public health – Page 54 – The NEN

‘We sink, or we swim, together’

COVAX: World unites to ensure vaccines will be available to all … but USA and China say NO

64 higher income economies have now joined the COVAX Facility, with a further 38 economies expected to sign in the coming days
These self-financing economies, which include 29 from ‘Team Europe’ participating as part of an agreement with the European Commission, join 92 lower income economies eligible for financial support through the Gavi COVAX Advance Market Commitment
This means a total of 156 economies, representing nearly two-thirds of the global population, are now committed to or eligible to receive vaccines through the Facility Click here for the list of economies

64 higher income economies have joined the COVAX Facility, a global initiative that brings together governments and manufacturers to ensure eventual COVID-19 vaccines reach those in greatest need, whoever they are and wherever they live.

These 64 economies include commitments from 35 economies as well as the European Commission which will procure doses on behalf of 27 EU member states plus Norway and Iceland.

By pooling financial and scientific resources, these participating economies will be able to insure themselves against the failure of any individual vaccine candidate and secure successful vaccines in a cost-effective, targeted way.

The 64 members of the Facility will be joined by 92 low- and middle-income economies eligible for support for the procurement of vaccines through the Gavi COVAX Advance Market Commitment (AMC), a financing instrument aimed at supporting the procurement of vaccines for these countries.

This means that 156 economies, representing roughly 64% of the global population in total, are now either committed to or eligible for the COVAX Facility, with more to follow.

With the Commitment Agreements secured, the COVAX Facility will now start signing formal agreements with vaccine manufacturers and developers, which are partners in the COVAX effort, to secure the doses needed to end the acute phase of the pandemic by the end of 2021. This is in addition to an ongoing effort to raise funding for both R&D and for the procurement of vaccines for lower-income countries via the Gavi COVAX AMC.

“COVAX is now in business: governments from every continent have chosen to work together, not only to secure vaccines for their own populations, but also to help ensure that vaccines are available to the most vulnerable everywhere,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, which is coordinating the COVAX Facility.

“With the commitments we’re announcing today for the COVAX Facility, as well as the historic partnership we are forging with industry, we now stand a far better chance of ending the acute phase of this pandemic once safe, effective vaccines become available.”

The COVAX Facility is part of COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, which is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and the World Health Organization (WHO) – working in partnership with developed and developing country vaccine manufacturers, UNICEF, the World Bank, Civil Society Organisations and others.

The allocation of vaccines, once licensed and approved, will be guided by an Allocation Framework released today by WHO following the principle of fair and equitable access, ensuring no participating economy will be left behind.

Policies determining the prioritization of vaccine rollout within economies will be guided by recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE), which has recently released a Values Framework laying the groundwork for subsequent guidance on target populations and policies on vaccine use.

“COVID-19 is an unprecedented global crisis that demands an unprecedented global response,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “Vaccine nationalism will only perpetuate the disease and prolong the global recovery.

“Working together through the COVAX Facility is not charity, it’s in every country’s own best interests to control the pandemic and accelerate the global economic recovery.”

The commitment of fully self-financing economies will now unlock vital funding and the security of demand needed to scale up manufacturing and secure the doses needed for the Facility. CEPI is leading COVAX vaccine research and development work, which aims to develop at least three safe and effective vaccines which can be made available to economies participating in the COVAX Facility. Nine candidate vaccines are currently being supported by CEPI; eight of which are currently in clinical trials.

“This is a landmark moment in the history of public health with the international community coming together to tackle this pandemic. The global spread of COVID-19 means that it is only through equitable and simultaneous access to new lifesaving COVID-19 vaccines that we can hope to end this pandemic”, said Dr Richard Hatchett, CEO of CEPI.

“Countries coming together in this way shows a unity of purpose and resolve to end the acute phase of this pandemic, and we must now work closely with vaccine manufacturers—who play an integral part in the global response—to put in place the agreements needed to fulfil COVAX’s core aim: to have two billion vaccine doses available by the end of 2021. Today, we have taken a great leap towards that goal, for the benefit of all.”

The success of COVAX hinges not only on economies signing up to the COVAX Facility and commitments from vaccine manufacturers, but also filling key funding gaps for both COVAX research and development (R&D) work and the Gavi COVAX AMC to support participation of lower income economies in the COVAX Facility.

Governments, vaccine manufacturers (in addition to their own R&D), organisations and individuals have committed US$ 1.4 billion towards vaccine R&D so far, but a further US$ 700-800 million is urgently needed to continue to move the portfolio forward in addition to US$ 300 million to fund WHO’s SOLIDARITY trial.

The Gavi COVAX AMC has raised around US$ 700 million from sovereign donors as well as philanthropy and the private sector, against an initial target of US$ 2 billion in seed funding needed by the end of 2020. Funding the Gavi COVAX AMC will be critical to ensuring ability to pay is not a barrier to accessing COVID-19 vaccines, a situation which would leave the majority of the world unprotected, with the pandemic and its impact continuing unabated.

The Commitment Agreements also commit higher income governments to provide an upfront payment to reserve doses by 9 October 2020. These funds will be used to accelerate the scale-up of vaccine manufacturing to secure two billion doses of vaccine, enough to vaccinate one billion people assuming the vaccine requires a two-dose regimen.

