Tag: public health

Omicron: Scotland faces ‘potential tsunami’, says First Minister

Danger of Omicron ‘running riot’ – but Nicola Sturgeon backs away from tighter restrictions

Statement given by the First Minister Nicola Sturgeon at a media briefing in St Andrew’s House this afternoon:

Good afternoon everyone, thanks for joining us. As you can see I’m joined today by the Chief Medical Officer and the National Clinical Director.

Throughout this pandemic – and particularly at key stages of it-  I’ve tried, we’ve tried, to be open and upfront with you about the challenges and the uncertainties confronting us, so that you can better understand – if not always agree with, I accept – the difficult judgments and decisions that we have had to make.

I’m afraid that this is another moment when such frankness is really important.

The purpose of today’s update is to level with you on what we know so far about spread in Scotland of the new Omicron variant – and also our estimate at this stage of what we are likely to face in the days and weeks to come.

The fact is that we do face a renewed and a very severe challenge in the shape of the Omicron variant.

To be blunt, because of the much greater and faster transmissibility of this new variant, we may be facing – indeed we may be starting to experience – a potential tsunami of infections.

Now we’re not alone in that, far from it – everything I am about to share with you about the situation in Scotland is, I believe, broadly reflected in the data for the rest of the UK too. And although I’m not familiar with the data elsewhere, I would suspect it is reflected there too.

However, we have just published an evidence paper which seeks to provide you with more detail about the Omicron variant here in Scotland at this stage, and you can find that evidence paper online on the Scottish Government website or Twitter feed.

Now I’m going to come back to more detail in that and to tell you what we do know about and what we expect from Omicron and I’ll do that shortly.

Firstly, though, as I usually do, I’m just going to briefly summarise today’s statistics.

5,018 positive cases were reported yesterday – which is 9.3% of all tests carried out.

Now, this is one day’s figures – but as you can see it is a sharp rise on the average of around 2,800 per day that we have been reporting recently, and it underlines our fear that a new wave may indeed be starting.

573 people are currently in hospital with Covid – that’s 5 fewer than yesterday.

And 40 people are in intensive care, 1 more than yesterday. Although I would remind you that there is always a time lag between rising cases and rising numbers of people in hospital and intensive care.

And sadly, a further 19 deaths have been reported in the past 24 hours, and that takes the total number of deaths under the daily definition to 9,707.

And I want again to send my condolences to everyone who has lost a loved one.

I am pleased to report, though, and this is important and will become increasingly important in the weeks to come, that the vaccination programme continues apace.

4,358,725 people now have a first dose, 3,967,477 are now double dosed, and we have also now, very significantly, passed two million booster or third doses administered in Scotland. To be precise, 2,000,915.

On first, second, third and booster doses, Scotland is still the most vaccinated part of the UK.

And again, I want to record my thanks to everyone involved in organising and delivering this vaccine programme. Without a doubt, the biggest peacetime logistical exercise that has ever been undertaken in Scotland.

Now, in relation to the Omicron variant specifically, as of 5pm yesterday, there were 110 confirmed cases in Scotland. And to give some context to that, 10 days ago we reported a total of 9 confirmed cases.

Now, these are confirmed cases and by that we mean that Omicron has been confirmed through genomic sequencing.

There are two reasons why confirmed cases represent just the tip of the iceberg and shouldn’t really be looked at as the best indicator of the true prevalence of the variant in Scotland right now.

The first reason is because genomic sequencing takes some time, much longer than processing a PCR test, so there is a time lag in these figures. But secondly, while in Scotland we do a lot of genomic sequencing, not all tests are or indeed can be analysed in that way.

So a much better indicator of whether a case is Omicron or not, is whether the PCR test shows a specific genetic characteristic known as the S gene drop out. And you may have heard us talk about that previously.

Now around 95% of all tests in Scotland are analysed in a way that allows us to know this.

And almost all tests that do show the S gene drop out just now will be the Omicron variant.

So these figures help to give a much better sense of the true scale of the variant in Scotland at this stage.

And, what they show, is that Omicron right now is rising exponentially. Indeed, what we are seeing in the data just now is perhaps the fastest exponential growth that we have seen in this pandemic so far.

In the final week of November, if we look at all of the Covid cases recorded in Scotland, there were no days when the proportion of cases with the S Gene drop out was higher than 1%.

However, by last Sunday, the 5 December, the proportion had risen to 2%. On Tuesday, it was just over 4%. On Wednesday it was almost 7%, and today, it is 15.5%.

Now you might think that these are still relatively small percentages, but consider that trend. This is doubling on a very, very, rapid basis. Indeed, our estimate at this stage is that the doubling time for Omicron cases is between 2 and 3 days. And actually it may be closer to 2 days than to 3 days.

Now, if that continues, and we have no reason at this stage to expect that  it won’t, Omicron is going to very quickly overtake Delta as the dominant strain in Scotland.

Indeed, I think we can now say with some confidence that we expect it to overtake Delta within days, not weeks. We estimate this will may be as early as the very beginning of next week.

Now you might be asking, why does that matter? It matters because Omicron has a much higher R number – a higher transmissibility – than the Delta variant which for some time now has been the dominant strain in Scotland and much of the world.

So, the R number in Scotland in recent weeks has been hovering around 1. We always like it to be below 1, but hovering around 1 is not the worst place to be in. Of course, we’ve been seeing a decline in cases in Scotland in recent weeks.

However, the R number associated with Omicron is likely we think to be well over 2 –and possibly closer to 3.

And as and when Omicron becomes the dominant strain as it is in the process of doing, the R number associated with it will then increasingly become the R number for Scotland as a whole.

So as a result, our estimate is that the R number overall is likely to rise and possibly to rise above 2.

All of these estimates are based on the limited data that we already have here in Scotland, and we have been analyzing that closely but also other data available from South Africa and elsewhere.

