Tag: public health

Coronavirus tracing app to be launched on Isle of Wight today

Isle of Wight residents will be the first to get access to a new contact tracing app as part of government action to minimise the spread of COVID-19.

  • Isle of Wight announced as first phase of new ‘test, track and trace’ programme
  • Rollout of NHS COVID-19 App to begin with the island’s NHS and council staff tomorrow, with all island residents to get access from Thursday
  • Data privacy and security paramount, with National Cyber Security Centre involved in app development
  • The app will be complemented by enhanced contact tracing using existing methods online and over the phone

Isle of Wight residents will be the first to be offered access to a new contact tracing app, as part of government action to test, track and trace to minimise the spread of COVID-19 and move towards safely reducing lockdown measures.

Everyone on the island will receive access to the official NHS COVID-19 contact tracing app from this Thursday, with NHS and council staff able to download from 4pm tomorrow, Tuesday 5 May.

Part of a new test, track and trace programme, the app will work together with enhanced contact tracing services and swab testing for those with potential COVID-19 symptoms to help minimise the spread of COVID-19.

Developed by NHSX, the technology arm of the health service, and a team of world-leading scientists and doctors, the app is designed to significantly speed up contact tracing, helping reduce the chance of the virus spreading by enabling us to rapidly identify people most at risk of infection so they can take action to protect themselves, the people they care about and the NHS.

When someone reports symptoms through the app, it will detect any other app users that the person has been in significant contact with over the past few days, including unknown contacts such as someone they may have sat next to on public transport.

The app will be able to anonymously alert these contacts and provide advice, including how to get a test to confirm whether or not they do have COVID-19. Users will be able order tests through the app shortly.

For those who may not have access to the app, or the ability to use a smartphone, there will be an option to report symptoms and order tests in other ways. As the integrated service develops, everyone who reports symptoms, including app users, will also be asked to record recent contacts using an online service (or through a telephone interview if they prefer), so that contact tracers can reach all contacts who may be at risk, whether or not those contacts are app users. Contacts will then be alerted either by the app or by email or telephone, advising them to self-isolate or offering public health advice.

As the test, track and trace programme rolls out nationally, expected in mid-May, Public Health England will oversee the deployment of 18,000 additional contact tracers to support the programme.

This first phase is a major step forward in the UK government’s next phase of the coronavirus strategy and will improve understanding of how this new integrated approach to test, track and trace will work for the rest of the population.

NHS and council staff will be emailed a download link on Tuesday afternoon. From Thursday the app will then open for all residents on the Isle of Wight. All households will receive a leaflet with clear instructions on how to download and use the app on Thursday, and a targeted marketing campaign will begin on Friday.

Health and Social Care Secretary Matt Hancock said: “The Isle of Wight is playing a vital role with this pioneering work to help keep Britain safe. This will pave the way for a nationwide roll-out when the time is right.

“Coronavirus is one of the greatest challenges our country has ever faced and this app will play a vital role in getting Britain back on her feet.

“The app will help control the spread of coronavirus by alerting people they may have come into contact with it and recommending appropriate action.

“This ground-breaking technology, combined with our heroic frontline health and social care staff, and both a nationwide contact tracing testing programme will ensure that we remain in the best position to move toward easing the lockdown.”

Matthew Gould, Chief Executive of NHSX, said: “Technology can help us get the country back on its feet.

“By launching the NHS COVID-19 app we can reduce transmission of the virus by alerting people who may have been exposed, so they can take action to protect themselves, the people they care about and the NHS.

“When combined with testing and enhanced web and phone contact tracing, this will help the country return to normality and beat coronavirus.”

Deputy Chief Medical Officer, Professor Jonathan Van Tam, said: “By widespread testing those suspected to be infected with coronavirus, tracing their contacts and where appropriate advising them to self-isolate, we can slow the onward spread of the virus.

“This new app-based system, developed by technology experts in partnership with clinicians and scientists, will run alongside traditional contact tracing by PHE. If uptake and use is widespread it will give us the greatest room for manoeuvre to ease other social distancing measures.

Dr Yvonne Doyle, Medical Director and Director of Health Protection at Public Health England, said: “Alongside the NHS COVID-19 app, PHE’s phone and web-based contact tracing will be a critical part of the government’s strategy to get the country back on its feet.

“Taking these first steps on the Isle of Wight will help us prepare for a scale up of our contact tracing capacity, with an 18,000 strong team ensuring the contacts of confirmed COVID-19 cases are followed up and given the information they need.”

The government has collaborated internationally and learned from examples of best practice across the world, which has informed the development of a bespoke approach that is right for the unique needs of the UK. The app uses similar Bluetooth low energy technology to that employed by Australia, Norway, and Singapore among others.

The privacy and security of users’ data is a priority and NHSX has involved experts from the National Cyber Security Centre to advise on best practice through the app’s development. Data will only ever be used for NHS care, management, evaluation and research and the NHS will comply fully with the law around its use, including the Data Protection Act.

The Isle of Wight was chosen to trial the project because it has a single NHS trust that covers all NHS services on the island.

Its geography as an island with a sizeable population makes it an ideal place to introduce the NHS COVID-19 app and wider testing service in its initial roll-out period.

Isle of Wight Council leader Dave Stewart said: “On behalf of the island I am very pleased we can be the first place to use this new digital technology in the country.

“I have always been keen to ensure we keep our special community safe from the virus but at the same time explore ways to enable us to get back up on our feet and move forward from it. This scheme offers the tightly controlled approach we need to help us do just that.

“Widespread tracing and testing holds the key to this ambition and if we are able to help the country move forward then the island will also have done its part in helping government in tackling this virus and re building our lives through safe social distancing when the time is right.

“I am sure islanders will rise to the challenge and help avoid post lockdown spread of the virus and keep people as safe as possible.”

The ambition of test and trace is to enable the UK to start to come out of some elements of lockdown. This will be a gradual process and public health experts are considering how best to do this in a way that keeps citizens safe and protects the NHS.

First Minister: ‘Test, trace, isolate, support’

Statement given by First Minister Nicola Sturgeon at a media briefing in St Andrew’s House, Edinburgh on Monday 4 May:

Good afternoon everybody. Thank you again for joining us for this briefing.

I want to start by updating you on some of the key statistics in relation to the virus in Scotland.

As at 9 o’clock this morning, I can confirm that there have been 12,226 positive cases confirmed – which is an increase of 169 from the figures reported yesterday.

A total of 1,720 patients are currently in hospital with either confirmed or suspected cases of COVID-19 – that is an increase of 54 from yesterday.

A total of 99 people last night were in intensive care with confirmed or suspected COVID-19, and that is no change since the figures yesterday.

I am also able to confirm today that since 5 March, a total now of 2,780 patients who had tested positive and been hospitalised for the virus have been able to leave hospital, and I wish all of them well.

