Stroke Association responds to Improvent Programme report

The Stroke Association has responded to Public Health Scotland’s Scottish Stroke Improvement Programme report 2021 which was published this week.

John Watson, Director Scotland of the Stroke Association said: “Two things leapt out to me in reading “The Scottish Stroke Improvement Programme annual report 2021″ launched today.

“First of all I am struck by how well stroke care teams around Scotland have managed to maintain specialist care and treatment to patients, in the face of unprecedented challenges.  Those teams deserve our thanks and respect.

“Of more concern was the reduction in the number of people coming into hospital with the signs of stroke. Although we are not fully sure why this is the case, it is presumed in this report that it has been due to a fear of hospital admission – likely due to hesitancy and fear of contracting COVID-19.

“This is a concern to us because stroke is a medical emergency and it’s essential to call 999 straight away if you suspect you or someone around you is having a stroke.  

“We continue to urge the public to use the world-famous stroke acronym, “FAST”, to familiarise themselves with the signs and symptoms of a stroke: Face, Arms, Speech and Time (to call an ambulance) – Act FAST.  

“FAST remains an important message that both we and others continue to promote.  

“The Scottish Government recognised pre-pandemic that stroke needed significant improvement and made welcome commitments towards that.  We are pleased to see increasing awareness of the signs of a stroke is included, alongside commitments relating to improved hospital care. We look forward to seeing further progress on those commitments in the coming months.”

For more information on FAST, go to: https://www.stroke.org.uk/what-is-stroke/what-are-the-symptoms-of-stroke

A link to the summary and full report:

https://publichealthscotland.scot/publications/scottish-stroke-improvement-programme/scottish-stroke-improvement-programme-2021-national-report/

NHS Lothian appeal to students changing address

Students changing address should register for their vaccination at http://nhsinform.scot/under30register by 4 June.

You can change the date, time and location of your appointment online if still in the same health board area, or by calling the helpline if in a different health board area.

Student writings show what life is really like living in poverty

A new, powerful collection of writing has highlighted the lived experiences of people living with, and tackling, poverty in their communities.

Disturbing yet timely, this collection of writing from students of the Health Issues in the Community course (HIIC) reveals the corrosive effect that poverty and inequality are having on a day-to-day basis in modern Scotland.

As a society that believes in compassion and justice, the writings act as a call to action to address inequalities and the increasing number of people being swept up in the wake of crushing poverty. 

Public health specialists have drawn attention to the serious impact inequalities have – made even worse by the global health crisis brought on by the Covid-19 pandemic. 

Amidst the grim picture that is so minutely described, the writings are also witness to the power of community, of kindness, of the sense of ‘the commonweal’ that is alive in our communities. 

Broadcaster and journalist Lesley Riddoch, who provided the publication’s foreword, said: “From all the grimness of lockdown and the staleness of news comes this wee gem of a collection – words from folk who live at the sharp end of life in Scotland.

“I’ve no doubt that the folk involved in this HIIC course will use the insights and comradeship they’ve gained to start moving mountains – while taking care of one another.”

Health Issues in the Community is an SQA-accredited course for adults and young people that helps students understand what affects their health and the health of their communities.

Running for more than 20 years, HIIC brings a community development approach to tackling health inequalities and reaches more than 300 participants each year.

HIIC is managed by the Community Health Exchange (CHEX) and funded by Public Health Scotland. You can learn more about HIIC here

While the HIIC course encourages participants to widen and deepen awareness of health issues in their communities and their involvement, we cannot solve this issue alone. Political action is required by governments to ensure Scotland is no longer defined by poverty and inequality in the 21st century.

These writings provide the voices of lived experience to help make that a reality.

Fiona Garven, Director of the Scottish Community Development Centre, said: “These students’ writings are a stark reminder of the impact of poverty in communities across Scotland – and the power of people coming together to take action on the things that are important to them.

“With a firm foundation in community development practice, HIIC has been tackling health and social issues for more than 20 years. These writings act as further evidence for community-led responses to health inequalities, enabling students to explore and take action to address their own health issues and the health of their communities.”

Bill Gray, Organisational Lead, Public Health Scotland said: “Public Health Scotland is proud to have supported the development of the HIIC course and recognises the need to listen to voices from our communities has never been more important.

