where possible to remain at home, where appropriate, with appropriate monitoring and advice rather than be admitted to hospital. This work will also help identify at an earlier stage patients likely to benefit from new antiviral treatments.

Of course, we can all help the NHS by taking steps to reduce transmission of the virus as much as possible.

Presiding Officer

While abiding by current guidance and protections is at this stage vitally important, we do know that measures which restrict our lives are not sustainable indefinitely.

And with a variant as infectious as Omicron, the kind of protections that are still possible within our financial resources and without causing greater harm in other ways – while still very important at this stage – won’t control transmission to the same extent as these measures would have done with other less transmissible variants.

So in light of this, coupled with the fact that unfortunately COVID won’t suddenly disappear and that Omicron is unlikely to be the last new variant we encounter, we need to continue to adapt our thinking about how to manage the virus and become more resilient to it in future.

Let me be clear at this stage, this does not, in my view, mean giving up on trying to control COVID completely – the impact of it on individual health and on our collective wellbeing is too significant for that.

But it does mean seeking ways of doing so that are more proportionate, sustainable and less restrictive.

There are no easy answers here, but adapting to the ongoing challenge of COVID is inescapable. The Scottish Government is therefore currently working on and will publish over the next few weeks a revised strategic framework, which will set out more fully how that process of adaptation can be managed with a view to building that greater resilience.

We will seek views from across Parliament as we develop this new framework in more detail. However, the changes I am about to confirm to the requirements on self isolation and testing are an early indication of an already adapting response.

I said last week that it was important to consider carefully changes to self isolation rules.

We wanted to ensure such changes are made only when in the view of clinical advisors, the benefits of them outweigh the risks of them.

I also want to make changes, as far as possible, in a coherent not a piecemeal manner, given the importance of clear public understanding of what is required.

As a result of this consideration, we are now proposing two changes to the self isolation rules, and one change to the requirement for PCR testing. And all of these changes will take effect from midnight tonight.

The first change to self isolation applies to those who test positive for COVID.

While the initial advice when someone tests positive will still be to self-isolate for 10 days, there will now be an option to end isolation after seven days as long as you, firstly, have no fever and, secondly, you record two negative lateral flow tests, one no earlier than day six after testing positive and another at least 24 hours after that.

The second change applies to close contacts of positive cases – and this includes household contacts – who are either under the age of 18 years, four months, or who are older than that and fully vaccinated.

Let me be clear, by fully vaccinated, we mean first, second and booster or third doses.

For close contacts in these categories the requirement to self-isolate will end and be replaced by a requirement to take a lateral flow test every day for seven days. Obviously, if one of these tests is positive, self-isolation will then be required.

Anyone identified as a close contact who is over 18 years and four months and not fully vaccinated will still be asked to self-isolate for 10 days and to take a PCR test.

These changes are significant and they are not completely without risk. However, at this stage of the pandemic they do strike an appropriate balance between the continued importance of self-isolation in breaking chains of transmission, and reducing the disruption self isolation causes in the economy and other critical services.

We are also proposing an important change to the advice on testing. And let me be clear again, this has been very carefully considered.

Scotland, indeed the UK as a whole, has one of the most extensive PCR testing systems anywhere in the world.

However, with infection levels are as high as they are, we must fully utilise all available testing capacity – PCR and lateral flow. And make sure isolation and advice happens as quickly as possible.

For those who have symptoms of COVID, the advice remains to book a PCR test, even if you have a positive lateral flow test.

And of course the advice to everyone is to test regularly with lateral flow devices, especially before meeting up with others.

However, from tomorrow, if your lateral flow test is positive, and you do not have symptoms, you will no longer be required to take a PCR test to confirm the result.

Instead, you must immediately isolate and also report your result online so that Test & Protect can commence the contact tracing process and give you advice as quickly as possible. You will also receive an online form that you must fill in, as would happen with a PCR positive in to ensure your contacts are notified.

Other countries, Canada for example, have already made this change.

It has been made possible because lateral flow tests are now widely available and work well.

Also, and really importantly, the Test & Protect system in Scotland can start contact tracing on the strength of a reported positive lateral flow result as well as a PCR.

And, crucially, at times of very high levels of infection the risk of a false positive lateral flow result is very low indeed – around just three in 10,000.

So the safest thing to do at this stage is treat a positive lateral flow test as confirmation of COVID. Even if you have no symptoms.

This allows us to maximise testing capacity and ensure a speedier start to the process of contact tracing and advice.

Presiding Officer

There are a few further points I want to briefly touch on today.

Firstly, the current situation continues to take its toll on every one of course, but it continues to take a toll on businesses.

Last week, I confirmed the allocation of more than £200 million of the £375 million in business support we are making available.

Today, I can confirm the allocation of a further £55 million.

Up to £28 million will be allocated to taxi and private hire drivers and operators. £19 million will support services such as beauticians and hairdressers.

£5 million will be provided for sport, and an additional £3 million for tourism.

Local authorities are as we speak working to get money into bank accounts as quickly as possible.

Secondly, in light of the widespread community transmission of Omicron in the UK just now, discussions are taking place today between the four UK governments about possible changes to travel rules, including the requirement for pre-departure testing.

If these discussions result in proposed changes, we will inform parliament as quickly as possible.

My third point relates to education, and the start of the new term.

All secondary school children are being asked to take a lateral flow test on the night before or morning of their first day back, and thereafter to test twice a week and also in advance of mixing socially with people from other households.

Likewise, university and college students should take a test immediately before travelling from home to term-time accommodation, and thereafter test twice a week and before socialising with people from other households.

And staff in all educational and early years settings should take a lateral flow test just before starting back at work, and in line with broader advice after that.

Our priority is to keep schools open and to minimise further disruption to education.

But with community transmission high, I know the next few weeks will be challenging for pupils, staff and parents.

Using lateral flow tests will help. So too will the changes to isolation rules – and updated education guidance reflecting these changes will issue shortly.

We will also work with councils to ensure the guidance issued before Christmas is followed to keep schools not just open but as safe as possible.

Presiding Officer, my final brief update today is on vaccination.

I am immensely grateful to everyone involved in delivering vaccines – and to everyone who has been vaccinated.

By the bells on Hogmanay, around 3 million people – 77% of those eligible – had received their booster or third dose.

If you weren’t one of these people – and you are eligible – please come forward now.

You can arrange an appointment online, or go to a drop-in clinic. There is plenty of capacity and you can get details at NHS Inform or your local health board website.

Getting a booster doesn’t mean we won’t get COVID, although it does reduce the chances of that, but it significantly enhances our protection against serious illness. It could quite literally save your life.

12 to 15 year olds can also now go to drop-in centres to get the second dose.

I encourage everyone in that age group to do so. If you are the parent or carer of someone in that age group, you can go with them to the vaccination centre.

The vaccine programme has been an outstanding success – but there are still many people eligible but not yet vaccinated.

If you are one of them, then for your own sake and indeed for the sake of all of us, please rectify that. It is not too late and no one will judge you for not having done it before now.

On the contrary, you will be welcomed with open arms.

Presiding Officer, This phase of the pandemic is possibly the most challenging we have faced so far.

The most infectious variant so far is creating a volume of cases that, notwithstanding its possibly reduced severity, still has the potential to overwhelm us.

And of course two years in, the kind of measures that have helped us control transmission in past phases are becoming less tolerable and causing more harm.

So while not easy, we do need to continually adapt our ways of managing this virus, and we will do so.

But in the meantime, we must continue to do what we know makes a difference now.

So get fully vaccinated as soon as you can – please do it this week.

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davepickering

Edinburgh reporter and photographer