Unfortunately though I also have to report that in the past 24 hours, five deaths have been registered of patients who had been confirmed through a test as having the virus, and that takes the total number of deaths in Scotland, under that measurement, to 1,576.

I’d ask you to bear in mind, though, that today’s figure might be artificially low due to the lower levels of death registration that we know takes place at weekends.

And, as always, I want to stress that these numbers are not just statistics, and we should never, ever view them as such.

They represent unique and irreplaceable individuals who are being mourned and missed by their loved ones. So I want to send my deepest condolences again to everyone who is coming to terms with a bereavement as a result of this virus.

I also want to thank – again – our health and care workers. The entire country continues to appreciate the extraordinary work that you are doing.

Now, I have one issue that I want to update you on today. As you know, Thursday this week is the date by which we must review the current lockdown measures.

I’ve said already that it is very unlikely that any change this week will be possible.

Although we are making real and significant progress, and that is definitely the case, the numbers still being infected by the virus, and the all-important R number, remain too high, right now, to make any meaningful change without risking the virus running quickly out of control again.

We also know – as we see on Skye today – that care home transmission continues to be a very significant challenge, and the Health Secretary will say a bit more about that shortly.

So all things considered, and while – let me stress – decisions are yet to be formally taken, it is very likely that on Thursday I will be asking you to stick with lockdown for a bit longer.

Now I know you understand why that is the case – but I also know it is really hard. And I know that, even as you comply with these measures, you do want to see light at the end of the tunnel.

So today and tomorrow – building on the paper we published a week and a half ago – I want to share with you some of the work we are doing to make sure that we will be in a position to make changes to the lockdown restrictions just as soon as the evidence tells us that it is safe to do so.

Tomorrow, I will set out our current assessment of levels of infection and the R number and also, in general terms, the possible changes that the Scottish Government will be considering ahead of the next review date of 28 May as we do try to get a degree of normality back into our lives while being careful still to suppress the virus.

This is work we will of course be seeking to align as far as possible with the other UK nations but, as I’ve said before, our primary task is to make sure that we are making the right decisions, at the right pace, for Scotland.

Now, that is what I will set out tomorrow, but today I want to outline what will be a key part of the approach we take when we have sufficiently suppressed the virus and are able to start moving into the next phase – and that is called ‘test, trace, isolate’ approach, or TTI for short.

In summary, TTI involves anyone who has symptoms indicative of COVID-19 immediately isolating themselves, as everybody is meant to do right now, quickly getting in touch with the NHS to arrange a test, and also sharing details of the people that they’ve been in contact with.

Professionals called contact tracers then get in touch with those contacts to advise them to isolate for 14 days. And if any of them develop symptoms, they get tested and the process starts again with their contacts.

It is all about breaking the chain of transmission of the virus – but without all of us being confined to our homes all of the time, as is the case right now.

Now we have just published a short paper outlining this approach in more detail – and I encourage you, if you are able to, to read it at www.gov.scot – but I wanted to set out a few key points today, I suppose, to get you thinking about it.

And the reason I’m really keen for you to think about it is this – a test, trace, isolate approach will only work if you, the public, are willing to do what we ask of you.

So it’s really important to start building your knowledge of and confidence in such an approach now – as part of that grown up conversation you know that I am keen to have.

The initial key point I want to make is that a successful TTI approach depends on us first suppressing the virus to as low a level as possible.

If infection rates are too high, or if they get too high again in future, the number of people with symptoms and who will need tested could overwhelm the system – even with a vastly expanded testing capacity.

Second, TTI will be a key part of our approach – but it will not on its own keep infection rates down or the R number below one. It’s not a quick fix or a magic solution.

It will have to be combined with continued physical distancing, rigorous hygiene and the appropriate use of face coverings.

And crucially, it will mean you, the public, knowing exactly what it is we are asking you to do, and why we are asking you to do it, and being prepared to do it.

That means if you have symptoms, you need to recognise them and be willing to isolate, to contact the NHS and get tested and also be prepared to share details of anyone you’ve been in contact with.

And for all of us, it will mean being prepared to isolate for 14 days if we are contacted and told that we’ve been in close proximity to someone with the virus. And that, of course, could happen multiple times, with significant disruption to our lives.

We also know that some people will need support to isolate and we are considering how we can provide that, drawing on the arrangements that are currently in place for the shielded group.

It’s also why, as you will see if you read the paper, we are calling this approach in Scotland ‘test, trace, isolate, support’.

We are also making the other preparations now to be in a position to start delivering an enhanced TTI approach by the end of this month.

Firstly, that means continuing to expand our testing capacity. You’ll recall that I told you on Friday that by the middle of this month, we expect to have the capacity to do 12,000 tests per month in Scotland. Our initial estimate – though it is important to stress this is still being refined – is that we will need to get to around 15,500 tests a day just to support TTI. So it is very clear that continued ongoing expansion will be needed to meet all of our testing requirements.

We also estimate we will need up to 2,000 additional contact tracers to do the work that will be required.

We are also building a digital system to make sure as much of this process as possible can be automated.

Now, you might also have heard talk of an app as part of TTI, and I want to address that briefly too, because that’s separate to the kind of digital approach that I’ve just mentioned.

The kind of app being talked about – a proximity app – would operate on Bluetooth technology. If you download it and then you tell it that you have symptoms, it would automatically alert anybody that you’ve been in close contact with, as long, of course, as they have also downloaded the app.

The development of this app is being led by the UK government and we are seeking to maximise Scottish Government involvement in it. We believe it could be a very important part of a TTI system – but as an enhancement. It is important to be clear that in Scotland we are not building our whole system around that.

We know that the success of an app like that will depend on high take up by the public – and that in turn will depend on building confidence in the technology and in the use of data. So we want to do that very carefully indeed.

So I hope today, albeit very briefly, I have given you a sense of what TTI involves. Because it is something you will increasingly be hearing talked about.

And we will give updates on progress and further detail in the days and weeks to come.

But this will be an important tool in our efforts over the next few weeks to get some normality back into our daily lives – so please, if you can, do take the time to read the paper, which as I said earlier you will find on www.gov.scot.

My last point for now is this one. The work I am sharing with you today and I will share with you tomorrow is for the future – and the hard fact is that we will only be in a position to implement it if we continue to suppress the virus now.

So I ask all of you to please stick with the lockdown rules.

Over the weekend, I received quite a lot of emails from people worried that the roads were busy again, and that there were too many people on the streets and in parks.

I have to be honest with you I share that concern, though, don’t get me wrong, I fully understand the frustrations that all of you are feeling.

But in a few weeks I desperately want to be standing here at this podium telling you about the steps we are able to take to get back to a semblance of normality. My big worry is that if we ease up now, I won’t be able to do that.

So please stay at home, except for essential purposes like shopping for food or getting medicines.

Stay two metres apart from others when you are out for essential purposes.

And please don’t meet up with people from other households, and if you are displaying symptoms or anyone in your household is displaying symptoms of COVID-19, then please completely isolate and don’t even go out for essential purposes.