What it all that means is that in our judgement right now, it isn’t any longer a question of if we are facing a surge in cases.  We now believe that to be virtually certain.

Our health protection teams are working really hard through contact tracing, testing and isolation to slow the spread of Omicron cases and I want to thank them for the excellent work they are doing and everybody across the population who will be following their advice.

But the nature of transmission, and the nature of a variant that is even more transmissible than what has come before, means we do expect to see a rapid rise in cases in the days and weeks ahead.

This is driven by the transmissibility of this variant. Figures we are seeing here in Scotland are consistent with data from around the world. And they provide a considerable degree of certainty that Omicron is significantly more transmissible than the Delta variant.

The best expert advice at this stage also tells us that that Omicron is more capable of re-infecting people who have had the virus previously.

And – based on preliminary laboratory trials – the best evidence suggests it can evade to some extent the immunity conferred by vaccination.

Now, and I want to underline – triple underline – this point. That does not mean that the vaccines will not significantly help us. Being less effective is not the same – nowhere near the same  – as vaccines being ineffective.

And booster doses, in particular, will help retain a higher level of vaccine efficiency.

So getting your vaccines, including your booster, remains absolutely crucial.

The thing we don’t know yet, is whether Omicron cases cause more or less serious illness than the Delta variant.

However, there is an absolutely crucial point that we all need to understand, and it is one of the most important points I need to set out today because it is a matter of basic and quite brutal arithmetic.

Even if the variant is generally a little bit less severe for most people – and let me stress we still don’t know if that is the case – but even if it is, and we certainly hope it will be, for some people it will still cause serious illness, hospitalisation, and, tragically, some people will die.

But the overall impact point here is that even if a smaller percentage of people overall than is the case for Delta require hospital treatment, a small percentage – and a smaller percentage – of a bigger number will result in a massive number of cases who might need hospital care.

And given the volume of people who could be infected by Omicron because of its greater transmissibility, even if most of those cases are mild, the number of cases of serious illness amongst those infections will put massive strain on the ability of the NHS to cope.

Also, the numbers of people becoming infected even mildly – and having to isolate – will put a significant strain on the economy and on critical services.

And we’re actually starting to see this already. I can tell you that today there are 60 ScotRail cancellations due to staff shortages, and these staff shortages are mainly due to Covid.

And as you may have seen in the media already today, many staff at an Accident & Emergency unit in Lanarkshire are having to isolate – through no fault of theirs, incidentally – after attending a social event and becoming infected.

So, all of this means that Omicron, I am afraid, is an immensely concerning development – even if it does prove to be slightly less severe than Delta. It’s concerning for Scotland, for the UK, and indeed for the world.

I wanted to set this out to you today, not to try and scare people, but to provide the context for the difficult decisions that all governments might have to take in days to come. And to do what I have always tried to do – level with you and try to share the rationale for these decisions.

We, in the Scottish Government, will be considering our next steps very carefully – but also mindful, in the face of this virus, particularly a more transmissible variant, of the need to act quickly.

We will be discussing matters on a 4 nations basis too. I am very mindful, very mindful, that anything we do – including some of what I am saying today – has an economic and a financial impact for businesses and UK funding arrangements means we have no choice but to look to the Treasury to act. That’s a point I will be raising again with the UK Government in a COBR meeting later this afternoon.

It is worth noting though – as I illustrated a moment ago – that not acting will also have a financial and economic impact as more people get infected and have to be away from work. But the impact of not acting will be less managed and therefore potentially more damaging.

Now, I will keep you and obviously Parliament fully updated in the days ahead.

But, there are two points I want to briefly make today before I conclude.

The first is in response to advice I received last night.

Given that Omicron is now becoming dominant, our response to it has to become more general. Because it will quickly be the case that most people who have Covid have the Omicron variant.

And we must do all we can in that context to break the transmission chains.

Therefore, from tomorrow, our advice will be that all household contacts of any confirmed Covid case should isolate for 10 days regardless of their vaccination status and even if they initially get a negative PCR test.

I know that this is not easy – and we will obviously keep it under review. We will also ensure careful exemptions for critical services.

But we believe this to be essential at this moment to help slow transmission.

Non household contacts should continue to isolate pending a PCR result. If that is negative they can leave isolation at that point as long as they are double vaccinated.

Secondly, I want to refer to the advice that Public Health Scotland made public late yesterday afternoon that people should think about deferring work Christmas parties.

This is not easy advice to give or to hear.

But it is incumbent on public health experts to set out very clearly and frankly the risks we face, and it is incumbent on me and government to pay attention to that advice.

There is a significant risk with Omicron – and we are already seeing the reality of it – of Christmas parties or events with lots of people becoming super-spreaders.

And if that happens lots of people get infected and if these are work events, as well as the risk to individual health, there is a risk to the ability of the workplace to operate as people have to isolate. And I’ve already cited the train cancellations and the Accident & Emergency unit in Lanarkshire as examples and illustrations of that.

So the public health advice – which I have no alternative but to agree with given the evidence of risk that I know about and have now shared with you – is that we should all think a bit more carefully about unnecessary contacts, especially in crowded places just now. And that it would be sensible to defer work Christmas parties.

Now I know this has a big impact on businesses which is why we are considering – and pressing the UK government – on financial support.

But once again we face a situation that frankly has no easy options.

We know that any additional protective measures will cause social and economic harms – especially after almost two years of this pandemic.

But we also know – from past experience – that early action is often needed when dealing with this virus. In fact acting early, is often the best way of acting proportionately. So we can’t rule out further measures. And I’m afraid we can’t avoid the advice that I have shared with you today.

I will continue to do all I can to be upfront and open with you in the days ahead. And I continue to be so grateful for the responsibility the vast majority across the population are showing.

For now, though, I will end with a plea to abide by all the current protections that we have in place. It is more important than ever.

In fact, doing that still gives us the best chance we have of minimising the need for any further protections

So I want to stress once again what those current protections are.