“Our Strategic Plan sets out a clear ambition to embed engagement with communities across all of our programmes of work and the experiences of HIIC participants, set out in this powerful new publication is an invaluable resource for anyone working to address health inequalities in Scotland.”

Covid: Vaccination of Scotland’s healthcare workers offers some protection against transmission to their household contacts

A study of all healthcare workers employed by the NHS in Scotland and their households, shows that the rate of infection with Covid-19 for people that live with healthcare workers is at least 30% lower when the worker has been vaccinated mostly with a single dose.

Since household members of healthcare workers can also be infected via other people (not just via the healthcare worker they live with), this 30% relative risk reduction is an underestimate of the ‘true’ effect of vaccination on transmission.

Research led by Public Health Scotland and the University of Glasgow (with contributions from researchers at the London School of Hygiene and Tropical Medicine, Glasgow Caledonian University, the University of Edinburgh, and the University of Strathclyde) involved over 300,000 people in total and ran between 8 December 2020 and 3 March 2021.

The study, using record linkage, compared cases of Covid-19 and hospitalisations due to Covid-19 in household members of both vaccinated, and unvaccinated health care workers.

Where healthcare workers had received a second dose of the vaccine at least 14 days before, their household members had a rate of Covid-19 which was at least 54% lower than household members where healthcare workers had not been vaccinated.

While the study was not designed to examine the uptake of vaccination among healthcare workers, current work does suggest that at least some patient facing healthcare workers, particularly younger staff and those not in high exposure roles, may not have been vaccinated yet.

PHS hope that these findings would give them extra encouragement to be vaccinated, as it suggests that the vaccine offers protection not only to themselves but also to their close contacts. Any patient-facing healthcare worker who has not yet been vaccinated should contact their local health board.

Public Health Scotland will be publishing more definitive results on vaccination uptake in patient-facing healthcare workers on our daily dashboard later today (Friday 12 March).

Dr Diane Stockton, PHS Lead for COVID-19 Vaccination Surveillance Programme, said: “The results from this study as part of our vaccine effectiveness work, are very encouraging because it suggests that the vaccine helps prevent people from passing on the virus to others – something that has been suspected but hasn’t previously been shown. 

“Despite this good news, it is important to remember that infection prevention and control practices in healthcare settings remain of paramount importance, as do the mitigations to prevent spread in our daily lives. The risk of transmission did not go down to zero after the healthcare worker was vaccinated.

“As Scotland continues to deliver its national Covid-19 vaccination programme, this study does give one more reason why everyone invited to have a vaccine should take up the offer, as not only will it help protect them from COVID-19, but it will help protect the people close to them.”

Dr David McAllister, University of Glasgow said: “Our study has important implications for informing vaccination strategies. The JCVI in the United Kingdom recently commented on the lack of real-world evidence evaluating the role of vaccination programmes on transmission.

“We provide the first direct evidence that vaccinating individuals working in high-exposure settings reduces the risk to their close contacts – members of their households. Our work will also be of interest to modellers, as it can be used to inform their predictions about future rates of COVID-19 in the community.”

More than 1,500 children have been waiting over a year for mental health treatment

The Scottish Children’s Services Coalition (SCSC), an alliance of leading providers of children’s services, has called for the Scottish Government to urgently increase mental health spend in its budget.

The call comes as new figures published today (2nd March 2021) from Public Health Scotland indicate that at the end of December 2020, 1,560 children and young people had been waiting over a year for mental health treatment.

These figures are the worst on record and represent a near tripling from December 2019 (589).

The SCSC has urged greatly increased investment in services for children and young people to tackle a current mental health pandemic. It has also called for a ‘national crusade’ as referrals begin to return to pre-lockdown levels.

The call comes amid growing concerns over a ‘lost generation’ of vulnerable children and young people, whose mental health is being impacted by the pandemic.  Even prior to the pandemic cases of poor mental health were at unprecedented levels and there are a growing number of vulnerable children who cannot access services.

However, just over 50p in every £100 of the NHS budget is being spent on specialist child and adolescent mental health services (CAMHS). A frighteningly low figure even though mental health services are literally creaking at the seams due to greatly increasing demand.

The figures from Public Health Scotland also indicate that only four Scottish health boards are meeting the Scottish Government’s waiting time target of 18 weeks from referral to treatment over the quarter to December 2020. One out of four individuals are not being seen within this already lengthy 18-week target.