What I am asking you today is please make sure we keep that light at the end of the tunnel on – and let’s all keep making sure that it gets brighter with every single day that passes. Please don’t risk extinguishing that light by easing up to quickly.

So thank you very much for your continued compliance, and tomorrow I will share a bit more with you about the current state of the virus, and what we might be able to consider in the weeks to come.

But for now I’m going to hand over to Professor Jason Leitch, our National Clinical Director, to say a few words, and then the Cabinet Secretary for Health will say a little bit about care homes.

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More mental health support after forty days of lockdown

Key mental health services to support families, young people and autistic people are to receive more than £1 million additional funding.

Health Secretary Jeane Freeman made the announcement yesterday after 40 days of lockdown when many people have felt an effect on their mental health.

The allocation of funding comprises:

• £768,000 for a relationships helpline to be delivered by The Spark counselling service
• £105,000 to support Young Scot to develop enhanced digital content and resources on mental health
• £205,000 to support 47,000 autistic people across Scotland, including funding to increase capacity at the Scottish Autism Helpline and help for the National Autistic Society to keep people in touch online during lockdown

Ms Freeman said: “While everyone is experiencing different challenges at this time, the mental health of children, young people and families can be put under great strain.

“We appreciate that spending a lot of time together in isolation and home-working, home-schooling and juggling childcare can be really tough.

“This crisis means many people are dealing with anxiety, fear, uncertainty, anger or sadness. They may feel overwhelmed and relationships can be placed under a lot of pressure.

“We want to ensure that the right help and support is in place for the mental wellbeing of our children, young people and families. This package of measures focuses on prevention and recovery, and on maintaining healthy relationships throughout the current restrictions. It follows the launch of our national campaign, Clear Your Head, last week.”

The Clear Your Head campaign highlights practical ways to look after mental health and wellbeing while continuing to stay at home – and signposts sources of help and advice.

The Spark is a third sector organisation which delivers counselling services to families across Scotland, including relationship and couples counselling and counselling for children and young people.

They currently operate a Relationship Helpline on a small scale for nine hours a week. The number of the Relationship Helpline is 0808 802 2088 and this additional funding will enable the helpline to operate Monday-Thursday 9am to 9pm and Friday 9am to 4pm.

Scotland has launched a digital resource called Mind Yer Time specifically to help children and young people learn about the healthy use of screens and social media.

It supports mental and physical health online and was developed by the Scottish Youth Parliament and Children’s Parliament. In the first ten days since its launch the guide had almost 13,000 views.

The additional funding will allow the Scottish Autism Helpline to open 8am-8pm, seven days a week on 01259 222022.

Testing: the picture in Scotland

A further expansion of coronavirus (COVID-19) testing in Scotland has been announced as it was confirmed that the target to reach capacity for 3,500 tests a day across NHS labs has been exceeded.

On Friday, it was announced that the normal daily capacity for analysing tests in Scotland had now reached 8,350. This figure is made up of 4,350 NHS tests and 4,000 from the Glasgow Lighthouse Laboratory.

The First Minister confirmed the numbers as she announced testing in Scotland will be expanded to include:

  • enhanced outbreak investigation in all care homes where there are cases of COVID – this will involve testing, subject to individuals’ consent, all residents and staff, whether or not they have symptoms. Where staff work between homes run by the same operator, testing will also take place in those homes following a risk assessment
  • sample testing in care homes without cases of the virus. This will involve testing of some asymptomatic residents and social care workers
  • testing through the regional testing centres and mobile units of symptomatic over 65s, and those with symptoms who cannot work from home and need to leave their homes to work. Households of these two groups will also be eligible for tests where they have symptoms. The online booking system for these tests is being updated and tests will be available over the weekend
  • Health Protection Scotland will introduce antibody testing as part of enhanced surveillance testing. Antibody testing detects whether somebody is likely to have had the virus more than two weeks ago. It takes approximately two weeks for the immune response to fully develop. Starting next week, blood samples from across Scotland will be tested as part of this enhanced surveillance enabling us to learn more about the virus and gain an understanding of how it is spreading through the population in Scotland

First Minister Nicola Sturgeon said: “At the start of this outbreak, only two laboratories in Scotland carried out tests. Now there are labs at all 14 health boards, we have exceeded our target to test 3,500 samples a day in the NHS and, working with the Lighthouse Lab at Glasgow University, capacity for testing in Scotland has now reached 8,323 and is on track to expand further this month.

“Given that our capacity has now expanded significantly, that means we can further extend eligibility for testing.

“We now intend to undertake enhanced outbreak investigation in all care homes where there are cases of COVID-19 – this will involve testing, subject to individuals’ consent, all residents and staff, whether or not they have symptoms. In addition, we are testing symptomatic over 65s as well as those who need to leave their homes to work.

“We are also expanding the surveillance testing programme to include antibody testing. This is another tool which will allow us to monitor the proportion of people exposed to COVID-19 and help tackle its spread across the population.”

Testing at Regional Testing Centres and mobile units

In addition to key workers currently eligible, all symptomatic over 65s and household and those of any age who are symptomatic who need to leave their homes to work and household will have access to tests.

Tests will be booked through the UK Government’s on-line system at https://self-referral.test-for-coronavirus.service.gov.uk/ and will be conducted at five regional drive-through test sites in Glasgow, Edinburgh, Aberdeen, Inverness and Perth and at mobile test sites being initially located at a number of locations including Motherwell, Dunoon, Prestwick, Stranraer, Galashiels, Peterhead and Elgin. At times a queuing system may have to be put into operation on the website for those locations where demand is highest. This is monitored regularly.

Serology stream of the enhanced surveillance programme (antibody testing)

The serology stream of Health Protection Scotland’s enhanced surveillance programme will run for at least 16 weeks and will initially involve six NHS boards; expansion into other boards is also planned.

Approximately 500 residual blood samples from biochemistry laboratories (submitted from primary care) will be tested per week at the Scottish Microbiology Reference Laboratory in Inverness. To ensure comparability with other UK data, HPS will be using similar methodology originally developed by Public Health England. To achieve a fair representation of the Scottish population, the initial samples will be distributed across the six participating boards, and by age-group and sex.

Laboratory capacity to process tests in Scotland on 30 April 2020

NHS Scotland Labs: 4,350 tests

Glasgow University Lighthouse Laboratory: 4,000 tests

Total current capacity in Scotland: 8,350 tests.

Target was 3,500 by end April.

Note:

Since the start of the Coronavirus outbreak, NHS lab capacity has been increased from two NHS labs (Glasgow and Edinburgh) with total capacity to do 350 tests a day, to a point today where there is lab testing capacity in all 14 health board areas.

NHS Scotland labs – this figure represents maximum capacity. Capacity may fluctuate – and exceed testing demand – on a daily basis for a number of reasons. We work closely with health boards to improve the efficiency of the testing system and the National Labs Programme (led by NSS) is leading work to optimise the capacity utilisation of the system.