Firstly, please get vaccinated. What I’ve set out to you today is grim to hear, I understand that. But vaccination, even with that, means we are in a better position than last year and a better position – a vastly better position – than we would be without it. So please get your vaccination – first, second, third or booster dose – as soon as you are able to. It’s the single best thing we can do. And it’s not too late if you haven’t done that already.

Secondly, test yourself regularly and often.

If you are going to meet other people – then test yourself before you do so. And if you are asking someone round to your home, or if you’re meeting someone for lunch or a drink, test yourself and stress the importance to the people you are meeting of them doing the same.

Do that even if you are going out for Christmas shopping.

The evidence we have, suggests that lateral flow tests are as effective at identifying Covid for Omicron cases, as they are for Delta cases.

So that means they are a hugely important way of helping us find out whether we might have the virus – especially if we don’t have symptoms. So if we take these tests before we go, and if we’re positive if we isolate and get a PCR test, we significantly reduce the risk that we then pass the virus on, inadvertently, to others.

You can get LFD devices online, NHS Inform, they’ll be mailed to your home, or get them from a local pharmacy or test centre. They’re easy to get and they’re going to be made available in other places over the next period – shopping centres, garden centres, for example. But they’re already easy to get and they’re easy to use as well.

And finally, please comply with all of the other basic protections.

It’s more important than ever that you’re wearing your face covering on public transport, in shops, and when moving about in hospitality.

Keep windows open when you are meeting people indoors. Don’t get me wrong, I know that is not an easy thing to ask in Scotland in December, but it does make a difference.

And follow all of the advice on hand hygiene and cleaning surfaces.

And please work from home if you can. If you were working from home at the start of the pandemic, please work from home now. And employers, if that was the case for your staff, please enable it to be the case now.

This is not a briefing any of you would have wanted to hear. It’s certainly not one I wanted to deliver, especially not as we approach Christmas. Just as I’m sure all of you long for the day you never have to see me, or any of us, at this podium again for a Covid briefing, let me assure you I long never to have to do another Covid briefing again.

But we face a really challenging period ahead again. And the only way through it, and we know this from experience, is together, with a shared understanding of what we need to do and a shared willingness to do it for our own sake and the sake of all those around us.

And a key thing to remember is that – even with Omicron – we know the things we can do to help to make a difference.

So please – get vaccinated, test yourself regularly, and follow all of the other rules and guidelines. That will help us get through, even with everything I’ve said today I hope it will help us have a Christmas much more normal than last year. Above all, a Christmas that is safe and allows us to go into the new year still hoping for that better Spring ahead.

omicron-scotland-evidence-paperDownload

RCEM: Current A&E performance trend is ‘extremely worrying’

In October 2021 there were 108,279 attendances to major Emergency Departments across Scotland, the number of attendances dropped by 5,719 patients (5%) compared to the previous month, September 2021.

Despite this, data show that four-hour performance in major departments has once again reached a new record low, with 70.9% of patients being seen, transferred or discharged within four-hours – 2.5 percentage points lower than the previous month, September 2021. 

In October 2021 2,533 patients spent 12-hours or more in a major Emergency Department, this is an increase of 30% compared to the previous month, September 2021, and the highest number on record. 

Data also show that 8,181 patients spent eight hours or more in a major Emergency Department. This is an increase of 21% compared to the previous month, September 2021 and is also the highest number on record. 

Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “Yet again we are reporting on the worst performance figures on record. 1 in 13 patients are now delayed by eight hours are more.

“This trend is extremely worrying and, most of all, dangerous for patients. Each month, the number of patients that have come to avoidable harm grows. So far in 2021, 387 excess deaths have occurred as a direct result of crowding. 

“This number will continue to increase unless patient flow is prioritised this winter; this means freeing up beds where possible by ensuring that patients have timely access to social care, utilising the Discharge to Assess model, and avoiding admission when appropriate by maximising the use of Same Day Emergency Care. 

“Every winter we know that the increase in demand for unscheduled care, and therefore beds, disrupts elective surgery – this is not a new phenomenon by any means. 

“However, with a record number of patients awaiting surgery, ensuring that unscheduled care does not derail progress on the backlog is more crucial than ever. This requires a whole system approach and cannot be tackled in isolation. If poor patient flow in emergency departments is addressed successfully, this will go some way in mitigating the risk of further disrupting elective care. 

“We are very keen to work with the Scottish government on what can be done in the short term to alleviate the immense pressures EDs are currently facing.

“Accompanying this, we continue to call on the Scottish government to set out a long-term workforce plan. The required expansion in capacity cannot be safely achieved without both recruiting new and retaining existing staff.

“At present we need an additional 130 EM consultants along with sufficient numbers of both junior and supporting staff and nurses.”

Appeal for more vaccinators

Jason Leitch rolls up his sleeeves

Scotland’s National Clinical Director Jason Leitch is becoming a vaccinator and is encouraging more people to enrol to help accelerate the national booster jab programme.

Since 19 November, the equivalent of 300 full-time additional staff (more than 1000 individuals) have joined the national vaccination effort and health boards are actively recruiting to create extra capacity.

Following the most recent advice from the Joint Committee on Vaccination and Immunisation (JCVI) everyone aged 18 and over who is eligible will be offered a slot for the booster jab by the end of January. Currently those aged 40-49 are invited to make an appointment through the online portal or the national helpline, from 12 weeks after their second dose. The national programme is also delivering second doses to 16 and 17 years olds.

Professor Leitch said: “I am pleased to join the fantastic team at NHS Greater Glasgow and Clyde and look forward to helping administer booster jabs to adults and second doses to 16 and 17 years olds as we continue to protect Scotland’s population as quickly as possible.

“To be a small part of this national mission is a real privilege. It also gives me the opportunity to thank the clinical teams and volunteers who have got us this far.