Further details on these upfront payments are available in Gavi’s COVAX Facility Explainer.

As well as procuring doses for participating economies, the COVAX Facility will also maintain a buffer of doses for emergency and humanitarian use.

Participating country comments

“COVID-19 poses serious health concerns to people everywhere, and that’s why Canada is committed to working with partners around the world to end the pandemic,” said the Rt. Hon. Justin Trudeau, Prime Minister of Canada.

“Equitable, timely, and affordable access to a safe and effective COVID vaccine will be critical to help protect people’s health. Canada supports the objectives and principles of the COVAX Facility as the only global pooled procurement mechanism for countries to collaborate on this monumental undertaking. Our country is a part of this important global response.”

“New Zealand’s commitment to the COVAX Facility supports access to vaccines against COVID-19 for other countries too,” said Rt Hon Jacinda Ardern, Prime Minister of New Zealand.

“COVAX and the idea of equal access to a COVID-19 vaccine, regardless of ability to pay, is not just a moral imperative, it is the only practical solution to this pandemic. Protecting everyone is the only way we can return our world – our trade, tourism, travel, business – to normal,” said the Honourable Dr Edwin G. Dikoloti, Minister of Health and Wellness for Botswana. “We urge those countries who have not yet signed up to do so. Let us work together to protect each other.”

“Immunisation saves lives. Investing in immunisation infrastructure helps strengthen health systems. We have seen this time and again through our work with Gavi and Alliance partners,” said Dr Lia Tadesse, Minister of Health for Ethiopia.

“By being a part of the COVAX Facility and the AMC we can continue this work and protect our citizens – and the world – against the impact of COVID-19.”

“With COVAX, the world is joining forces and proving that together, we are stronger – and together, we can defeat this pandemic,” said Ekaterine Tikaradze, Minister of Health for Georgia.

“Georgia will be joining the COVAX Facility to give our citizens the best chance at having access to safe vaccines. By doing this, we also make sure health care workers and other high risk persons all over the world have access to these life-saving tools, helping to bring the pandemic under control – and we can all recover and rebuild.”

“Joining the COVAX Facility was not a difficult decision – not only will this give Kuwaiti citizens access to COVID-19 vaccines as they become available, it will also mean our friends and partners outside our borders also get access,” said His Excellency Sheikh Dr Basel Humoud Al-Sabah, Minister of Health of the State of Kuwait.

“We need a global solution to this global pandemic: we believe COVAX is that solution.”

“We believe international cooperation – a global effort – is key,” said Dag-Inge Ulstein, Minister of International Development for Norway. “We must continue to work for equitable access to vaccines, tests and treatments.

“To defeat the coronavirus pandemic, well-off countries need to act swiftly and boldly to make vaccines and treatments available to those who cannot afford to pay themselves. With the commitments to the COVAX facility we are heading in the right direction.”

“This is a hugely important initiative, which could offer us a path out of the acute phase of this pandemic and a return to normality,” said His Excellency Dr Ahmed Mohammed Obaid Al Saidi, Minister of Health of the Sultanate of Oman.

“I would urge every country that has not yet done so to sign up, for all our sakes. It is far better for us to work together than apart.”

Partner comments:

“The history of vaccines will be defined by our response to COVID-19; the COVAX facility is at the epicenter of this response. Industry is at the forefront in vaccines development and manufacturing leading to supplies of several billion doses within the next few years”, said Mr. Sai D. Prasad, President of the Developing Countries Vaccine Manufacturers’ Network (DCVMN).

“The COVAX facility will have a major impact on lives, livelihoods and accelerate the return to normalcy for countries. The DCVMN is fully engaged with its partners to enhance its mission of global public health and to leave no one behind.”

“It is very encouraging to see so many countries move from talk to full commitment,” said Thomas Cueni, Director General of the International Federation of Pharmaceutical Manufacturers (IFPMA).

“The Facility can only work, and equitable access can only be achieved, if there is solidarity between rich and poorer countries. Today vaccine makers who have the unique skills and expertise to scale up manufacturing to levels never seen before, stand ready, together, to take up the challenge of providing two billion doses of yet unknown COVID-19 vaccines.

“This is no mean feat, as it requires doubling existing capacity in record time. Today, marks a significant step forward, and is a historic mark of solidarity which has the power to bring the acute phase of this pandemic to an end; and we are proud to be part of this unique endeavour to leave no one behind.”

“Uniting our efforts through COVAX must guarantee fair allocation and equitable delivery of the COVID-19 vaccine to those who need it most, and not just those who can afford it,” said Jagan Chapagain, Secretary-General of the International Federation of Red Cross and Red Crescent Societies.

“We all have a moral and public health imperative to protect the poor in rural communities as the affluent in cities, the old in care homes as the young in refugee camps. The power of our humanity and the success of COVAX will be measured by how we collectively protect the most vulnerable among us.”

“Global cooperation must be the cornerstone of our global response to COVID-19,” said Kevin Watkins, Chief Executive of Save the Children. “The COVAX Facility has the potential to help ensure universal and equitable access to future COVID vaccines.

“For this to happen, we need to ensure people in low- and middle-income countries get their fair share and can access the vaccines they need to help overcome the biggest public health and child rights crisis of our generation.”

