The First Minister has praised those manufacturers and businesses which have stepped in to support frontline services by diversifying production lines, increasing capacity and exploring new distribution routes during the coronavirus (COVID-19) pandemic. Continue reading Businesses rally to the cause in the battle against coronavirus
Tag: Scottish Government
The NHS Is Open campaign launched
Figures indicate patients are delaying seeing their GP during the pandemic and there has been a drop in urgent suspected cancer referrals, and a reduction in families bringing children for immunisation.
Reasons may include wishing to reduce the strain on the NHS, or concerns over becoming infected with COVID-19 as well as the misconception that doctors do not want to see patients.
The NHS is Open campaign urges people to contact their GP or local hospital if they have urgent health worries.
Health Secretary Jeane Freeman said: “It is vital for people to know that GP surgeries and hospitals are still there for them if needed.
“While we appreciate the public doing all they can to reduce the strain on our NHS at this challenging time, if people have serious health concerns or symptoms, it’s just as important as ever to seek immediate medical assistance.
“This pandemic does not mean we’ve stopped the fight against cancer, heart attacks or other serious health conditions. It is vital people continue to raise any health worries with their doctor at the earliest possible time and continue to attend regular check-ups and appointments when they are invited to do so.”
https://twitter.com/i/status/1253753235166441472
Dr Carey Lunan, a working GP and Chair of the Royal College of General Practitioners in Scotland, will feature in TV adverts as part of the campaign. She said: “The NHS is open and it is safe. Appointments may feel a little different – they might happen on the phone or even by videolink. If people need to be seen face-to-face, we can arrange that too.
“Accident and Emergency units are also still open and able to help. We are here for patients and we want to hear from anyone if they have an urgent medical problem.”
The marketing campaign will run on TV, radio and digital channels for an initial three weeks.
The campaign will encourage people to call their GP surgery, or 111 out of hours, if they have urgent health concerns. In emergencies, they should still dial 999.
Attendance at A&E and Paediatrics in Scotland has halved during COVID-19.
Attendance at A&E in week commencing 29 March was 11,020 and in week commencing 5 April 11,263 compared to normal average attendance of 25,000 per week. Paediatrics attendance is down 50 per cent in Scotland, with late presentation becoming an issue.
There has been a significant drop (72 per cent) in urgent suspected cancer referrals, as fewer people are presenting their symptoms to their GP practice.
First Minister: envisaging a ‘new normal’
Good afternoon everyone. Thank you for joining us for today’s briefing as usual.
Today I’m going to focus quite a lot on the paper we’ve just published about how we might, at the right time and in the right way, begin to restore some normality to our lives, while still containing the COVID-19 virus.
But before I do that, I will start as usual with an update on some of the key statistics in relation to the virus in Scotland.
As at 9 o’clock this morning, there have been 9,409 positive cases confirmed – which is an increase of 371 from yesterday.
A total of 1,748 confirmed or suspected COVID-19 patients are in hospital – and that is a decrease of 28 from yesterday.
And a total of 148 people last night were in intensive care with confirmed or suspected cases of the virus. And that is a decrease of seven since yesterday. Let me say again as I did yesterday, these figures on hospital admissions and admissions in to intensive care are very encouraging and do give us real optimism at this stage.
However in the last 24 hours, I am very sorry to have to report that 58 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 1,120.
Once again, it’s really important for all of us to remember that each of these deaths represents a unique, loved and irreplaceable individual. And I want to again extend my deepest condolences to everyone who has lost a loved one.
I also want again to thank all of our health and care workers right across the country. This evening many thousands of us will, yet again applaud your efforts – we are all so deeply grateful to you for the extraordinary work you are doing.
So let me turn now to the paper we have published just a few moments ago about the decisions we will need to take as we seek to contain this virus while also restoring a semblance of normality to our lives.
And I want to be very clear with you at the outset – what we are publishing at this stage today is, by necessity, a first cut.
I am seeking today really, to start a grown up conversation with you, the public.
The decisions that lie ahead of us, of all of us, are really complex.
We will – as we have done all along – seek to inform those decisions with the best scientific advice possible.
But the science will never be exact, so we will also require to make very careful judgments.
And we are in uncharted territory – it’s impossible to know with absolute certainty what the impact of our decisions will be in advance.