While 4,091 children and young people were treated over the period October to December 2020 by child and adolescent mental health services (CAMHS), only 73.1 per cent were seen within the 18-week waiting target and only four health boards met this target.

In addition, 332 had been waiting over a year prior to treatment, compared with 272 in the same quarter the previous year.

The SCSC has warned that mental health services will face an overwhelming and unprecedented pressure due to pent-up demand created by the Covid-19 lockdown, coupled with a cut in youth support services. This could potentially lead to a ‘lost generation’ of vulnerable children and young people who are missing out on the support they vitally need.

The SCSC has also called for a renewed focus on prevention and early intervention and greater partnership working between the public, private and third sector. The coalition has also urged that greater awareness is made of the services on offer, especially those at a community level.

A spokesperson for the SCSC commented: “These latest figures are deeply troubling and point to a highly challenging environment for both our young people and our mental health services.

“We welcome the fact that the Scottish Government is intending to invest more than £1.1 billion in mental health services overall, but significantly greater funding is needed to address the current crisis facing our children and young people.

“While referrals are beginning to return to pre-lockdown levels, it is vital that children and families are provided with the support they so desperately need, especially given the impact of the pandemic on mental health. The fact that more than 1,500 of our most vulnerable children have been waiting more than a year for treatment in this respect is deeply disturbing.

“We would urge the Scottish Government to look to not just the NHS, but the third sector and other private sector organisations to play a key role in this, renewing its focus on prevention and early intervention.

Our mental health services must receive the funding they vitally need or we face having a ‘lost generation’ of vulnerable children and young people.” 

Concern over urgent cancer referral numbers in NHS Lothian

Lothian MSP and Co-chair of the Cancer Cross Party Group at the Scottish Parliament, Miles Briggs, has warned about the drop in urgent cancer referrals over the last six months in NHS Lothian.

Public Health Scotland figures released this week showed that over the last two quarters (ending June 20 and September 20) 484 and 463, 947 total, were urgently referred for and received a cancer treatment.

This compares to the same six months last year (ending June 19 and September 19) when 591 and 616, 1207 total, patients were urgently referred for and received a cancer treatment.

This is equivalent to 21.5%, or just over a fifth, fewer patients being urgently referred and receiving treatment for cancer in NHS Lothian.

Co-chair of the Cancer Cross Party Group at the Scottish Parliament, Miles Briggs, said:

“This is extremely concerning that there has been such a drop in patients being urgently referred to cancer patients in the last six months.

“Early detection and treatment of cancer is the best way to improve survival rates for cancer and these figures show fewer people are having cancer detected and treated.

“The focus of our National Health Service has been on Covid-19, but people are still going to get ill and it is vital that access to cancer services is available for everyone.”

ENDs…

Table with eligible referrals attached, tab 4e.

https://beta.isdscotland.org/find-publications-and-data/conditions-and-diseases/cancer/cancer-waiting-times/

NHS Lothian – Eligible referrals

 62 day standard from receipt of an urgent referral with suspicion of cancer to first treatment        
  
 Dec-18Mar-19Jun-19Sep-19Dec-19Mar-20Jun-20Sep-20
All Cancer Types*579529591616601605484463
All Cancer Types* (screened excluded)447414443489447455416449
All Cancer Types* (screened only)1321151481271541506814
Breast201169195173202197132110
Breast (screened excluded)92787167837976103
Breast (screened only)10991124106119118567
Cervical786116555
Cervical (screened excluded)454105544
Cervical (screened only)3321111
Colorectal72717985911038368
Colorectal (screened excluded)5250576557717262
Colorectal (screened only)202122203432116
Head & Neck2930233424272432
Lung6541576258544149
Lymphoma17148151251317
Melanoma1722436540221322
Ovarian47108641010
Upper GI6054646262806364
Urological10711310610110010810086

Latest suicide figures are ‘the tip of the iceberg’, says charity

Data from National Records of Scotland (NRS) released yesterday shows that there were 833 probable suicides registered in Scotland in 2019, an increase from 784 in 2018.

Six hundred and twenty men and 213 women took their own lives in 2019, with people aged 45-54 most at risk. People in our poorest areas were also more likely to take their own lives.