“Seeing such unity in the face of the COVID-19 crisis gives us confidence that, together, we can ensure the equitable delivery of COVID vaccines globally,” said Henrietta Fore, UNICEF Executive Director.

“With our globe-spanning supply chain and on-the-ground presence across 190 countries, UNICEF is proud to support this historic effort.”

COVID ALERT: UK MOVES TO LEVEL 4

The UK’s Chief Medical Officers issued a joint statement last night recommending that the UK COVID-19 alert level move from level 3 to level 4:

‘The Joint Biosecurity Centre has recommended that the COVID-19 alert level should move from level 3 (COVID-19 epidemic is in general circulation) to level 4 (COVID-19 epidemic is in general circulation, transmission is high or rising exponentially).

‘The CMOs for England, Scotland, Wales and Northern Ireland have reviewed the evidence and recommend all 4 nations of the UK should move to level 4.

‘After a period of lower COVID cases and deaths, the number of cases are now rising rapidly and probably exponentially in significant parts of all 4 nations. If we are to avoid significant excess deaths and exceptional pressure in the NHS and other health services over the autumn and winter, everyone has to follow the social distancing guidance, wear face coverings correctly and wash their hands regularly.

‘We know this will be a concerning news for many people. Please follow the rules, look after each other and together we will get through this.’

Chief Medical Officer for England, Professor Chris Whitty

Chief Medical Officer for Northern Ireland, Dr Michael McBride

Chief Medical Officer for Scotland, Dr Gregor Smith

Deputy Chief Medical Officer for Wales, Dr Chris Jones

Earlier yesterday the Prime Minister had calls with the First Ministers of Scotland, Wales and Northern Ireland and the deputy First Minister of Northern Ireland about how coronavirus is spreading across the country.

During these calls, the Prime Minister made clear that the rising infection rates are a cause for great concern, which he is taking very seriously.

He reiterated his unwavering commitment to working with the devolved administrations as we continue to tackle the virus. They all agreed to act with a united approach, as much as possible, in the days and weeks ahead.

The Prime Minister invited the First Ministers and the deputy First Minister to attend a COBR this morning to discuss next steps for the country.

Further restrictions are expected to be announced later today.

First Minister: ‘The bottom line here is that the virus is on the rise again’

Statement given by the First Minister Nicola Sturgeon at a media briefing in St Andrew’s House this afternoon (Friday 18 September):

I can report that the total number of positive cases that were reported yesterday was 203. This represents 4.4% of people newly tested and takes the total number of cases now to 23,776.

Let me remind you again that these are positive cases reported yesterday.

Because of the processing backlog we have been dealing with, which as I said yesterday is improving, more of these than normal may be from swabs taken over the past few days.

However, as I’ve also said before, when we look at whether case numbers are rising or not, we look at results by the date the sample was taken, not just the reporting date – so the backlog doesn’t distort our trend analysis.

The full regional breakdown will be published later as normal, but I can confirm now that 69 of the 203 cases are in Greater Glasgow and Clyde, 30 in Lothian, and 29 in Lanarkshire. The remaining 75 are across the other 8 mainland health board areas.

I can also confirm that 61 people are in hospital – which is an increase of 9 on yesterday. 5 people are in intensive care, which is the same as yesterday. And finally, I regret to say that in the past 24 hours, one additional death was registered of a patient who first tested positive over the previous 28 days.

That means that the total number of deaths, under this daily measurement, is now 2,502.

This is a reminder that we are again reporting deaths, albeit small numbers, on a regular basis again.

That’s an indication that in Scotland, as elsewhere, Covid is accelerating again, and I will say more about that shortly.

But I want once again to pass on my condolences to everybody who has lost a loved one to this illness – including of course, those grieving as a result of the death that was registered yesterday.

I’m joined today by our National Clinical Director Jason Leitch. After my remarks, Jason will say a few words about the news this morning that an Edinburgh Rugby Academy player has tested positive for Covid.

Before that, though, here are a few items I want to cover.

The first let me briefly highlight an announcement that was made by the Scottish Government last night.

We have added two additional places to the list of those that are subject to quarantine restrictions. Those are Slovenia and Guadeloupe.

That means that from tomorrow, people travelling to Scotland from these countries must self-isolate for 14 days, upon their return or arrival in Scotland. And it is very important that people comply with that.

By contrast, Singapore and Thailand were removed from the international list.

So anyone arriving from either of these countries, from tomorrow, no longer has to quarantine. However, if you have arrived from Singapore or Thailand in the past few days, you do need to complete your 14 days of isolation.

This is all a further reminder of how quickly levels of the virus – in any country or area – can change. So I’ll say again, please avoid non-essential overseas travel at the moment, if possible.

Indeed, please think carefully about non-essential travel at home, as well. In particular, avoid travelling to parts of the UK, that are under tougher restrictions right now because levels of Covid are rising fastest.

The main thing I want to do today is to take a moment to take stock of where the country stands right now in the pandemic.

We are seeing increasing numbers of places both here in Scotland and across the rest of the UK that are under local and regional restrictions. And, many will have woken up this morning to hear the news of the potential for new national restrictions.

The bottom line here is that the virus is on the rise again.

Our case numbers are not yet rising as fast as there were back in March. But they are rising again and they are rising quite rapidly. The percentage of tests coming back positive is also not anywhere near as high as it was back in March, but again it is rising.