The capacity of NHS Scotland labs is projected to increase to at least 8,000 by the middle of May.

Coronavirus (COVID-19): how to get tested

First Minister: Please, please stick to restrictions

Statement given by the First Minister Nicola Sturgeon at a media briefing in St Andrew’s House, Edinburgh, on Thursday, 30 April:

Good afternoon. Thanks for joining us for today’s briefing.

I want to start – as I always do – by updating you on some of the key statistics in relation to the spread of the virus in Scotland.

As of 9 o’clock this morning, there have now been 11,353 positive cases confirmed – that is an increase of 319 since yesterday.

A total of 1748 patients are currently in hospital with either confirmed or suspected cases of COVID-19 – that is an increase of 21 from yesterday.

A total of 109 people last night were in intensive care, again with either confirmed or suspected cases. That is a further decrease of 5 since yesterday.

I am also able to confirm today that since 5 March, a total of 2,538 patients who had tested positive for the virus and been admitted to hospital as a result, have now been able to leave hospital.

However, on a sadder note, I also have to report that in the last 24 hours, 60 deaths have been registered of patients who have been confirmed through a test as having the virus – that takes the total number of deaths in Scotland, under that measurement, to 1,475.

These numbers, as I stress every single day, are not just statistics. They represent people who are right now deeply missed by the friends, families and their wider network of loved ones. So once again, I want to send my deepest sympathies and condolences to everyone who has lost a loved one to this virus, we are all thinking of you at this time.

I also want to thank – as I always do – our health and care workers. At 8 o’clock this evening I will join with many others in applauding our health and care workers, in what I think has become a very precious and very special moment in the week.

And to health and care workers, I hope that this shows you, albeit in a symbolic way, just how grateful everybody across the country is for the extraordinary and very courageous work that all of you are doing.

There are two things I want to talk about today. First of all, I want to take the opportunity to emphasise the vital importance of sticking with the lockdown restrictions at this time.

I set out last week our decision making framework for starting – slowly and gradually – to ease aspects of the lockdown when it is safe to do so, and the factors and uncertainties we will have to take into account as we make these difficult decisions.

I promised to be open with you as our thinking and our decision making develops and I absolutely will be. I intend to update you again next week – ahead of the official review date of 7 May – on our considerations and judgements so far. I am very grateful to all of you have taken the time to send us views on the paper that we published a week ago today.

But part of the grown-up conversation I want to have involves me being willing, when necessary, to deliver tough messages as well as hopefully the more positive messages about how, when it is safe to do so, we can start the journey to what I described last week as a ‘new normal’, and start to reduce some of the harms to the economy and our well-being that we know the lockdown restrictions are having.

Right now, that means I have to be straight with you that it may very well be too early, even this time next week, in any meaningful way, to safely lift any of the current restrictions.

I want to share with you the reasons for that.

We have worked very hard as a country to bring down the transmission rate of this virus – and we are definitely seeing results from those efforts.

In fact we see that fewer people are now in intensive care than two weeks ago, and that figure appears to be reducing now on an ongoing basis, and hospital admissions, although they are fluctuating as you see today, are also on a slowly reducing curve.

Overall, we think that transmission in the community of the virus has been reduced very significantly as a result of the lockdown – although of course we know that it remains higher in settings such as care homes.

The R number which you hear us talk about – the rate at which the virus reproduces – is, we believe, now below 1. Remember, that at the start of lockdown, we think it was above 3. So that is real and very positive progress.

And that progress matters. With the R number below 1, that means every 100 people with the virus, between them pass it on to fewer than 100 more people and so on – and so the total number of cases will gradually decline.

We do think that is happening now. However we are not confident that the R number is very far below 1. That means any easing up at all in the current restrictions – either formally by government decisions, or informally by people becoming a bit less compliant as we all get more and more weary and frustrated – would quickly send it back above 1. Indeed, there have been reports in the last day or so from Germany that their R number is rising again as a slight easing up there has been taking effect.

And if the R number does go back above 1 – let’s say it goes to even 1.5 – then our 100 people from a moment ago would between them transmit the virus to 150 people, they in turn pass it on to 220 people and so on and so on, and suddenly the virus is spreading exponentially again.

That would mean more people in hospital and in intensive care and even more people dying.

So the point I am making today is not an easy one, but it is an essential one. The progress we have made is real and it is significant, but it is still very fragile. The margins we have for ensuring the virus does not take off again are really, really tight. That means we must be very cautious at this stage.

That’s why it’s so important that everyone sticks with the restrictions. In recent weeks people have been absolutely superb at doing that – and I will never be able to tell you how grateful I am to all of you for that. You are the reason that the NHS has not been overwhelmed, as I really feared a few weeks ago that it might be, and by sticking to the guidance,  you have undoubtedly saved lives.

However we are now seeing slight increases in people using our roads. In addition, more people are using concessionary bus travel than a few weeks ago. Both of these trends are from low starting points, but they are still sources of some concern.

For example the number of people who are using concessionary transport increased by almost 1/6 last week.

The car traffic we’ve observed on major roads is less than 1/3 of its pre-lockdown levels, but it has increased this week by about 5% this week, compared to last week. On some town and city roads, traffic has been 10% higher than in the week before.

So what I am asking all of you to do today, and you know the reasons that I am asking you to do this, is think about whether or not it is the case that right now you are a little bit more active than you might have been at the start of the lockdown, and to ask yourself why that is the case.

Was your journey really essential? You might think it’s only you making an extra journey, and that it’s only one trip – and you might well feel you deserve it after weeks of restraint. Believe me, I really understand all of that. But all of it adds up – and the fact remains that if everyone eases off, the virus will quickly take off again and it will have devastating consequences for all of us.

I know this is a long haul – I know that people want to travel a bit more, I know that children want to spend more time outside. I absolutely know that every grandparent is desperate to see and to hug their grandchildren. But as things stand, our progress against the virus, albeit very real progress, is too fragile for us to let up.

But the more we do stick to the lockdown, the more we will reduce the R number below 1, and the lower it goes, the more scope we will have to ease the lockdown measures in future.

So please, I am asking you again, stay at home – except for essential purposes.

If you do leave home, remember to stay more than 2 metres away from other people, and don’t meet up with people from other households.

If you have any symptoms of the virus, you and your household should isolate completely. And everybody should still be washing their hands regularly and thoroughly.

By sticking to all of that, we can keep that R number below 1. We will slow the spread of the virus, protect the NHS, and we will save lives. And – while it might not feel like it right now, and I am pretty sure it doesn’t – we will actually all help each other to come through the other side of this a bit more quickly.

The other thing that I want to update you on, is our support for business.

Today, three new business support funds, which total £100 million, open for applications.

They are part of a wider package of measures to support business, which are worth around £2.3 billion in total.