This link between deprivation and suicide is well known. Between 2015 and 2019, people living in the most deprived areas were three times more likely to die by suicide compared to those living in the least deprived areas.

Claire Sweeney, Director of Place and Wellbeing at Public Health Scotland said: “Each of these deaths are a tragedy arising from profound distress, and are all preventable. They will have left immeasurable grief across families and communities.

“The unprecedented challenges we have all faced in 2020 perhaps make it easier to understand that anyone can experience mental illness. That’s one of the reasons why Public Health Scotland is prioritising improving mental wellbeing as part of our strategic plan (A Scotland where everybody thrives).

“We will work with our partners to help grow the understanding of levels of suicide in the communities they work with, and more broadly to support better mental wellbeing across Scotland.”

Following the release of these figures the Scottish Public Health Observatory has published supporting information available.

View the report on the ScotPHO website 

If you or someone you know are experiencing thoughts of suicide please call Breathing Space on 0800 83 85 87 or Samaritans on 116123.

Responding to Public Health Scotland figures revealing that 833 people died by probable suicide in 2019, a spokesperson for the Scottish Children’s Services Coalition commented: “The statistics highlighting that there were 833 probable suicides registered in Scotland in 2019 is devastating for so many families and only the tip of the iceberg when it comes to highlighting the mental health crisis we are currently in.

“We have for some time called for radical transformation in our mental health services and expressed our concerns over the lack of investment in these for our children and young people. Currently around 50p in every £100 of NHS spending goes to child and adolescent mental health services (CAMHS), and yet we know that one in ten children has a diagnosable mental health problem and that figure is increasing. These problems of course if not addressed carry on into adult life.

“With increased numbers of those experiencing mental health problems, as well as those whose existent conditions are being worsened due to the coronavirus pandemic, coupled with further cuts in services, this points to a mental health crisis ‘perfect storm’.

“While referrals have dropped during lockdown and children are not accessing support, we are storing up immense problems for the future as mental health services face being overwhelmed due to greatly increased demand.

“In addition to the NHS, local authorities, the third sector and other independent organisations play a key role in providing mental health support. Yet these services have seen their resources cut over the years, putting an even greater burden on specialist and costly mental health services. It is vital that they receive increased funding or we face witnessing a ‘lost generation’ of vulnerable children and young people

“Mental health services must be given funding and resources equal to that of physical health provision and this pandemic has ushered in an urgency to deliver on this which cannot be ignored.”

CANCER: ‘If you’re worried – see your GP and get checked out’

Four thousand fewer pathologically confirmed cancer diagnoses in March – June 2020 compared to 2019

As part of the ongoing response to COVID-19, Public Health Scotland provides an overview of changes in health and use of healthcare services during the pandemic.

This week, data on the numbers of people who have had a diagnosis of cancer confirmed using a sample of tissue (a pathologically confirmed cancer) between 1 January and 21 June 2020, compared with how many there were in the same period in 2019 are included in our analysis for the first time. 

This information is provided to help inform the ongoing response to COVID-19 and is a subset of the fuller information on cancer incidence in 2020, which is due to be published by the Scottish Cancer Registry in 2022.

The data show that between January and March 2020, the number of people who had a pathological diagnosis of cancer was similar to the number in the same period in 2019. 

By the week ending 21 June 2020, around 4,000 fewer people in Scotland had a pathologically confirmed cancer diagnosis than would have been expected.

Between March and June 2020, numbers fell by about 40% of those in 2019. In total, therefore, between January and the end of June 2020, the overall number of patients diagnosed was down by 19% on 2019 figures in the same period. 

The fall in numbers is unlikely to be due to a reduced occurrence of cancer, and is likely to reflect a combination of: patients with possible cancer symptoms not seeking out help from their GP (as they may be worried about catching COVID-19); changes to the national screening programmes in the first few months of the pandemic; or reductions in the availability of diagnostic services and treatment during this period.

It is clear that COVID-19 has caused substantial direct and indirect harm to the health of the people of Scotland.  As we continue to provide guidance on and evidence for actions to stop the spread of the virus we will also monitor the wider impact it has in our communities.

PHS will do this so that, together with partners in Government, local Government and in Health Boards across Scotland, we can work to protect the health of all of Scotland’s people.