“This has been the biggest immunisation programme in the history of the NHS and the hard work and commitment shown by health boards and vaccination teams across Scotland means we have the highest vaccination rate for people aged 12 and over of all UK nations for first, second and boosters/third doses and the winter vaccination programme has already delivered more than 2 million booster and third doses to the most vulnerable groups, covering 45% of the adult population (aged 18+).

However, we would warmly welcome any former NHS employees and of course, they will receive full training before giving any vaccines. I’ll be helping when I can alongside my main role.

“Even a shift a week will help, so if you’re a dentist, a nurse, an optometrist or a doctor and you can help us then please contact your local health board. Every vaccine dose given is another step out of the pandemic. If you don’t have a clinical background, it’s not a problem, you can still assist the programme in another capacity through the British Red Cross.

“We have accepted the JCVI’s updated recommendations and aim to offer the booster vaccine to everyone aged 18 or older who is eligible by the end of January, and we would love some more vaccinators to join our incredibly national programme to assist us through this particularly busy period.”

Vaccination Programme Director at NHS Greater Glasgow and Clyde Anne Harkness said: “In the last year, our vaccination team at NHSGGC have administered more than 2.1 million jags, working with the public to protect our communities.

“We are continuing to build our pool of vaccinators and we are delighted to welcome Jason to the vaccination team and wish him – and all the new recruits – well.”

People who wish to apply to become a vaccinator can find more information at NHS Scotland

Volunteers who are not currently involved in COVID response, or other critical work, who would be interested in assisting the COVID response generally and the vaccine programme in particular, can find out more by emailing:

Covid_19ResponseScotland@redcross.org.uk

“Horrendous”: Deaf children seriously failed by NHS Lothian

An extensive expert review has found failings in the standard of hearing tests carried out for children in NHS Lothian’s Paediatric Audiology service.

The review, conducted independently by the British Academy of Audiology (BAA), identifies significant concerns about hearing tests that were not carried out to the required professional standard, with consequences for children and their families.  In some cases, diagnosis of hearing loss or impairment may have been missed or delayed.

Early identification of hearing loss or impairment from birth is important because the earlier it is picked up, the more successfully it can be treated with hearing aids or cochlear implants and the better the outcomes for the child.

Tracey Gillies, Medical Director NHS Lothian said; “We are very sorry and saddened to learn that there are some children whose conditions were not diagnosed correctly, or as early as possible, as a result of testing that was not up to standard.

“Due to these failings, the diagnosis of hearing loss or impairment in six children was missed.  Diagnosis of a further six children was significantly delayed with long term consequences for these children. Their long-term development of speech and language will be affected and these children will require specialist support.”

Ms Gillies continued “Delayed diagnosis of hearing loss in a further 48 children is also likely to have resulted in some harm, though the longer-term impact of this will depend on the individual circumstances of each child. Some children may require to be retested.

“We have already written to the most severely-affected families individually to offer support and a face-to-face meeting to discuss their child’s condition. We have also arranged appointments for those children whom the review recommends should be tested again.

“In addition, measures have been put in place to identify young children currently in the system whose cases may require clinical review. If any concerns are found, the families will be contacted immediately.

“We apologise sincerely to all affected children and their families for these failings and for the worry and distress caused. We would encourage families who may have concerns to contact our helpline for information on 0131 465 5457. Lines will be open on Monday to Friday from 9am to 4pm.

“We have been engaging closely with the National Deaf Children’s Society and would like to thank them for the support they are able to provide families via their own helpline, which can be contacted on 0808 800 8880.”

NHS Lothian commissioned the full, external review of the service following criticism in May about the diagnosis and care of a child with hearing difficulties. The review is part of the Health Board’s response to the recommendations made by the Scottish Public Services Ombudsman who investigated that case.

Other actions already taken include the appointment of an additional senior expert to provide support in Paediatric Audiology, a comprehensive training programme for service staff and support from NHS Ayrshire and Arran and NHS Greater Glasgow and Clyde with testing in the interim.

The review consisted of an audit of cases from 2009 -2018, an appraisal of the clinical governance structures in place as well as a week’s residential visit by external experts to observe working practices in the service.

NHS Lothian Chief Executive, Calum Campbell said: “The thoroughness of the review reflects our determination to improve the service and outcomes for the children in our care.

“We note that the report was positive about some aspects of the care of the audiology team who are committed to working hard to improve the quality of testing provided by the service.  

“A number of improvements have already been made and a detailed action plan has been developed to implement all the recommendations of the BAA in full.

“We continue to work closely with the BAA and would like to thank them for their diligence and support in conducting the review.

“I apologise to the affected families and give them my assurance that lessons have been learned and that the recommendations from the review are being implemented in full.”

The National Deaf Children’s Society has called for a sweeping review of children’s audiology services in Scotland after almost a decade of failures by NHS Lothian.

At least 887 children are known to have been affected during the nine-year period, 155 significantly, but the actual number could potentially include thousands more and the problems have continued.

The charity has spoken out after a new report, published yesterday, uncovered repeated mistakes by NHS Lothian’s audiology service, with at least 100 deaf children among those affected.

The report reveals cases of deaf children being wrongly deprived of crucial technology, incorrectly discharged or identified years later than they should have been. Some have been left with life-changing consequences as a result.

In response, the charity has today written to the Cabinet Secretary for Health and Social Care, Humza Yousaf MSP. The letter calls for an assurance that such catastrophic errors will never happen again and asks for urgent Government action to improve audiology services across the country.

The failures were revealed in a new audit report, carried out by the British Academy of Audiology to examine NHS Lothian’s children’s audiology caseload of 22,900 from 2009-2018.

It sampled 1,007 cases and found there were concerns about assessment and care in 887 of them (88%). Of those, 155 had “significant concerns”.