One of the funds is the Newly Self-Employed Hardship Fund, which is managed by Local Authorities.

It is open to newly self-employed people who are facing hardship but – because they became self-employed in the last year – are ineligible for other support. They will be able to apply for grants of £2,000.

The lack of support for newly self-employed people is something which has been much commented upon – I am glad we can now do something now to give assistance.

The second fund is the Creative, Tourism & Hospitality Enterprises Hardship Fund. This is managed by our Enterprise Agencies with support from Creative Scotland and VisitScotland.

It will provide grants of up to £25,000 for smaller creative, tourism and hospitality companies who do not benefit from business rates relief – for example if they do not have premises which can benefit.

And finally, we have also established the Pivotal Enterprise Resilience Fund, which is again managed by our Enterprise Agencies.

This will provide grants and support to small and medium sized businesses which we think are potentially vital to Scotland’s economic future, or to the economies of certain local areas – but which have been made vulnerable by this crisis.

This is an important way of trying to safeguard our economic future and potential – by ensuring that smaller companies with lots of potential are not driven out of business during this crisis.

Applications for these funds will be open from 2 pm today. We hope that successful applicants will start receiving money in the next couple of weeks.

If you think that you might qualify for one of these grants, you can find more detail at www.FindBusinessSupport.gov.scot

I want to end by re-iterating my earlier message. Please stick to the guidance. I know this is not easy. And when I say that, I am not just saying what I know you want to hear – I really know this is not easy. But it is making the difference: so please, please, stick with it.

Coronavirus: ‘Risk of second wave is very real’

Foreign Secretary Dominic Raab gave the 29 April 2020 press briefing on the government’s response to the COVID-19 pandemic:

Welcome to today’s Downing Street Press Conference. I’m pleased to be joined by Professor Jonathan Van Tam, Deputy Chief Medical Officer, and also Professor Yvonne Doyle, Medical Director at Public Health England.

Let me just start by saying, I think on behalf of us all, huge congratulations to the Prime Minister and to Carrie on the wonderful news of the birth of their baby boy. I’ve spoken to the Prime Minister and I can tell you that both mum and son are doing really well.

Next, let me give an update on the latest data on coronavirus from our COBR data file.

I can report that, through the Government’s ongoing monitoring and testing programme, as of today, there have now been:

818,539 tests for the virus across the UK, including 52,429 tests that took place yesterday.

165,221 people have tested positive, and that’s an increase of 4,076 cases on yesterday’s number.

As the Health Secretary announced yesterday, from today, we are moving to an improved daily reporting system for deaths, so that deaths in all settings are included, wherever the individual has tested positive for COVID-19, rather than just those in hospitals.

And those figures show that, up to yesterday, on the new measure, we have recorded an additional 3,811 deaths in total and I think it is just important to say that those additional deaths were spread over the period from the 2nd March to 28th April, so they don’t represent a sudden surge in the number of deaths.

Sadly today’s figures show an additional 765 deaths compared to yesterday. I will let Professor Doyle talk us through the data in detail. I think we must never lose sight of the fact that behind every statistic, there are many human lives that have been tragically lost before their time.

We also pay tribute, of course, to those caring for the sick, and yesterday at 11am the whole country observed a minute’s silence, a moment to reflect on the sacrifice of all of our frontline workers who have died whilst dedicating themselves to caring for others and serving others.

On 16 April, I set out five principles that would guide our approach to the transition away from the current set of social distancing measures in place, and into a second phase.

We continue to see evidence in the data of a flattening of the peak of the virus, which is only happening because we have delivered on two of the central pillars of our strategic approach to defeating coronavirus.

First, we reinforced our NHS capacity, through the Nightingale hospitals, extra critical care capacity, more ventilator beds and extra doctors and nurses on the frontline.

And, second, we introduced social distancing measures, at the right time, guided by the scientific and medical evidence.

The public’s overwhelming support for those rules has helped to save lives and protect the NHS from becoming overwhelmed.

We are still coming through the peak, and this, as I have said before, is a delicate and dangerous moment in this crisis.

So, I know that a lot of people have made a lot of sacrifices, which is why it is so important that we don’t let up now and risk undoing all of that hard work.

So as we look to the future, our 5 tests remain key.

First, we must continue to boost NHS capacity, preventing it from being overwhelmed.

Second, we need to see a sustained and consistent fall in the number of deaths.

Thirdly, we must see further reductions in the rate of infection to manageable levels, across all the relevant areas and settings.

Fourth, we must be confident that the NHS will be able to cope with future demands, including as a result of any changes to existing measures or new measures we need to take.

Fifth, and this is probably the most critical of all, we need to be confident that any adjustments to the current measures will not risk a second peak of infections that could overwhelm the NHS.

A second spike would be harmful to public health, resulting in many more deaths from Covid-19.

That itself would lead to a second lockdown, inflicting further prolonged economic pain on the country.

And, as the Governor of the Bank of England, Andrew Bailey, said last week, that would not just be economically dangerous, it would inflict a serious blow to public confidence.

This issue of a second spike and the need to avoid it – it’s not a theoretical risk, and it is not confined to the UK.

Having relaxed restrictions in Germany over the past week, they have seen a rise in the transmission rate of coronavirus. And Chancellor Merkel has said publically, and she has made it clear, that they might need a second lockdown in Germany if the infection rate continues to rise.

So, this risk is very real, and it is vital that we proceed carefully, guided by the scientific advice, so that our next step through this crisis is a sure-footed one.

We mustn’t gamble away the sacrifices and progress we’ve made.

We must continue to follow the scientific evidence,

And we must continue to take the right decisions at the right moment in time.

We are working on all of the potential options for a second phase.

There is light at the end of the tunnel – whether you are an NHS worker on the front line working tirelessly shift after shift, or a parent at home with young children.

But we need to be patient and careful as we come through this moment of maximum risk.

So, we will wait for SAGE’s next review of the data in early May.

We’re ramping up the testing, with capacity now at over 73,000 per day, and 52,429 tests carried out per day, and eligibility for those tests has now been expanded further, to include anybody who needs to go to work and can’t work remotely, and who has symptoms.

It also includes anyone over 65 with symptoms and all care home residents, as well as care home staff.

And at the same time as we ramp up the testing capacity, we’ll keep working on our tracking and tracing capability which will be a key component in the next phase of the crisis.

We will continue to source ventilators and personal protective equipment at home and abroad.

Paul Deighton is leading the national effort to increase domestic production and supply.

We continue to source PPE from abroad setting ourselves out as the international buyer of choice. In the last 10 days, we have secured over 5 million masks from China, we’ve had three flights with gowns from Turkey – because we know that every single one of those items of PPE is needed by those working so hard on the front line.

Both in the NHS and also in our care homes.

Our international effort is not confined to procurement. I can tell you we have also made huge progress in returning UK nationals, who otherwise would have been at risk of being stranded abroad.

Since the outbreak in Wuhan, we have helped and estimated 1,3million Britons return on commercial flights.