Professor David Morrison, Director of the Scottish Cancer Registry at Public Health Scotland said: “Understanding the impact of the pandemic on health and healthcare services is a crucial part of our efforts to respond to and recover from it.

“As part of the Scottish Cancer Registry’s response we wanted to help understand how cancer diagnoses and cancer services have been affected. The reduction in cancer diagnoses this year gives us a sense of the scale of the impact of COVID-19 on all stages of the journey from first seeking help to recovering from treatment.   

“If you’re worried you might have cancer – see your GP and get checked out. It’s probably not cancer – but if it is, the sooner you’re diagnosed, the better your chances of successful treatment.”

To see the further information on the wider impacts of the COVID-19 pandemic on people’s health, and their use of healthcare services, including the data on cancer outlined above, please visit our COVID-19 wider impacts on the health care system web pages.

For information on screening, please visit NHS Inform.

First Minister: Blackpool’s aff!

Statement given by the First Minister Nicola Sturgeon at a media briefing in St Andrew’s House yesterday (Wednesday 14 October):

Good afternoon, and thank you for joining us . I will give the daily of statistics for COVID. I can report that the total number of new positive cases reported yesterday was 1,429.

That represents 16.4% of people newly tested, the total number of positive cases is now 42,685. 537 of the new cases are in Greater Glasgow and Clyde, 327 in Lanarkshire, 239 in Lothian and 92 in Ayrshire and Arran. 

The remaining cases were spread across 8 other health board regions. Only Orkney and the Western Isles did not have new cases reported yesterday.

I can also confirm that 570 people are currently in hospital – that is an increase of 43 on the number I reported yesterday.

49 people are currently in intensive care, that’s 14 more than yesterday.

I’m also very sad to report that in the past 24 hours, 15 deaths were registered of patients who first tested positive over the previous 28 days.

That means that the total number of deaths, under the measurement we use for the daily figures, is now 2,572.

Now confidentiality means that I can’t ever go in to detail about the people behind the statistics I report every day but I do want to point out this to you today, half of the 15 deaths that I’ve just reported are of people under the age of 80 – a small number of them are of people under the age of 60.

Please do not ever think that this virus only poses a risk to the lives of the very elderly – it poses a risk to all of us and I’m asking everybody again to take and treat that risk extremely seriously.

I can also report that National Records of Scotland has just published its weekly update, that as you will recall includes cases where COVID is a suspected or contributory cause of death.

Today’s update shows that by last Sunday, the total number of registered deaths linked to COVID, under that wider definition, was 4,301.

25 of those were registered last week, which is 5 more than in the week previously. 17 of the 25 deaths were in hospital, 7 in care homes, and 1 in a home or in an other non-institutional setting.

Once again, I want to send my deepest condolences to all those who have lost a loved one to this virus throughout the course of the pandemic and of course that is particularly the case to those who have recently lost someone and who are currently in that very acute stage of grieving.

Now tomorrow, Parliament has to review the restrictions we imposed on household visits three weeks ago. I will cover that issue and others in a video statement to a virtual meeting of the Scottish Parliament tomorrow.

As you might expect, we are unlikely, very unlikely to announce any changes or easing of the current rules on household gatherings.

I will however say a bit more to parliament tomorrow about new rules on face coverings, and about our options once the current two-week period of additional restrictions ends on 25 October.

For today though, the main issue I want to highlight relates to travel.

For many people, the October half term is approaching, and indeed in some parts of Scotland, it has already begun.

So I want to highlight some general guidance on travel, and I’m also going to provide one much more specific recommendation.

The first piece of general guidance relates to the five health board areas in Scotland that currently have additional restrictions on hospitality, because they have especially high rates of COVID just now.

And to remind you these areas are Lothian, Lanarkshire, Forth Valley, Ayrshire and Arran, and Greater Glasgow and Clyde.

If you live in one of these five health board areas, we have already asked you not to travel unless you very need to – and not to leave your health board area unless it is really necessary.

And we’ve also asked people from the rest of Scotland, not to travel to any of these five central belt areas unless they really need to.

As I said last week, this guidance does not stop you from taking an October half-term break if you have already booked it and you don’t want to cancel. If you are taking such a break or if you are already on such a break, please be very careful and please follow all of the rules whilst you are there.