The specific findings of the report include:

  • The average age of children identified as deaf under NHS Lothian was 1,653 days (4.53 years old), compared to 109 days in England. The report says this appeared to have gone “unreported and un-noticed.”
  • 12 children were eligible for cochlear implantation, but this was significantly delayed, to the extent where some missed out on getting them altogether.
  • There was no evidence that nine of the children were offered a hearing aid, even though it would likely have helped them.
  • 49 children had a delayed identification of hearing loss or the fitting of their hearing aid was delayed.
  • 30 were not offered the right hearing aids.
  • The remainder of the 155 were wrongly discharged or mismanaged.

As a result, the National Deaf Children’s Society is calling for a review of children’s audiology services across Scotland. It wants to see the Scottish Government introduce national leadership for services, robust data collection and a mandatory program setting out clear standards for care.

Without urgent action, the charity says there’s a real danger that many more deaf children risk not getting the quality of care they need.

Locally, it wants NHS Lothian to commit to following the recommendations made by the report, review its past caseload to avoid repeating the same mistakes and announce a clear plan on how it will catch up and deliver for deaf children and their families.

The charity is also strongly advising all affected families to seek independent specialist legal advice. It is already offering support to families affected and says that anyone who is worried about the report should contact its helpline.

Susan Daniels, Chief Executive at the National Deaf Children’s Society, said: “The horrendous findings in this report represent a real-life nightmare for the families involved.

“They placed their trust in a service that was supposed to help, only to be completely let down. Some will be left with life-changing consequences, while many others across Scotland will now be facing the very real fear that the same thing could happen to them.

“Early identification and the right care are vital in helping deaf children develop language and communication at a crucial age, so this must never be allowed to happen again.

“This means we need urgent action from the Scottish Government, starting with a thorough review of children’s audiology services across the country. Until we have national leadership, better data collection and mandatory standards that services must comply with, thousands more deaf children could be at risk and families won’t be able to rest.

“We’re already in touch with several families affected and we’ve provided them with support and guidance. Anyone else who’s been affected, or feels worried about this issue, can contact our helpline or visit our website at www.ndcs.org.uk.”

Lothian MSP, Miles Briggs said: ““These findings by the British Academy of Audiology are extremely concerning and families in NHS Lothian have been totally failed.

“It is crucial that all 36 recommendations for the paediatric audiology service are implemented as soon as possible.  

“The average age for diagnosing hearing loss in NHS Lothian is far too late and measures must be put into place to ensure that children with hearing loss are diagnosed much sooner.

“I have written to the Health Secretary to request a meeting about why it takes four and half years in NHS Lothian for a child to be diagnosed with hearing loss, compared to 109 days in England.”

Copies of the report are available:

BAA Summary Report

BAA Audit Report

BAA Governance Report

NHS Lothian Helpline:  0131 465 5457 Mondays to Fridays 9.00am to 4.00pm. 

National Deaf Children’s Society Helpline:  0800 800 8880 Mondays to Fridays   9.00am – 5.00pm

For information and services provided by the National Deaf Children Society, please visit their website https://www.ndcs.org.uk/our-services/

Public Health Scotland urges public to defer Christmas parties

Given the number of COVID-19 outbreaks that are being linked to Christmas parties, particularly those caused by Omicron, Public Health Scotland (PHS) is URGING PEOPLE TO DEFER SUCH PARTIES AT THIS TIME.

Dr Nick Phin, Director of Public Health Science and Medical Director, PHS explains: “There is much that we still need to learn about Omicron, but early evidence suggests that this new Covid variant is much more transmissible.

“The impact of this transmissibility has been seen in recent weeks, with a number of Omicron outbreaks linked to parties.

“We still need to learn more about the severity of disease caused by Omicron and the effectiveness of vaccines, but there are important things that we can do to help protect ourselves and our families now. To help minimise the further spread of Covid-19, and Omicron in particular, I would strongly urge people to defer their Christmas parties to another time.

“I appreciate that everyone is keen to celebrate this festive season, particularly after the pressures of the last twenty months, but by postponing some plans we can all do our bit to protect ourselves and our loved ones.”

A reminder of the other measures we can all take to continue to keep safe over the festive period:

  • Please get your vaccine and your booster when your turn comes.
  • Please test at least twice weekly using LFDs and take a test each time you are socialising with people out with your household.
  • Reduce the number of people you catch up with. Try to meet outdoors; if indoors, ensure ventilation is good.
  • Keep up the other public health measures: wash your hands, clean surfaces, maintain distances and of course wear a face covering in public spaces.

It’s understood First Minister Nicola Sturgeon will give a Coronavirus update tomorrow (Friday).

NHS Lothian marks milestone with 1.6m vaccinations

Vaccination teams in Lothian have administered a massive 1.6m doses of the lifesaving COVID-19 vaccine in just 12 months.

As NHS Lothian yesterday marked a year milestone since the first vaccination was administered, figures show that vaccinators have delivered massive numbers of first, second and booster doses of the vaccine, helping in the battle to save countless lives and prevent serious illness.

A total of 712,827 first doses, 657,528 second doses and 266,153 doses of the booster vaccine have been delivered since the programme began, as well as 8,324 doses for patients who are severely immunosuppressed.

Since the annual flu vaccination programme began some weeks ago, vaccination teams have also delivered 278,517 doses of flu vaccine to people who are eligible.

The Cabinet Secretary for Health Humza Yousaf visited the team in Lowland Hall vaccination centre in Royal Highland Centre, Ingliston, yesterday to mark the anniversary of the programme and thank staff for their outstanding efforts.

Laura Hall, centre manager, said: “When I look back on the last year and everything we have achieved, I feel really proud.

“In Lowland Hall so far, we have delivered 330,000 doses of COVID-19 vaccine as part of the Lothian-wide programme. It is a massive achievement.”

NHS Lothian’s vaccination programme, which is the largest of its kind ever to be undertaken, began on 8 December 2020 and over the last 12 months has evolved and grown at rapid pace.

Now, amid fears around the new OMICRON variant and during the run-up to Christmas, the teams are facing one of their busiest stages yet.

Teams have geared up across the board to make more appointments available in all of the centres in Lothian.