And we have done that by working with the airlines and with those governments to make sure that the flights can run and that the airspace is kept open.

And we have brought back over 200,000 Brits back from Spain, 50,000 back from Australia, and over 11,000 from Pakistan. To name but just three countries.

As well as those commercial flights, we have also chartered flights, where commercial options weren’t possible,

And we have now reached the stage where we have brought back over 20,000 British nationals on 99 flights from 21 countries and territories

That includes over 9,000 UK nationals back from India, 2,000 home from South Africa, and 1,200 from Peru.

In terms of repatriations it is worth also just bearing in mind that on the 17th March, when we changed our travel advice for those travelling on cruise ships, there were something like 19,000 British passengers on 60 cruise ships sailing around the world.

And as border restrictions were put in place by country after country, we faced a daunting task in getting our people home.

But, we stuck at it, and 6 weeks later, we have now got all 19,000 British passengers back home safe and sound.

That was an enormous effort, and we recognise that the job is not done yet.

And we will continue this unprecedented effort, with further charter flights from New Zealand, Pakistan and Bangladesh, amongst others, over the next week or so.

So, I must pay tribute to the outstanding work of the consular teams working night and day at the FCO in London and at our Embassies and High Commissions around the world.

Finally, the Health Secretary announced last week that UK trials have started, as we draw on the incredible scientific talent we have in this country to pursue a vaccine.

And that effort too has an international dimension to it.

So, today, we announced that the UK will provide GAVI the international vaccine alliance with the equivalent of £330 million each year over the next 5 years as we seek to develop a vaccine both to protect the British people, but also to help immunise millions of the poorest and most vulnerable people around the world,

Combining the depth of our innovative know-how, with the big-hearted determination that has characterised our national effort to defeat the coronavirus.

Further expansion of access to coronavirus testing

Anyone in England with coronavirus symptoms who either has to leave home to go to work or is aged 65 and over will now be able to get tested.

  • Everyone in England aged 65 and over with coronavirus symptoms can now get tested, along with symptomatic members of their household
  • Symptomatic workers who are unable to work from home also eligible for testing
  • Testing of all asymptomatic NHS and social care staff and care home residents also being rolled out
  • New expansion of testing made possible due to rapidly increasing testing capacity

Anyone in England with symptoms of coronavirus who has to leave home to go to work, and all symptomatic members of the public aged 65 and over, will now be able to get tested, the UK government has announced.

This will mean people who cannot work from home and those aged 65 and over can know for sure whether they have coronavirus and need to continue isolating.

Members of their households with symptoms – a new continuous cough or high temperature – will also be eligible for testing.

Anyone eligible can book a test using an online portal.

The government also announced that NHS staff, care home staff and care home residents will be eligible for testing whether or not they have symptoms.

Working with Public Health England, the Care Quality Commission and the Association of Directors of Adult Social Services, the government is piloting sending packages of ‘satellite’ test kits directly to care homes across England to enable testing of residents.

So far, 4,760 tests have been delivered to more than 4,300 locations. In addition, over 25,000 care staff have already been tested.

Secretary of State for Health and Social Care Matt Hancock said: “Expansion of our testing programme protects our most vulnerable and keeps people safe.

“Testing is now available to all over 65s and members of their households, if they have symptoms.

“Any worker who needs to leave their home in order to go to work, and their households, if any of them have symptoms can also get a test. This means construction workers to emergency plumbers, research scientists to those in manufacturing – can now be tested.

“All they need to do is go on the internet and apply for a test.”

Testing for coronavirus helps the government and scientists understand its current spread and plan how to manage the pandemic.

As capacity has increased, testing has been offered to different groups in a phased approach, prioritising NHS workers. However, the ultimate aim is that anyone who needs a test will be able to have one.

Yesterday’s announcement marks a further step towards that goal. It follows the announcement last week that all essential workers with symptoms can now book a coronavirus test, or order a home testing kit, using the new online portal.

There are now more than 40 drive-through testing sites across the country, and, by the end of the week, 25,000 home testing kits will be available for ordering every day.

A network of mobile testing units is also travelling the country to reach care homes, police stations, prisons and other sites where there is demand for testing. The network is expected to reach over 70 units by the weekend.

Since the beginning of April, the government has significantly increased the UK’s coronavirus testing capacity, which currently stands at 73,400 tests per day and is on track to reach 100,000 tests daily by the end of the month.

The response to coronavirus is a national effort. Each of the devolved administrations will have their own eligibility criteria and testing priorities, however the government is working closely to align approaches.

“Some Promising Signs”: Jeane Freeman updates Holyrood

Statement given by the Cabinet Secretary for Health and Sport Jeane Freeman to Scotland’s Parliament yesterday:

Thank you very much Presiding Officer, and thank you for the opportunity to update the chamber on several key areas around our response to COVID-19, and to say something about our future planning.

Today is International Workers’ Memorial Day, and across Scotland many people observed a minute’s silence to particularly honour health and social care staff who have tragically died during this pandemic. A number of our own colleagues in Scotland have lost their life to COVID-19 and my thoughts, and I know those of members across the chamber, are with their families and loved ones.

In the last 24 hours, 70 deaths have been registered of patients who have been confirmed as having COVID-19 – and that takes the total number of deaths in Scotland, under that measurement, to 1,332.

As always, it is so important to remember that behind each one of those numbers is the loss of someone loved and now much missed and I offer my sincere condolences to their families and friends.

Presiding Officer, notwithstanding all of that, we are starting to see some promising signs that the efforts and the sacrifices that the overwhelming majority of people across Scotland have made are having an impact.

The number of patients in hospital with confirmed or suspected COVID-19 has been broadly stable in recent days, and the number of people in ICU with COVID-19 has shown signs of decline.

We should not read too much into all of this yet – these are early days – but these trends are both welcome and cautiously hopeful.

As of today, 50% of adult care homes have reported an outbreak of suspected COVID-19. Last week I set out a series of additional steps to support those who live and work in our care homes.

These steps increase the clinical support focussed on preventing COVID-19 infection and transmission in care homes. Our NHS Directors of Public Health are now providing enhanced clinical leadership and have contacted every care home in Scotland. They are assessing how each home is managing infection control, staffing, training, physical distancing and testing.

We have provided a direct delivery of PPE to care homes and have worked with local partners to significantly improve the operation of local PPE hubs. Whilst the supply of PPE is primarily the responsibility of care home providers in both the private and the public sector, we will continue to provide both top up and emergency provision to ensure staff have what they need and they and the residents have that protection.

Work is also underway to ensure that all COVID-19 patients being discharged from hospital should provide two negative tests before discharge, and that all new admissions to care homes, and all residents who are symptomatic should be tested and those new admissions should be isolated for 14 days.

Social Care and care home staff continue to be priority key workers for testing and I have written to all care homes reminding them of this and asking them to make sure that as employers they follow through where this testing is required.