That means we must also be prepared to adapt and change course as we go. We want to ease restrictions, of course we do, but we cannot absolutely rule out having to reapply some of them in future should we have evidence that the virus is again running out of control.
And I want to be frank with you every single step of the way about all of these complexities and uncertainties.
So while today’s paper is still quite high level, it is the start of a process.
It sets out the objectives and the principles that will guide us, the different factors that we will need to take into account, the framework in which we will take decisions, and the preparations we need to make now.
In the days and the weeks ahead, evidence, data and modelling will allow us to take firmer decisions.
As that happens, this paper will evolve into a detailed plan with metrics, actions, milestones and measurements attached to it.
And I give an assurance today that as we go through this process, we will share our thinking on an ongoing, iterative basis.
But let me briefly set out some of the key points today.
Firstly, and this is an obvious point, this virus causes real harm. And we see that every day in the statistics that we report, especially in the numbers of people who have died.
But the lockdown measures we are taking to contain the virus are also doing damage.
They’re doing harm to the economy and to living standards, to children’s education, to other aspects of our physical health, and to mental health and wellbeing. And the toll of all of that may also, in time, be measured in poorer health outcomes and lives lost.
So we must try to find a better balance than the one we have right now.
But my second point is that, as we do so, we cannot and we must not take our eye off the need to suppress the virus and minimise the damage that it does.
And let me be very clear about this, continuing to suppress COVID-19 is the central objective that we set out in this paper today.
Obviously, we cannot guarantee that no one will get this virus in the future – far from it – but an assumption that it is somehow safe to allow a certain proportion or a certain section of the population to get the virus is not part of the approach we will be taking.
Third, we are increasingly confident that measures we are taking now are suppressing the virus.
The key factor – and you may have heard this before – is what is known as the reproduction rate – the R number. And that needs be as far below one as possible.
Now before lockdown that R number was very likely above three. And that means everyone with the virus was infecting three more people, each of them was infecting three more people and so on and on. That is what is exponential growth.
Our best estimate now is that the R number is somewhere between 0.6 and one – though I should say that it is probably still higher in certain settings, such as care homes.
But we can’t yet be absolutely sure about any of that. That’s why we need more time to monitor the statistics we report every day – like case numbers, hospital and ICU admissions, and numbers of deaths. And we need to develop further our data through ongoing surveillance.
It’s only when we are sure that the virus is under control that we can even start to ease any of the restrictions.
And it’s my next point really that takes us to the hard part.
When we do reach that stage, the virus will be under control only because of the severity of the restrictions we are all living with just now. But the virus will not have gone away.
So as we start to lift the restrictions, the real risk – and it is a very real risk – is that COVID-19 runs rampant again.
So a return to normal as we knew it is not on the cards in the near future. And it’s really important that I am upfront with you right now about that.
What we will be seeking to do is find a new normal – a way of living alongside this virus, but in a form that keeps it under control and stops it taking the toll that we know it can do.
Social distancing and limiting our contacts with others will be a fact of life for a long time to come – certainly until treatments and ultimately a vaccine offer different solutions. So that means possibly for the rest of this year and maybe even beyond.
And that’s why talk of lifting the lockdown – as if it’s a flick of a switch moment – is misguided.
Our steps – when we take them – will need to be careful, gradual, incremental and probably quite small to start with.
We will need to assess them in advance and monitor them in action. Sometimes, as I said a moment ago, we may even need to reverse things.
As we go, we will apply our judgment to the best scientific advice possible, we will continue to collaborate closely with the other governments across the UK, and we will learn from international experience. The fact is that different countries are at different stages of this pandemic – but none of us are anywhere near through it yet and we all face the same challenges.
So as we make these decisions here, careful balances will have to be struck.
For example, it may be that be that certain business in certain sectors can re-open – but only if they can change how they work to keep employees and customers two metres distant from each other.
Similarly with schools – classrooms may have to be redesigned to allow social distancing, so maybe not all children can go back to or be at school at the same times.
Some limited outdoor activity might be able to restart earlier than indoor activity. But let me be clear, big gatherings and events are likely to be off for some months to come.
We will also consider whether different approaches would make sense for different areas – though our preference, not least for ease of understanding, will be for as much consistency as possible.
And of course given how severely this virus is affecting older people and those with other health vulnerabilities, some form of shielding will almost certainly be required for the foreseeable future.