Pat Wynne, Nurse Director of Primary and Community Care, NHS Lothian, said: “We have come such a long way in the last year, but we still have more to do.

“We are receiving emerging new information and evidence about the new OMICRON variant, but vaccination remains our best defence.

“Our teams are gearing up across Lothian to make sure we can administer as many doses as possible. We would urge anyone who is eligible for any doses of their vaccine to make an appointment or use one of our drop-in clinics.”

UK marks one year since deploying world’s first COVID-19 vaccine

Vaccination programme has been a phenomenal success with almost 120 million doses administered, saving countless lives and reducing pressure on the NHS

  • A year ago today the UK became the first country in the world to deploy an approved COVID-19 vaccine
  • Vaccination programme has been a phenomenal success with almost 120 million doses administered across the UK, saving countless lives and reducing pressure on the NHS
  • Booster programme accelerating, with new vaccine sites opening, support from military and new vaccinator recruitment drive to offer top-up jabs to all adults by end of January
  • UK approaching 21 million boosters and third doses administered

The UK administered the first COVID-19 vaccine in the world, outside of clinical trials, one year ago today as the Health and Social Care Secretary Sajid Javid urges people to get their booster jab as soon as they are eligible.

On 8 December 2020, 90-year-old Margaret Keenan received a Pfizer-BioNTech vaccine at University Hospital in Coventry, administered by Matron May Parsons.

Thanks to the UK Government’s quick action to secure the most promising vaccine doses in advance, almost 120 million doses have been administered across the UK in a year, saving countless lives and helping stop the NHS from being overwhelmed.

In light of the new Omicron variant and following advice from the Joint Committee on Vaccination and Immunisation (JCVI), the government is expanding the booster programme to all adults over 18 and announced that all eligible people will be offered a top-up jab by the end of January, as well as halving the minimum gap between second doses and boosters.

To speed up the vaccination programme, around 450 military personnel have been drafted in to support deployment, with extra community pharmacy sites, hospital hubs, and pop-up sites opening in convenient locations across the country. Payments to GPs, community pharmacies and primary care staff will help boost capacity and encourage more visits to those who are housebound.

NHS England has also launched a recruitment drive for 10,000 new vaccinators, administration staff, healthcare support workers and volunteers to join the national vaccination mission.

Almost 21 million boosters and third doses have been administered in the UK and, on Saturday, more than 450,000 top-up jabs were administered in a single day. In the last week, the booster programme reached more people than the adult population of Greater Manchester.

Everyone over the age of 40 who had their second dose at least three months ago will soon be able to book an appointment for their booster jab. Younger age groups will be invited by the NHS in order of age in due course. The BT Tower in London will celebrate the anniversary with a message encouraging people to get vaccinated, get boosted and get protected.

Prime Minister Boris Johnson said: “Since the first jab was delivered one year ago today, our phenomenal vaccine rollout has saved hundreds of thousands of lives and given us the best possible protection against Covid-19.

“So many people have been involved in this national vaccination effort, including our brilliant NHS staff, pharmacists, the military, the thousands of volunteers who dedicated themselves to the rollout, the incredible scientists, researchers and their teams who developed these life-saving vaccinations, and crucially every single one of you who has taken up the offer of a jab with such enthusiasm.

“Our fight against the virus is not over yet, but vaccines remain our first and best line of defence against the virus – so the best way to continue to protect yourself and your loved ones is to get behind the vaccine programme and get boosted as soon as you’re eligible.”

Health and Social Care Secretary Sajid Javid said: “I’m incredibly proud of our phenomenal COVID-19 vaccination programme. In one year we have administered almost 120 million doses across the UK, saving countless lives and giving us a powerful weapon to fight this devastating virus.

“The battle is not yet over and we are working around the clock to boost the booster programme to maximise immunity following the emergence of the Omicron variant.

“It is absolutely crucial everybody comes forward for their vaccines and booster jabs as soon as you are eligible so we can strengthen our wall of defence against COVID-19 and enjoy Christmas safely with our families and loved ones this year.”

The first real-world study on the effectiveness of booster vaccines against the dominant Delta variant by the UK Health Security Agency shows top-up jabs boost protection back up to over 90% against symptomatic COVID-19 in adults aged over 50 two weeks after being vaccinated.

As shown in the COV-Boost study, the booster vaccines, Moderna and Pfizer, increase the immune response substantially, which makes it more likely that protection will be maintained against Omicron. The best thing anyone can do given the new variant, is to get a booster.

People who have had their booster vaccine by 11 December will likely have very high protection against COVID-19 by Christmas Day.

Vaccines Minister Maggie Throup said: “Our COVID-19 vaccination programme has been an incredible success. Booster jabs will top-up the immunity people have already developed to ensure we are protected during the winter and ahead of Christmas.

“I encourage everybody to come forward for the first, second, booster and flu vaccines to protect yourself and those around you.”

The COVID-19 vaccination programme is the largest in British history and was established at unprecedented speed. The UK Government’s Vaccines Taskforce secured early access to almost 340 million doses of the most promising vaccine candidates in advance for the entire UK, Crown Dependencies and Overseas Territories, enabling a rapid deployment once approved by the medicines regulator.

New deals have been signed to buy an additional 60 million doses of the Moderna vaccine and 54 million more Pfizer/BioNTech doses for 2022 and 2023. These future supply deals include access to modified vaccines if they are required to combat Omicron and future Variants of Concern.

The UK has one of the highest COVID-19 vaccine uptake rates in the world, with 4 in 5 people aged over-65 in England already receiving their booster jab.

Flu is another winter virus that can be serious. To give people the best protection over winter, those eligible for a free flu vaccine should come forward and book an appointment at either their GP practice or their local pharmacy, or take it up when offered by their employer or other healthcare provider.