And as I reported yesterday, the R number we believe is now above 1.

Across the UK, and this is particularly the case in England right now, hospital admissions are rising. ICU admissions are rising too. While this is particularly the case in England right now, this should sound a warning signal for us here in Scotland too.

And, while for the last few weeks, people might have taken comfort from the low levels of older, more vulnerable people contracting the virus, I have to say to you that picture is also beginning to change.

Recent data shows that the percentage of cases in the older population is now beginning to rise as well.

Looking more widely, we can observe that in broad terms we might now be, at an earlier stage, on a similar path to that which has been taken in recent weeks by France.

About four weeks ago, France stood broadly where we do today.

But now they face around 10,000 new cases per day and hundreds of people in ICU and deaths in France are already rising now as well.

So our task is to make sure – if we can – that we interrupt that, and we don’t end up where they are now.

What lies behind this is a simple reality: we are facing the risk again of exponential growth in Covid. And we all know from our experience earlier this year what that looks like, and why it is so important to seek to avoid it.

So, I want to talk briefly about what we need to do.

First and foremost, we need to act to interrupt that exponential growth. No one wants to see another full-scale lockdown.

And, above all, we want to keep schools and childcare open because we know how important that is to the education but also to the broader well-being of children and young people.

So right now, and I mean right now, today, over the weekend and into next week, that means following all of the rules and the advice currently in place.

Work from home if you can, that remains our advice. As I said a moment ago, avoid if you can non-essential travel. Don’t meet up with any more than six people from a maximum of two households, indoors and outdoors.

If you live in Glasgow, as I do, or in East or West Dunbartonshire, Renfrewshire or East Renfrewshire, North or South Lanarkshire, don’t visit other households at all, unless you have to visit to care for or deliver shopping to a vulnerable person.

The fact is we know, and this is one of the things we have learned about this virus, is that when it gets into a household, it is very likely to infect everyone in that household.

So to be blunt, we must do everything we can to keep it out of our households. When we do have to interact with others, the last piece of advice I want to remind you of right now, is to remember to follow FACTS: all of the basic things that help us reduce the risks of transmitting the virus.

These are the current rules and I am asking everybody to please abide by them strictly and rigorously. But it may well be that if we are to interrupt and break this growth, we will have to do more over the next few weeks. And this weekend will be critical in the assessment of how best to do that.

As widely reported, SAGE met yesterday. I have chaired a meeting of senior Scottish Government officials and advisors this morning to assess the current situation and discussions across the 4 nations of the UK will, I hope, take place in the coming days. I’ve this morning asked the Prime Minister to convene a COBRA meeting over this weekend.

So, I am today giving the nation advance notice, that the coming days are likely to see some hard but necessary decisions.

If we want to avoid another full-scale lockdown, which all of us do, doing nothing almost certainly isn’t an option.

Now I will of course, as I have sought to do throughout this pandemic, keep you regularly and fully updated. But for now, over this weekend, please rigorously follow all of the current rules and all of the current advice.

Now there is another issue that I want to update you on, another area where some of us may be able to help in the fight against this virus, and it involves Scotland’s involvement in the UK-wide COVID Infection Survey.

The survey is designed to track the spread and prevalence of the virus in the general population. It is conducted by the Office for National Statistics, and the University of Oxford. And following a successful pilot in England, it has been expanded to other parts of the UK.

In Scotland, it will ultimately see up to 15,000 people being tested, every fortnight. Households will be randomly selected for the survey. And over the coming period, these households will all be sent a letter, inviting them to participate.

Those letters will provide details on how to register. The first of them should be arriving today. And from Monday, survey teams will begin visiting households that agree to take part.

Those who do take part will be asked to administer swabs to their throats and noses, to test for the virus. People aged 12 years or older can take the swab themselves – but parents and carers should administer them for younger children. A subset of participants – over the age of 16 – will also be invited to provide blood samples, to test whether they have already have had Covid.

Participants will be asked to take further tests every week for the first 5 weeks, then every month for up to a year. Members of the survey team will visit households, to collect the tests.

These results will help us to see how many people are infected with the virus at a given point in time – whether ot not they have symptoms.

And they will give us a sense of how many people are ever likely to have had the infection. They should therefore provide us with really important new insights into the spread of Covid in Scotland.

The survey will also provide additional data on the characteristics of those who are testing positive and so it will help us to examine any difference in the impact of the virus, on different groups in society.

The initial survey results for Scotland should be available in November. But that is dependent, and that is why I am raising it today, on people’s willingness to sign up. So if you receive a letter, and you are able to do so, I encourage you to take part in this survey, it is really important and it will be a vital tool in our efforts to understand the virus and therefore equip ourselves better to know the things to keep it under control.

Now to close today, I want to really come back to emphasise my earlier point and really emphasise to you that we are at another really critical point. Covid-19 is on the rise. Not just here in Scotland, it is on the rise in the UK and across Europe.

Just yesterday, the World Health Organization warned that weekly cases across Europe, have now topped 300,000.

That’s higher than it was in March – when the virus first peaked.

As the WHO has said, that must serve as a wake-up call for all of us. The virus could get out of our grip again. That’s the news that should be the wake-up call.