As members know we also have over 21,000 returning health and social care staff alongside student nurses, student midwives, AHPs and newly graduated doctors, all willing to apply their skills and experience to the collective effort. Many of them are able to work in both the care and the primary care setting. And, as of today, 185 applicants have been matched into roles in care homes and care at home services, and a further 218 are ready and available. I expect the number of matches to increase rapidly in the coming weeks.

As well as those working in care homes to protect our most vulnerable people, I know there are many carers – both paid and unpaid – who are supporting people to stay in their own homes and they, too, must be protected. So we have extended the provision of PPE to Personal Assistants and unpaid carers.

From the start of this week, the local PPE Hubs for the registered social care sector are receiving enhanced supplies and support so that they can distribute to the whole of the social care sector where normal supply routes have failed.

We have published advice for unpaid carers on the appropriate use of PPE and how to access it, and will be publishing equivalent guidance for Personal Assistants shortly.

I have asked the National Carer Organisations and local carers’ centres to discuss with carers their needs, and help us with directing them to their local Hub where they need PPE.

We will ensure Hub locations are clearly signposted on the Scottish Government website and Health and Social Care Partnerships are working with local carers’ centres to make clear how individuals can get the necessary Personal Protective Equipment.

Throughout this difficult time, it is critical that social care support is maintained to ensure the safety, dignity and human rights of people who already receive that support.

In addition to the funding directed towards social care from the 2020-21 budget, I reached agreement some weeks ago with COSLA that we would meet additional costs incurred because of the impact of the pandemic.

That agreement was specifically reached to ensure that both existing and new demand and need could be met. Alongside this, those additional returning staff I mentioned a moment ago are also available for deployment to these services to ensure staffing resilience.

So it is not acceptable to me that care packages are cut – in some instances by 100%.

I expect the steps I have already taken to be used and if there is more that needs to be done to ensure existing packages are not cut and new demand is met, then I hope that colleagues in the sector know that my door is always open and I expect them to come to me with those additional requirements.

I want to turn now to testing. By 22 April, 17,800 health and social care staff, or symptomatic household members, had been tested. 21 per cent of those tested were social care staff.

By the end of April, all 14 Health Boards should have local testing capacity. In terms of testing capacity, we are on track to reach at least 3,500 tests available per day by the end of this month, making steady progress from the start of this pandemic, where capacity was 350 tests per day, from two labs.

We also continue to work with the UK Government on its testing programme, which is expanding both capacity and access in Scotland.

Four UK Government drive-through testing facilities are already operational, with a fifth due to open in Perth this Thursday.

Five mobile testing units manned by army personnel are going live in Scotland this week, and it is anticipated that a further eight units will be live in Scotland within the next week or two.

This increased capacity in our own NHS labs and through that participation in the four nation testing exercise has ensured that we are able to expand the areas and the groups whoa re being tested. So we have increased availability to key workers beyond the Health and Social Care sector using the categories that we have outlined before, and have today also increased testing to all 70-year-old and over admissions to a hospital setting.

In terms of access to the UK four nation exercise, this is controlled through the queueing system managed by the UK Government and through their digital portal.

I want to touch on now on two other issues before I conclude: research and ongoing changes to healthcare delivery.

The pandemic has required fundamental change to how health and care is accessed and delivered. This has involved a significant reorientation of resources, and the incredible support and efforts of local leaders, planners, clinicians – in fact the entire workforce. The work has included:

  • preparing to quadruple ICU beds and ensuring there is sufficient hospital bed capacity
  • significant increases in digital access for health services – with around 60% of GPs now using “Near Me”, and weekly digital consultations increasing from around 300 to over 9,000
  • the reshaping of primary care to support COVID-19 hubs with 24/7 access
  • shielding almost 150,000 clinically vulnerable people and focusing multi-disciplinary teams working on anticipatory care planning with them
  • and expanding mental health support by moving towards a 24/7 NHS24 mental health hub and digital therapies

What is clear is that, in line with our framework for decision making that was published last week, we need to achieve a careful balance in managing our healthcare capacity going forward including our commitment to continue to treat emergency, urgent and maternity cases. 

So we will continue to work closely with Health Boards and their partners to ensure there are robust plans in place to safeguard local resilience and responsiveness, whilst we also consider how and when we can increase the business as usual work of our NHS.

The incredible levels of compliance with social restrictions that we’ve seen show a clear willingness on the part of the people of Scotland to think beyond individual health to population health. As we move to introduce the test, trace and isolate measures required, we will need that focus on population health to continue.

Finally, I want to update you on research proposals for COVID-19 that we launched on 25 March.

139 proposals were received from across Scotland’s Universities and Research Institutes.

Following an independent expert review process, 55 projects have been selected for funding.

This has resulted in a Pan-Scotland portfolio of research, with 15 different institutions leading on projects.

In summary, the outcome of the call is a programme of projects meeting the aim of establishing a broad Scottish programme of high quality research on COVID-19 that will be delivered rapidly and inform policy and clinical practice in responding to the pandemic.

Presiding Officer, I continue to be grateful for the tremendous resilience of our health and social care staff, our key workers, and most importantly people all across Scotland.

Together, we are making progress, we are suppressing the virus, we are saving lives and we are showing that we can continue to rise to the challenges of this pandemic.

Thank you.

Scots encouraged to use face protection in enclosed public places

Coronavirus update: First Minister’s speech Tuesday 28 April 2020:

Good afternoon. Thanks for joining us for today’s briefing.

I want to start – as I always do – by updating you on some of the key statistics in relation to Covid-19 in Scotland.

As at 9 o’clock this morning, there have been 10,721 positive cases confirmed – an increase of 200 from yesterday.

A total of 1,754 patients are in hospital with Covid-19 – that is an decrease of eight from yesterday.

A total of 126 people last night were in intensive care with confirmed or suspected Covid 19. That is also a decrease of 8 since yesterday.

These figures continue to give us cause for cautious optimism.

I am also able to confirm today the positive news that since 5 March, a total of 2,448 patients who had tested positive for the virus have been able to leave hospital.

On a much sadder note, I have to report that in the last 24 hours, 70 deaths have been registered of patients who have been confirmed through a test as having Covid-19 – that takes the total number of deaths in Scotland, under that measurement, to 1,332.

Tomorrow of course will see the publication of National Records of Scotland weekly statistics that cover not just those who have die having had a positive test,  but those where Covid-19 is a presumed factor in the deaths.

These numbers, as I stress every day, are not just statistics. Behind each of these numbers is a unique and irreplaceable individual whose loss is a source of grief to many. So once again, I want to send my deepest condolences to everyone who has lost a loved one to this virus.

I also want to thank – as I always do and consider it important that we always do – our health and care workers. Everyone across Scotland is grateful to you for the extraordinary work that you are doing.

Many of us will have joined the minute’s silence at 11 o’clock today to honour the frontline workers – including, of course, health and care workers – who have sadly lost their lives while working to tackle this pandemic.