Stats from the COVID-19 vaccination programme:

  • The highest number of new vaccinations reported in one day in the UK was 844,285 on 20 March 2021 – that’s equivalent to vaccinating the entire population of Liverpool in one day.
  • The highest number of new vaccinations reported in a 7-day period in the UK was 4,215,859 between 15th-21st March 2021 – that’s equivalent to vaccinating the entire population of Birmingham more than four times in a week.

More than 27,000 deaths averted in Scotland

More than ten million vaccination doses have been administered in Scotland since the first jabs against COVID-19 were given exactly one year ago.

The biggest vaccination programme ever undertaken has seen 4,355,063 first doses, 3,962,203 second doses and 1,922,604 boosters and third doses administered from around 1,200 locations.

Staff at 750 GP practices and more than 17,800 vaccinators have worked to protect people from the pandemic.

Recent figures from the World Health Organisation (WHO) estimated that more than 27,000 deaths have been prevented in Scotland as a direct result of the rapid uptake of vaccinations.  

Health Secretary Humza Yousaf said: “This has been a year like no other and firstly I would again like to extend my deepest sympathies to all those who have lost loved ones to the virus.

“The national vaccination programme has provided us all with hope for the future. It is an overwhelming success. From the outset, our Health Boards and vaccination teams have worked tirelessly and at extraordinary pace to give everyone the opportunity to be protected against coronavirus over the past twelve months.

“In fact, they have delivered more first, second, booster and third doses per head than any of the other UK nations and we are so grateful for their professionalism and ongoing dedication.

“And of course to those who have taken up the offer of vaccine – thank you. Not only do vaccines reduce the severity of illness and prevent deaths, getting vaccinated may prevent you from unknowingly infecting someone in your household.

“The vaccines we have are extremely safe and highly effective and I urge anyone who is eligible and not yet vaccinated to book an appointment.

“While vaccination is the bedrock of our fight against COVID-19, with the emergence of the Omicron variant it is particularly important that we take other precautions to prevent transmission.

“So test regularly for the virus, particularly before socialising and meeting up with others from outside your household, wear face marks where required and open windows to improve ventilation.”

Thousands of elective care operations cancelled amid crisis in urgent and emergency care

Data from The Royal College of Emergency Medicine’s Winter Flow Project 2021/22 reveals that in November 2021 6,726 elective care operations were cancelled and in October 2021 6,335 elective care operations were cancelled.

Dr Adrian Boyle, Vice-President of the Royal College of Emergency Medicine, said: “In its first week of reporting, the Royal College’s Winter Flow project 2021/22 has a stark warning for the months ahead.

“Nearly 7,000 elective care operations were cancelled at reporting sites in November alone. This data comes as the National Audit Office, in their latest report, predict that the elective care waiting list could reach 12 million by March 2025.

“Data show 12-hour stays are twice as high as the same time last year; four-hour performance remains incredibly low averaging at 62% in November; long hospital stays have increased 13% since the beginning of October. Urgent and Emergency Care is verging on crisis and it is impacting and derailing elective care, meaning surgery for patients with serious conditions is delayed.

“The situation is unsustainable; we must see a willingness to address these crises and tackle the problems. The core of the issue is poor patient flow throughout the hospital and exit block caused by difficulties in discharging patients. These blockages cause ambulance handover delays, crowding and corridor care.

“Capacity must be expanded to avoid a hard-hitting impact on elective care. While it is crucial that social care is resourced to enable a timely and supported discharge of patients.

“In the long-term, restoring bed capacity to pre-pandemic levels and publishing a long-term workforce plan are vital to ensuring no parts of the system are compromised or derailed; to promoting good flow throughout the system; and keeping patients safe.”

Flu: get your child vaccinated

The flu vaccine is given to children as a nasal (nose) spray. It’s quick and painless and will just feel like a tickle in their nose.

Visit http://nhsinform.scot/childflu

Why should I have my child vaccinated?

Flu is very infectious and can be serious. Flu can lead to complications that may result in hospitalisation or even death.

The flu vaccine will reduce the risk of your child getting or spreading flu to friends and family who are at greater risk from flu and coronavirus, such as grandparents or people with health conditions.

The flu vaccine provides both individual protection for the child and reduces transmission across all age groups.

Getting the flu vaccine will help prevent the flu virus putting extra strain on our NHS services this winter.

Every year in Scotland, children are hospitalised for the treatment of flu or its complications.

In some cases flu can lead to complications. These can include:

  • bronchitis
  • pneumonia
  • painful middle-ear infection
  • vomiting
  • diarrhoea

For children with health conditions getting flu can be even more serious. Health conditions that make children more vulnerable include:

  • asthma
  • bronchitis
  • heart disease
  • kidney disease
  • liver disease
  • neurological disease
  • diabetes
  • immunosuppression
  • asplenia or dysfunction of the spleen

Childhood vaccinations are very important. Please bring your child to their vaccination appointment to protect them and others against flu.

If you think you or your child are showing symptoms of coronavirus call the number on your invitation to rearrange your appointment.

Who’s being offered the vaccine?

The flu vaccine’s offered to all:

From September 2021 all primary and secondary school pupils in Scotland will be offered the flu vaccine.

How will my child get the vaccine?

The child flu vaccine is normally given at school between September and December.

If your child misses their vaccination in school, please contact your local NHS Board to find out about local arrangements for getting their vaccine at another time.

Home-schooled children are also eligible for the flu vaccine. Your local health board will contact you directly to offer vaccination.

Children aged 6 months to less than 2 years of age with an eligible health condition will also be offered the flu vaccine. Your local health board or GP practice will invite you by letter to get your child’s flu vaccine.

Primary and secondary school-aged children (including those with eligible health conditions) will be offered the vaccine at school.

If a young person has left secondary school, they are not eligible to get a flu vaccine at school. 16 and 17 year olds with an eligible health condition who have left school can phone 0800 030 8013 to receive an appointment for the flu vaccine.

If you don’t know the phone number for your local health board, you can phone 0800 030 8013.

What vaccine is used?