The better news is that hasn’t happened yet: we do still have time to prevent it happening, and that is down to Government to take a lead and be very clear and decisive in what we have to do, but it also ultimately comes down to all of us. So before I hand over to Jason, I want remind all you watching, and to ask you to remind others, of what we need you to do.

If you live in Glasgow; East or West Dunbartonshire; Renfrewshire or East Renfrewshire; North or South Lanarkshire, please don’t visit any other households anywhere in Scotland.

In the rest of the country, please do not meet with more than 6 people, from a maximum of 2 households. Don’t give the virus an opportunity to spread between households, because if it spreads between households we know it quickly spreads within households.

Download the Protect Scotland app, if you haven’t already done so. A million people have done so, already. We know that will help make a difference

And finally – in everything you do – lets all follow the FACTS. These are the five golden rules that help all us of us minimise the risk of transmission:

Face coverings in enclosed spaces
Avoid crowded places.
Clean hands and clean all hard surfaces that you are touching regularly
keep two metres away from people other households.
and self isolate, and book a test, if you have symptoms.

We are at a critical point right now, but as I said in one of these briefings a couple of days ago, nothing is inevitable. We all have power to try and stop this virus running out of control again.

I know the responsibility that is on the shoulders of me and the government here to take the hard decisions that will determine whether we succeed or not.

But as I have said, so many times throughout, this is down to all of us. We are all in this together and it is only by acting together that we can stop it running out of control and ultimately save lives.

My thanks again to everybody who I know are making all sorts of sacrifices to help us do that. Keep spreading the word to everyone you know.

Protect Scotland app goes live

Additional protection against coronavirus

https://youtu.be/rzGzh0msKNA

First Minister Nicola Sturgeon has urged smartphone users across Scotland to download NHS Scotland’s new contact tracing app to help suppress the spread of coronavirus (COVID-19).

The Protect Scotland app is now available to download for free via Apple and Google stores.

Supported by a dedicated Protect Scotland website, the app is an extra tool complementing existing person-to-person contact tracing which remains the main component of NHS Scotland’s Test and Protect system.

Individuals privacy will be protected as the app uses Bluetooth technology to anonymously alert users if they have been in close contact with someone who has tested positive for COVID-19, and advises them to self-isolate. Users of the app who test positive will still get a call from a contact tracer to confirm their details and who they have been in close contact with.

The app does not store details on an individual or their location but uses encrypted, anonymised codes exchanged between smartphones to determine all close contacts. Close contacts are defined as people who have been within two metres of someone who has tested positive for 15 minutes.

Built by software developers NearForm for NHS Scotland, the app uses the same technology as the Republic of Ireland and Northern Irish proximity tracing apps.

First Minister Nicola Sturgeon said: “The launch of the app is a welcome development which will offer an additional level of protection – supporting NHS Scotland’s Test and Protect system as it works to drive down the spread of COVID-19 across the country.

“I would encourage everyone to download the free app if they have a compatible smartphone, and help slow the spread of COVID-19. This will support the work of NHS Scotland and has the potential to help avoid local lockdowns.

“The more people who download and use the app, the more effective it can be in helping to make connections that may otherwise have been missed. This will allow people to self-isolate quickly if they are exposed to the virus, reducing the risk of them infecting others.

“We all have a part to play in suppressing the virus, and downloading the app – alongside other vital measures such as following hygiene and physical distancing guidance – will help protect you, your family and your community.

“We also know that not everyone uses a smartphone or will be able to or want to access the app, which is why this software is very much there to complement existing contact tracing methods.”

Cian Ó Maidín, CEO, NearForm said: “We’re delighted to partner with NHS Scotland on the Protect Scotland app which puts power in citizens’ pockets to join the fight against COVID-19.

“This open source technology was built with privacy and data protection at its core and, through anonymous keys, allows Scottish citizens to engage, protect each other and break transmission chains.

“The Scottish Government has taken a great approach, using open source software, that has been peer reviewed and rolled out successfully in Ireland and Northern Ireland.”

Since launching last night, the app has already been downloaded more than 600,000 times.

SNP MSP Gordon MacDonald said: “The Scottish Government has now launched the ‘Protect Scotland’ proximity tracing app, to help stop the spread of the Covid-19 virus and complement the person-to-person approach of Test and Protect.

“The app – which takes less than a minute to download – will allow us to alert people at risk far more quickly, so that we can all take steps to reduce the risk of infecting others.

“Scotland’s official contact tracing app will help us all to protect ourselves, our family, our friends and our community by enabling faster contact tracing.

“The more people who have the app, the more it can help to slow the spread of Coronavirus.

“That’s why I’m urging people in Edinburgh to download the app, and let’s all protect Scotland.”

For more information on the Protect Scotland app visit www.protect.scot

Quarantine measures introduced for travellers from Greece

Importation of new cases remains ‘significant’ public health risk

Travellers from Greece will be required to self-isolate at home, or another specified address, for 14 days on arrival in Scotland from 4am Thursday morning (3 September). This is due to a significant rise in cases of coronavirus (COVID-19) being imported into Scotland by people who have been in Greece.

Evidence of virus importation, especially from the Greek islands, has led to the country being removed from the exemption list on public health grounds. It is believed prevalence of COVID-19 in Greece currently remains lower than 20 per 100,000, however, a number of cases of the virus in Scotland can be traced back to travel to Greece.

