Tag: public health

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.