Children aged 2 years and older are given the flu vaccine as a nasal (nose) spray into each nostril. It is quick and painless and is the best available protection against flu.

Your child does not have to sniff or inhale the vaccine and will just feel a tickle in their nose.

The Fluenz Tetra nasal spray suspension Influenza vaccine (live attenuated, nasal) is routinely used in Scotland.

Children aged 6 months to less than 2 years with an eligible health condition will be offered the injectable vaccine.

young girl next to flu jag

Vaccine side effects

As with all medicines, side effects of the nasal spray flu vaccine are possible, but usually mild.

More about child flu vaccine side effects

Vaccine safety

The flu vaccine is the safest, most effective protection against flu.

All medicines, including vaccines, are tested for safety and efficacy before they’re allowed to be used.

Once they’re in use, the safety of vaccines continues to be monitored by the Medicines and Healthcare products Regulatory Agency (MHRA).

The nasal spray flu vaccine has been used safely since 2014 and millions of doses of the vaccine have been given to children in the UK

The virus in the vaccine has been weakened so it doesn’t cause flu. It helps your child build up immunity to flu.

Children who don’t get the vaccine are not at risk of catching flu from children who have had the vaccine. The only exception to this would be children who are extremely immunocompromised (have a weakened immune system).

How effective is the vaccine?

The annual vaccine offers protection against the most common types of flu virus that are around each winter. The flu vaccine should start to protect most children about 10 to 14 days after they receive their vaccination.

Over the last few years the flu vaccine has worked very well, providing protection against flu. It has also reduced the chance of spreading flu into the wider community.

There is still a chance that your child could get flu after having the vaccine. If they do get flu after vaccination, it is likely to be milder and not last as long.

Children who can’t have the nasal spray vaccine

An alternative injectable form of the vaccine is available for children who cannot have the nasal spray vaccine.

This includes children who:

  • have their immune system suppressed because they’re getting treatment for serious conditions, such as cancer, or if they’ve had a transplant
  • have a serious condition which affects the immune system, such as severe primary immunodeficiency
  • live with or are in close regular contact with very severely immunocompromised people who require isolation
  • are taking regular high doses of oral steroids
  • have had a severe reaction to a previous dose of the vaccine
  • are undergoing salicylate treatment (for example, taking aspirin)

Children with egg allergies

Children with an egg allergy can safely have the nasal spray vaccine, unless they’ve had a life-threatening reaction to eggs that required intensive care.

An egg-free injectable vaccine which can be used in those from 2 years of age is available. If you’re affected, please speak to your immunisation nurse for advice.

Children with severe asthma

The nasal spray vaccine may not be suitable for some children with severe asthma who regularly need oral steroids for asthma control. If you’re affected, please speak to your health professional for advice.

Children on medications

If your child is at school, please make sure you list all of your child’s medications on the consent form. All consent forms will be checked by a health or immunisation team member before the immunisation session to make sure your child can have the nasal spray.

Pork gelatine

The nasal spray vaccine contains a highly processed form of gelatine (pork gelatine) which is used in many essential medicines.

The gelatine helps keep the vaccine viruses stable so the vaccine provides the best protection against flu.

Many faith groups, including Muslim and Jewish communities, have approved the use of vaccines containing gelatine.

However, it’s your choice whether or not you want your child to get the nasal spray vaccine.

The nasal spray vaccine is a much more effective vaccine than the injected flu vaccine and is the preferred option.

If you do not want your child to get the nasal spray vaccine for religious reasons, you may request the injectable alternative by ticking the box on the consent form (your child won’t automatically be offered the injectable alternative, you’ll need to tick the box every year).

New case of Avian Influenza

Disease confirmed in poultry in Scotland

A flock of free-range hens from a commercial premises near Gretna has tested positive for highly pathogenic avian influenza H5N1.

In order to limit the further spread of disease, appropriate restrictions have been imposed on the premises and any identified contact premises, plus the area of the Surveillance Zone, which overlaps into other regions.

The remaining birds at the premises will be humanely culled and a 3km Protection Zone and 10km Surveillance Zone have been declared around the infected premises – taking effect 00:01 on 04 December – to limit the risk of spread of the disease.

Within these zones, a range of different controls are now in place. These include restrictions on the movement of poultry, carcasses, eggs, used poultry litter and manure, and restrictions on bird gatherings.

Producers and bird keepers are reminded to comply with the Order to house birds, which came in to effect on 29 November, or to ensure their birds are kept separate from wild birds. Bird keepers must ensure they follow biosecurity procedures. 

The additional housing measures build on the strengthened biosecurity regulations that were brought in across Great Britain as part of the Avian Influenza Prevention Zone (AIPZ) on 3 November 2021 and in and Northern Ireland on 17 November 2021.

Rural Affairs Secretary Mairi Gougeon said: “With the recent disease confirmations in wild and captive birds across the UK, it is not unexpected for avian influenza to be found in birds here in Scotland.

“We ask that the public remain vigilant and report any findings of dead wild birds to Defra’s national telephone helpline. Do not touch or pick up any dead or sick birds that you find.”

Scotland’s Chief Veterinary Officer Sheila Voas said: “We have already made clear that all bird keepers – whether major businesses or small keepers with just a few birds – must ensure that their biosecurity is up to scratch to protect their birds from disease and prevent any contact between their birds and wild birds.

“Keepers who are concerned about the health or welfare of their flock should seek veterinary advice immediately. Your private vet, or your local Animal and Plant Health Agency office, will also be able to provide practical advice on keeping your birds safe from infection.

“Any dead wild swans, geese, ducks or birds of prey, or five or more dead wild birds of other species (including gulls) in the same location at the same time, should be reported to Defra’s national telephone helpline.

“Public health advice is that the risk to human health from the virus is very low and food standards bodies advise that avian influenzas pose a very low food safety risk for UK consumers, and it does not affect the consumption of poultry products including eggs.”