Justice Secretary Humza Yousaf said: “We are in the midst of a global pandemic and the situation in many countries can change suddenly. Therefore, people should think very hard before committing to non-essential travel abroad.

“With Scotland’s relatively low infection rate, importation of new cases from Greece is a significant risk to public health. I would also encourage people who have returned to Scotland from Greece in the last few days to be particularly careful in their social contacts and to ensure they stick to the FACTS.

“We continue to closely monitor the situation in all parts of the world and base the decisions we make on the scientific evidence available.

“Regular discussions continue with the other three governments in the UK.

“Requiring travellers arriving from a non-exempt country to quarantine for 14 days on arrival is vital to helping prevent transmission of the virus and to suppress it. More details about what this means can be found on the Scottish Government website.

“Wherever people have travelled from – an exempt country or not – it is a legal requirement to complete a Passenger Locator Form and provide it to Border Force officials. Failure to do so can also result in a fine since this, along with any failure to self-isolate where required, poses a significant risk to wider public health across Scotland.”

Chief Medical Officer Gregor Smith said: “There is a compelling public health risk around importation of the virus, especially given the number of imported cases linked to the Greek islands.

“The flow of travel between Scotland and Greece, and the behaviour we have seen from some of those travellers, means that on public health grounds there is a strong case – supported by public health directors – to remove Greece from the exemption list.”

Public health rules for international travel are an important part of Scotland’s wider response to the pandemic to limit the introduction of new chains of transmission.

To allow the appropriate arrangements to be put in place, following the laying of the regulations, the change will come into force at 4am on Thursday 3 September.

All international travellers arriving into Scotland, apart from a very limited number of individual exemptions, must complete a passenger locator form and provide evidence that they have done so on arrival in the UK if requested to do so by a Border Force official. This includes people arriving from countries where quarantine is subsequently not required. Individuals who do not complete the form and present it when asked on arrival may be fined £60. The fine can be doubled for each subsequent offence up to a maximum of £480.

Failure to comply with the requirement to quarantine may result in a fine of £480.

Those travelling abroad should check in advance for any local requirements to quarantine on arrival at their destination. Further information about the foreign travel public health rules, including quarantine requirements can be read on the Scottish Government website.

This includes the existing list of overseas destinations where those arriving in Scotland are exempt from self-isolation.

Work still to be done on school safety as 100,000 pupils posted absent

A survey of EIS union Reps in schools has confirmed that there is still a considerable amount of work to be done to ensure that schools are COVID-secure environments.

The EIS issued the survey last month following the re-opening of schools and received responses from almost 600 schools across the country.

Amongst the key issues of concern identified by school reps were:

92% of Reps reported no reductions in class sizes to enable effective physical distancing
30% of Reps reported that physical distancing between staff and pupils was not in place in their school
49% of Secondary school Reps reported no change to timetables or class groups to support physical distancing measures
10% of Reps reported that physical distancing between staff is not in place in their school
43% of Reps reported deficiencies in the delivery of agreed COVID mitigations in schools
31% of Reps reported that face coverings were not being worn where physical distancing was not possible
7% of Reps reported that teachers in more at-risk groups (such as those previously shielding, those who were pregnant, teachers from BAME groups) had not received support in requesting individual risk assessments to ensure their safety.

Commenting, EIS General Secretary Larry Flanagan said, “The results of our survey of school Reps make for worrying reading. While local authorities have taken numerous steps to make schools safer, there is still much to be done to ensure that all schools are as COVID-safe as they can possibly be.

“It is clear from the results of our survey that class groups are still too large to facilitate effective physical distancing measures, potentially placing staff and pupils alike at greater risk of COVID infection. While this is an issue in all schools, it is a particularly acute concern in the secondary sector where older pupils are at a greater risk of developing symptoms and of spreading the virus.”

Mr Flanagan added: “Teachers and pupils have a right to work in a safe and secure environment, so all possible steps must be taken to ensure that our schools are COVID-secure.

“The most effective means to ensure this is through physical distancing, which will require smaller classes and an increased number of teaching staff. Local authorities and the Scottish Government must act urgently to step up the deployment of the additional teaching staff required to ensure that all schools can operate safely in the weeks and months ahead.”

A copy of the report on the EIS national Reps’ survey is available here, for information.

It seems parents may be erring on the side of caution as over 100,000 pupils were marked absent from school last Friday, many suffering from cold-like symptoms.

Earlier this week national clinical director Dr Jason Leitch wrote an open letter to parents, offering advice and guidance on what parents and carers should do if their children are suffering from bugs and colds.

Guidance on children with non-COVID ailments

Education Secretary John Swinney has asked council Directors of Education and Head Teachers to assist in sharing more information on coronavirus to parents and carers.

In addition, Scotland’s National Clinical Director Jason Leitch has written an open letter for parents with answers about when children need to be tested for coronavirus.

Cold-like Symptoms

We recommend testing only for those with a continuous cough, fever, or loss of or change in the sense of taste or smell. The UK senior clinicians continue to keep the symptoms for case definition under review and will continue to use evidence to adjust these if it becomes necessary.