But this guidance is intended, very firmly intended, which is why I’m putting so much stress on it today, to minimise travel as much as possible between the central belt, and other areas of Scotland. So please ask yourself how necessary your journey is, before deciding – for example – to go on a day trip to another part of the country.

In fact, my general advice for everyone at the moment across the country is to think very carefully about whether you need to travel at all. And if you must travel, if your trip is necessary then travel carefully and safely.

For example make sure you wear a face covering on public transport, that is the law at the moment and also remember to physically distance from other passengers as much as you can. And avoid car sharing if possible.

The advice to think carefully before travelling is especially important in relation to areas with high rates of infection.

And so of course that advice applies – not just to travel to and from the central belt of Scotland and the more general advice I’ve just given to everybody but it applies to travel to and from parts of England with high levels of infection.

We are currently advising against non-essential travel to the parts of England which are classed as very high or high alert areas under England’s new three tier system. And I’m asking people from these areas not to travel to Scotland either.

Several of these areas are seeing even higher levels of infection than we are currently seeing in central Scotland and we will make sure we keep the information on which areas are covered by this guidance updated on the Scottish Government website.

But in addition to that general advice, there is a specific issue I want to cover today and I take no pleasure in doing this but it’s important that I give this advice and make a very specific recommendation to you.

Blackpool, a place that many Scots love and like to visit, particularly at this time of year, many of us have happy childhood memories of going to see the Blackpool illuminations – this is one of the places currently classed by the UK Government as a high risk area.

And I need to advise you that trips to Blackpool are now associated with a large and growing number of COVID cases in Scotland.

We indeed now have an Incident Management Team in Scotland that has been set up to look specifically at cases associated with Blackpool.

And I can tell you that in total, in the last month, and these figures are rising right now so the figure I’m about to give you will undoubtedly already be out of date – the most up to date figure I can give you is that in the last month around 180 people in Scotland with COVID, reported that they had recently been in Blackpool.

Now let me be clear, that doesn’t necessarily mean that they got COVID during their trip, as you heard us talk about in relation to hospitality it’s not possible to be absolutely certain where someone actually picked up the virus but Blackpool is being mentioned in Test and Protect conversations, far more than any other location outside of Scotland.

And to take the past week in more detail, 344 people who have spoken to Test and Protect teams after contracting COVID, reported some sort of travel outside of Scotland. 252 of those had travelled somewhere else in the UK. Of those 252, now remember this is in the last week alone, well over a third – 94 in total – had been in Blackpool.

So my specific advice is this. If you were thinking about going to Blackpool and you haven’t booked yet, then please do not go this year.

Even more specifically – because we know this is an issue – and I want to be very clear about this – do not travel to Blackpool this weekend to watch the Old Firm match in a pub. If you do that you will be putting yourself and you will be putting other people at risk, please do not do that this weekend.

And if you otherwise, not related to the football have already booked a trip; and you cannot cancel it without cost; and are determined to go – then please, please think very carefully indeed about how you travel, and what you do when you get there.

For example quite a lot of people who have contracted COVID, and who have also been to Blackpool, have travelled by coach. We understand that is very common, particularly at this time of year. Now again, that does not mean that they absolutely necessarily got the virus on the coach because we can’t be certain about that.

But if you have to travel to Blackpool by coach – or if you travel by any form of public transport – then try to maintain physical distancing, and make sure that you wear your face covering throughout the journey.

And once you arrive and I know this is really difficult, don’t spend too much time indoors – and don’t, if you can avoid it, spend much time in pubs and bars and other hospitality venues. Because doing that significantly increases your chances of getting the virus.

I know that many people look forward to trips generally but to Blackpool in particular in the autumn, and that for some of you – and I know that many people fall in this category it’s almost an annual ritual. But I’m asking you, if you can avoid it, please do so this October and if you do go there, if you have to go there – please be very careful.

My last point on travel relates to a letter I received yesterday from the First Minister of Wales and is very relevant to what I’ve already been talking about.

The First Minister of Wales is seeking agreement between the four UK nations on travel restrictions where necessary from high prevalence areas in one UK nation to lower prevalence in others. I want to be clear today, that I back the calls from the First Minister of Wales and I’ll be writing to the Prime Minister today to seek urgent talks on that issue.

I also support the First Minister of Wales call for another COBRA meeting in early course to discuss collectively between the four nations what further steps we can all take at this stage to suppress the virus.