It was a reminder of the selflessness of our health and care workers – choosing to treat and care for others during a time of crisis – and it was also a reminder of the government’s duty to do everything we can to keep those workers safe.

I have two issues I want to update you on today.

The first relates to testing. We have been making steady progress on increasing our testing capacity over the last month – from an initial starting capacity that could cope with 350 tests a day to a capacity of at least 3,500 by the end of this month.

We will give a further update on testing capacity at the end of the week.

As a result of the work we have been doing so far to build capacity, we have already been able to expand testing in some priority areas.

Tests are currently made available and processed within NHS labs for:

  • people in hospital with symptoms of Covid-19 and all those in intensive care
  • people who have been referred for testing by their local Covid hubs
  • people in care homes who have symptoms
  • people who are being admitted to care homes
  • and key workers in our health and care services and where appropriate their family members. More than 20,000 people in that category have now been tested.

In addition, of course, key workers in other sectors – for example the prison service – are now able to book tests online for the drive through centres established at different locations around the country.

We are today expanding testing further.  All NHS Boards are now being asked to put in place procedures to test all those over 70 who are admitted to hospital for any reason – not just those with Covid symptoms.

As we know, the virus can have an especially severe impact on older people. And so although we don’t usually test people without symptoms – because the test isn’t totally reliable in those cases – we do think that there could be a benefit in testing older people both on their admission to hospital and then at intervals thereafter.

So patients in this category will be tested on admission, and then every four days throughout their stay in hospital.

This will help us identify if the virus is being transmitted in hospital, and if so, how and where. It will also help us provide better care for older people in hospital and therefore contribute to our wider efforts to slow the spread of the virus.

The second issue I want to address relates to face coverings, an issue which has attracted lots of attention recently. Guidance on this has just been published on the Scottish Government’s website.

I want to stress at the outset that I am talking here about face coverings made of cloth or other textiles, such as a scarf. I am not talking about medical grade face masks that health and social care workers wear.

The guidance makes clear that the most important step we can all take to prevent transmission of the virus is to comply with the current stay at home, social distancing and hygiene rules.

Face coverings are not – I repeat not – a substitute for any of that.

The guidance also makes clear that the evidence on use of face coverings is still limited.

However, it recognises that there may be some benefit in wearing a face covering if you leave the house and enter an enclosed space where you will come into contact with multiple people and safe social distancing is difficult – for example on public transport or in shops.

Of course just now, most shops are closed so this would apply in particular to food shops.

To be clear the benefit comes mainly in cases where someone has the virus but isn’t aware of that because they are not experiencing  symptoms and therefore not isolating completely – so wearing a face covering in these circumstances may reduce the chance of that person transmitting the virus to others.

The Scottish Government is now recommending the use of face coverings in these limited circumstances as a precautionary measure.

Given that the evidence is relatively weak, we are not at this stage making this mandatory or suggesting that it will be enforced, though we will keep that under review as we go into future phases of managing and tackling the pandemic.

And of course it is worth bearing in mind that there are some people – people with asthma, for example – may have very good reasons for choosing not to cover their mouth and nose when they are out and about.

And we are not recommending the use of face coverings for children under the age of two.

However, to repeat we are recommending that you do wear a cloth face if you are in an enclosed space with others where social distancing is difficult, for example on public transport or in a shop.

Let me emphasise the key point here which is that you should not really be in situations very often like that right now if you are complying with the stay at home rules.

The guidance states that there is no evidence at this stage to suggest that there are benefits to wearing a face covering outside, except in unavoidably crowded situations. Again, we are keeping that aspect under review.

The guidance also includes some information on how to safely apply and wash coverings.

When you are applying or removing the face covering, you should wash your hands first, and avoid touching your face. And after each time you wear the covering, you must wash it at 60 degrees centigrade, or dispose of it safely.

The detailed guidance, as I’ve said, is available on the Scottish Government’s website, and the guidance on the NHS Inform website will also be updated very soon.

The most important point I want to stress is this one. The wearing of facial coverings is an extra precaution that you can and, we are suggesting, you should take. It may do some good in some limited circumstances. It is not – and must not be seen as – a substitute for the other rules and guidelines that we have been stressing. 

In particular, anyone with symptoms of Covid-19 – and all members of their household, regardless of whether or not they have symptoms – must self-isolate. Guidance on that is available on the NHS Inform website.

And physical distancing, hand washing and respiratory hygiene – covering up coughs with disposable handkerchiefs, or even with your sleeve – remain the most important and effective measures we can all adopt to prevent the spread of coronavirus.

So please, above all else, continue to follow the rules that we have set out.

Stay at home, except for essential purposes such as buying food or medicine, or exercising.

If you do leave the house, you should stay 2 metres apart from other people, and you should not meet up with people from other households.

And you should wash your hands thoroughly and regularly.

I know that sticking to these rules is really, really difficult but it is essential. It is how all of us can help to slow the spread of the virus, to protect the NHS, and continue to save lives. So thank you for sticking with it.

Primary Care services to remain open over May public holidays

Primary care services will remain open during the May public holidays, Health Secretary Jeane Freeman has confirmed.

Funded by £8.2 million from the Scottish Government, GP services and community pharmacies have been asked to remain open on the May public holidays, with NHS 24 operating with an increased number of call handlers.

Ms Freeman has praised the response and dedication of healthcare staff across the country who are ensuring people can continue to access services during the pandemic.

Ms Freeman said: “Health and social care staff are already working incredibly hard to look after people during this pandemic, and I want to thank each and every one of them for their ongoing commitment and dedication during this unprecedented time.

“Last month we asked GP services to remain open during the Easter holidays and once again, we have asked them to do the same for the May public holidays.

“Community pharmacies will also be open so they can continue to provide advice and treatment through the extended Minor Ailment Service for minor illnesses and common conditions. We have also taken steps to ensure NHS 24 can continue to meet the increase in demand.”

Dr Andrew Buist, chair of the BMA’s Scottish GP Committee, said: “Practices and out of hours services are working under increased pressure during this pandemic and I am extremely grateful to GPs across Scotland who are all willing to put in the extra work that is needed to help the NHS fight this virus.

“During this unprecedented time, GPs have been asked to keep their practices open over public holidays and, as we have witnessed recently over the Easter weekend, patients have been receptive to these changes and how we have adapted. The BMA was also clear that this needed to be supported by the Scottish Government and we welcome the funding put in place to make this happen.

“It is very important for patients to know their NHS is open for non-COVID-19 related health concerns, and they should always contact their GP if they have any worries. General practice is part of the protective ring around Scotland’s hospital system as we fight this pandemic.

“I am proud of how quickly GPs have responded to these challenging times with flexibility and ingenuity. There is a huge amount of work being put in from the Scottish Government and across the system and we should continue to work together with clear thinking and strong leadership.”

Health advice can be found at NHS Inform.