COVID-19 Symptoms

The key symptoms to be aware of are:

A new continuous cough
fever/high temperature
loss of, or change in, sense of smell or taste

If a young person or a child in your care develops any of the above symptoms, they should self-isolate and you should book them a test as soon as possible using the online portal at NHSinform.scot/test-and-protect, or by calling 0800 028 2816.

Education Secretary John Swinney said: “We know that many concerned parents, acting in their children’s best interests, have been keeping children off school. Parents, carers and schools need clear and simple national information, and that is why we are providing further advice today.

“It is critical that we remain vigilant for the symptoms of COVID-19 and this information explains the actions that we should take if someone develops signs of COVID-19 symptoms, either at school or at home.

“We will ensure that pupils, teachers and other school staff get the support they need to remain safe and feel comfortable in the school environment.”

Read National Clinical Director, Jason Leitch, letter here.

Clear information has also been published on the Parent Club website.

Link to relevant NHS Inform web page.

Guidance on how COVID-19 symptoms differ from those of other infections circulating at this time of year, from Scotland’s National Clinical Director:

Common cold and COVID-19 symptoms

To parents/carers

I understand these last few months have often been challenging, particularly for parents and carers. Now that schools and nurseries have returned I am writing to provide some advice where a child or young person in your care presents with symptoms of the common cold or similar bugs during this pandemic.

Following the return of schools after a prolonged break, it is common for colds and similar viral infections to circulate. In many cases, children will be well enough to attend school and continue their learning with little or no interruption to their education. In other cases, for instance where they have quite a heavy cold, they may need to take a day or two off to recover.

This is not the case for children and young people with potential COVID-19 symptoms, they are required to self-isolate and seek a test through www.NHSinform.scot/test-and-protect or by calling 0800 028 2816.

In order to ensure your children do not miss out on their education, it is important to be clear about how COVID-19 symptoms differ from those of other infections that we normally see circulating at this time of year.

COVID-19 symptoms

It is important that all of us – including those who make up the community around a school – are vigilant for the symptoms of COVID-19 and understand what actions we should take if someone develops them, either at school or at home.

The main symptoms to be aware of are:

new continuous cough
fever/high temperature
loss of, or change in, sense of smell or taste

If a young person or a child in your care develops any of the above symptoms, they should self-isolate and you should book them a test as soon as possible at www.NHSinform.scot/test-and-protect, or by calling 0800 028 2816.

We recommend testing only for those with a continuous cough, fever, or loss of or change in the sense of taste or smell. The UK senior clinicians continue to keep the symptoms for case definition under review and will continue to use evidence to adjust these if it becomes necessary.

It is essential that people who have COVID-19 symptoms, or who share a household with someone who has symptoms, do not attend school, nursery or other childcare settings, and must self-isolate along with all members of their household. If the test is negative, self-isolation can end for everyone. If the test is positive, Test and Protect will give you further advice.

Cold-like symptoms

If, however, your child does not have symptoms of COVID-19 but has other cold-like symptoms, such as a runny nose, they do not need to be tested and they and you do not need to self-isolate. Your child can go to school if fit to do so.

The Scottish Government appreciates the huge effort being made by parents, carers and school staff to ensure the risk of COVID-19 is minimised and to support children’s education.

Further information

For further advice please visit the Parent Club website at: www.parentclub.scot or www.nhsinform.scot.

Professor Jason Leitch
National Clinical Director
Scottish Government

UK-wide study shows children with gastrointestinal symptoms should be included in COVID-19 testing strategies

‘we may want to consider refining the testing criteria for children to include GI symptoms’

Over 1,000 children from Northern Ireland, Scotland, England and Wales, known as ‘COVID Warriors’ have had their antibodies measured in the UK-wide trial called ‘Seroprevalence of SARS-Cov-2 infection in healthy children’.

The findings were published on Friday (28 August) as a pre-print on the server medRxiv.

The study is led by Queen’s University Belfast, in partnership with the Belfast Health and Social Care Trust Northern Ireland and Public Health England.

The aim of the study, which began in May and is ongoing, is to assess the number of children who have had COVID-19, the symptomatology of infection and if those children have antibodies that may be able to fight off the infection.

To conduct the study, the researchers are measuring children’s COVID-19 antibodies via blood tests at baseline, with further tests planned at two months and six months.

The researchers have found that following the first wave of the pandemic, seven per cent of the children tested positive for antibodies, indicating previous infection with COVID-19.

Half of the children with COVID-19 reported no symptoms, and gastrointestinal (GI) symptoms (such as diarrhoea and vomiting) were also more common than cough or changes in the children’s sense of smell or taste, which may have implications for the testing criteria used for children.

The findings also showed young children under 10 years of age were just as likely to have evidence of prior infection as older children, and that asymptomatic children were just as likely to develop antibodies as symptomatic children.

Dr Tom Waterfield, researcher from the Wellcome-Wolfson Institute for Experimental Medicine at Queen’s University Belfast and lead on the study said: “Following the first wave of the pandemic in the UK, we have learnt that half of children participating in this study are asymptomatic with SARS-CoV-2 infection, and those with symptoms do not typically have a cough or changes to their smell/taste, with GI upset a far more common symptom.

“This study has shown that we may want to consider refining the testing criteria for children to include GI symptoms.”