Now, I’ve spoken at some length today about our guidance and recommendations on travel and that is for reason because it is important and restricting travel right now as much as we possibly can is another I know unwelcome but very important way in which we can all try to reduce and minimise the spread of the virus.

But of course there are other important steps we must all take to reduce our own personal risk of getting the virus or of passing it on to others. Including if we are in the younger healthier age groups ourselves, potentially passing it on to others who are much more vulnerable.

So please do not visit each other’s homes at the moment – except for the very specific exemptions for childcare or looking after a vulnerable person, stay out of the homes of other families right now, this is our single most important way of stopping the virus jumping from one household to another. I know it is incredibly hard but it is incredibly important.

When you do meet – outdoors, or in a café for example, which are allowed to stay open during the day to allow people somewhere that they can have contact with other – remember that the maximum group size is 6 and that should be from no more than two households. And that’s the rule that applies outdoors or in any indoor public place.

Only car-share if it is essential as I said earlier on. And if you must car-share, wear a face covering and try and keep the windows open.

Work from home if you can. That advice has never changed in Scotland – this is an important moment to underline it. If it is at all possible to, work from home. And employers across the country, please allow your workers to do that.

Download the Protect Scotland app, if you haven’t already done so.

And finally, remember the rules are encapsulated in FACTS – the difficult but fundamentally quite simple things we can all do to minimise the risk of transmission.

  • Wear face coverings whenever you’re out and about but particularly in any enclosed spaces.
  • Avoid places where crowds of places come together.
  • Clean your hands obsessively if necessary and clean hard surfaces after you touch them.
  • Keep a two metre distance from people in other households when you are coming in to contact with them.
  • And self-isolate, and book a test, if you have any of the symptoms of COVID and remember yesterday all of the information we gave yesterday about support for self-isolation – you can find that on the NHS inform and Scottish Government websites.

It is by following all of this advice and following of these rules however hard that it is and I know that it is hard, that we will collectively help to suppress the virus again.

We are, as I said yesterday, at a really critical moment again – many countries across the world are; we see more and more countries now dealing with a second wave and having to impose new restrictions – we will not shy away as the Scottish Government from doing what we think is necessary to keep the people of Scotland as safe as possible … but every single one of us can play a part in this, please follow all of these rules; don’t think it’s okay just to breach them on the odd occasion because the time you breach them may be the time the virus is close to you and may spread from you to somebody else or from somebody else to you.

And the chain of transmission that could set off could result in you becoming like the too many families across Scotland right now that are grieving the loss of a loved one.

So I’m sorry to be so blunt with you but I think it is important at this juncture not to shy away from these messages and to ask everybody right now to rededicate themselves to this collective effort to keep COVID under control and to stop it taking lives unnecessarily or making people ill unnecessarily.

So thank you once again to everyone who is doing that.

Commenting on the First Minister’s statement, Kirsty Licence, Chair of the Incident Management Team looking into cases associated with Blackpool, and led by Public Health Scotland said: “We are seeing a high number of cases of COVID-19 amongst residents of Scotland who have recently travelled between Scotland and Blackpool. 

“We know Blackpool is a popular destination, especially for holidaymakers from the west of Scotland. Many of these cases have travelled using group transport, especially coach, but also private transport, and many are of middle and older ages with increased risk of suffering from very severe COVID-19 illness.

“Our data shows the numbers of Scottish cases who visited Blackpool shortly before their illnesses substantially exceeds those having visited any other place in the UK. Over the past month, since 14th September, when Blackpool was first noted on a case there have been 286 cases in Scotland whose records note recent travel to Blackpool.

“These cases highlight the risk associated with travelling to areas with high rates of infection. People in Scotland should not be travelling to or from the health board areas under local restrictions except for essential reasons.  

“If you have to travel, follow all local guidance and restrictions, both where you live and where you are travelling to.  You should avoid close contact with others, keep away from crowded places and observe FACTS. 

“Those falling into a group that is at an increased risk of more severe illness, should in particular consider carefully where and how they travel.

“Anyone who has one or more symptoms of COVID-19 should immediately self-isolate and book a test. Those who are required to be in self-isolation either as a case or as a close contact of a known case must not travel – which may mean those visiting other areas of the UK are unable to travel out or return home for a significant period of time.”