Health and Social Care Research & Development Division (HSC R&D Division) of the Public Health Agency plays an ongoing role in supporting the conduct of high-quality health and social care research and has provided funding to support the delivery of this important study.

Professor Ian Young, Chief Scientific Advisor and Director of HSC Research and Development said: “Research studies are vital at this time, and thanks to efforts such as the COVID Warriors study, we now know more about COVID-19 in terms of the exposure of children in the UK to the SARS-CoV-2 virus since the pandemic began.

“These significant findings can now be explored further as this research continues to monitor community transmission in children, to help tackle the spread of COVID-19.”

The study is supported by funding from HSC R&D Division, Public Health Agency, The Belfast Health and Social Care Trust and is also subsidised by a donation from the Queen’s Foundation thanks to a past graduate of the University through a charitable gift in their will.

It is being delivered in partnership with The Belfast Health and Social Care Trust, Public Health England, the Ulster Independent Clinic, NHS Glasgow and Greater Clyde, Manchester University NHS Foundation Trust and Cardiff and Vale University Health Board.

Public message about Covid testing

NHS Greater Glasgow and Clyde’s Public Health team has made an appeal, following a rapid rise in requests for Covid-19 tests.

The following advice is good for people living in other NHS Scotland areas too, including NHS Lothian.

Since schools went back recently there has been a sharp spike in testing requests, particularly from parents concerned for their children.

Dr Linda de Caestecker said: “In order to ensure we do everything we can to prevent a rise in cases, we need to remind people how the testing system works.

“Firstly, only people who are symptomatic need a test unless you are explicitly asked to get a test by public health as part of the management of an outbreak.

“The symptoms are the onset of a persistent cough, or a temperature/fever or a loss of taste or smell. You only need one of these to be tested. This can be done by calling 0800 028 2816 or visiting the NHS Inform website – www.nhsinform.scot. You do not need to call NHS 24 to organise a test.

“I also want to stress that while family members need to self-isolate if someone in their household develops symptoms, they do not need to be tested unless they themselves go on to develop symptoms.

“If you are contacted by Test and Protect to tell you that you are a close contact of somebody with Covid-19, you do not require a test but you must isolate for 14 days. A test will not change the need to self-isolate.

“Another important point is if you do develop Covid symptoms and are ill and are worried about your health, you should call NHS 24 on 111. Please do not call NHS 24 unless you feel you need medical advice to deal with your illness.

“I want to thanks everyone for their continued patience with the system. We all need to work together as we enter this next phase in the fight against the virus.”

Please note you should only call 0800 028 2816 to book a test if you do not have access to the internet.

First of 11 planned walk-through sites set up

People who suspect they may have coronavirus (COVID-19) will be able to receive a test at a walk-through testing centre.

The clinically-approved and risk-assessed model means people can access testing in semi-permanent centres, both indoor and outdoor, just days after a site has been agreed.

Work has begun to set up the first of eleven sites planned to be up and running before winter.

Appointments will be available through NHS Inform to students and the wider community for the first of these, to be housed in the Victory Memorial Hall in St Andrews. Testing is expected to commence at this site in the coming days.

Consideration of location of the further 10 sites which will be easily accessible by bike, wheel or foot is underway including in the Highlands, Glasgow and Edinburgh.

Health Secretary Jeane Freeman said: “Containing and suppressing this virus relies on testing being accessible to everyone. These walk through testing centres will further increase Scotland’s testing capacity ahead of potential spikes as we move into winter.

“They can be operational in a matter of days, and we are working at pace with NHS National Services Scotland and local authorities to roll out more across the country so that more people have access to local testing.

“We will continue to adapt our testing strategy in line with the different stages of the pandemic. However, testing is only one effective intervention that we are using to manage the virus and it remains vital that people continue to follow physical distancing advice and practise good hand and cough hygiene not just for their own safety but in order to protect others.”

NHS Fife Deputy Director of Public Health Dr Esther Curnock said: “The new walk-in testing site in St Andrews is an important resource for the local population and will play a vital role in helping to limit the spread of the virus in north-east Fife.

“With the prevalence of COVID-19 now much lower than it was at its peak, it is easy to think that the virus in no longer a risk to our health, however, that is far from the case.

“It is crucial, therefore, that people arrange to be tested as soon as any symptoms develop, such as a new continuous cough, a fever, or a loss or change in the sense smell or taste, and isolate immediately rather than waiting on the result of their test.”

Scotland’s COVID-19 Testing Strategy.

Professor Sally Mapstone, Principal of the University of St Andrews, said: “We’ve been in discussions for some time with the Scottish Government and NHS Fife about local testing facilities, and this is a positive and prudent development.

“The new testing centre will support the many steps the University is taking to keep our staff, students and local community safe, including our own Covid Rapid Response Service which will support quarantining and contact tracing, and monitor adherence to public health guidelines.”

Co-Leader of Fife Council Cllr David Alexander said: “We are delighted to have been involved in getting one of Scotland’s first walk-in test centres up and running in St Andrews.

“With a high student population, a huge turnover of tourists and a centre of hospitality, St Andrews seemed to be an obvious choice for a test centre like this.”

Co-Leader of Fife Council Cllr. David Ross added: “These facilities are accessible for everyone in the area and will provide an invaluable resource in the fight against the spread of Covid-19 in our communities.”