Now let me stress that what I have just set out there are not firm decisions – but they do illustrate the kind of options we will be assessing.
And as we do so, we will consider not just the health imperatives, but also issues of practicality, sustainability, fairness and equity, ethics and human rights.
And lastly, as well as changes to how we live, we will use public health interventions and technology to the maximum possible to help us control this virus.
In the next phase, extensive testing, tracing of those who test positive and the isolation of symptomatic people to break the chain of transmission will be a central part of the approach that we will take. And the preparations to make that possible are already under way.
We will also discuss with the UK government – for this is a reserved responsibility – the need for stronger surveillance measures for those coming into the country from elsewhere.
So in short, this paper sets out the difficult decisions we face and the way in which we will go about preparing for them, making them and also assessing their impact.
I want to stress again because it’s important that I am frank. The path ahead is not an easy one – it is paved with complexity and uncertainty. But with openness, transparency and frankness along the way, I believe that together we will be able to navigate it. It is for me and for government to work through and lead that process. But this is about all of us – hence this discussion that we are opening up with all of you today.
The paper we have published is available on the Scottish Government website. I will post a link to it on Twitter, later this afternoon.
So, please, even if – like I suspect most of the population – you are not in the habit of reading government documents, have a look at it. And if you have views on it please let us know. These views are important and will be helpful.
As I said earlier, I will continue to share our thinking with you as it develops.
But let me now end now on a vital point and one that you have become used to hearing me make each day. Moving on from where we are now as all of us want to do as quickly as it is safe to do will only be possible if and when we do get this virus properly under control.
And that means sticking with the current rules that are in place just now.
Stay at home except for essential purposes.
Stay two metres apart from others when you have to be out.
Do not meet up with people from other households.
And isolate completely if you or anyone in your household has symptoms.
This is tough, this is the toughest set of circumstances that the vast majority of us have ever lived through – and I can’t stand here and promise you it is going to get a whole lot easier soon.
But as I hope we have started to set out today, if we keep doing the right things, and if we consider all of the options carefully and with the right objectives in mind, I do believe there will be a way through.
And we will find that way through. So thank you for all you are doing to help. And please if you can, engage with this discussion as we go through the days and weeks to come.
Thank you very much for your patience right now in allowing me to go through that in detail.
Looking Beyond Lockdown
A document outlining how decisions will be taken to control coronavirus (COVID-19) while restoring a degree of normality to everyday life has today been published by the Scottish Government.
The paper – COVID-19: A Framework for Decision-Making – sets out the position during this ongoing period of lockdown and outlines the factors that must be considered as we move gradually to ease restrictions.
It also recognises that new ways of living – effectively a “new normal” – may have to be in place for some time to come.
First Minister Nicola Sturgeon said: “Today I am seeking to start a grown up conversation with the public about the complex decisions that lie ahead of us as we look beyond lockdown.
“As we have done all along, we will seek to inform the public with the best scientific advice possible, but the science will never be exact and we are in uncharted territory so we also need to make careful judgements and be prepared to adapt and change course as we go.
“We want to ease restrictions, but we cannot rule out having to reapply them should the virus run out of control.
“Every day we see evidence that this virus causes real harm, but so too do the lockdown measures we are taking to contain it. This is causing harm to the economy and living standards, to children’s education and to mental health and wellbeing.
“That is why we need to try to find a better balance than the one we have now, but as we do so we cannot take our eye off the need to suppress the virus and minimise the damage it does.
“It is only when we are sure the virus is under control that we can even start to ease any of the restrictions because the virus will not have gone away.
“As we start to lift the restrictions, the real risk is that COVID-19 runs rampant again so a return to normal as we knew it is not on the cards in the near future.
“What we will be seeking to find is a new normal – a way of living alongside this virus, but in a form that keeps it under control.
“Physical distancing and limiting our contacts with others will be a fact of life for a long time to come – certainly until treatments and ultimately a vaccine offer different solutions. But if we all keep doing the right things, there will be a way through – and we will find it, together.”
SNP MSP for Edinburgh Pentlands, Gordon MacDonald, said: “It is welcome that the Scottish Government has published an outline of how and when the lockdown may be lifted and I urge everyone to take the time to read the document.
“It’s vital that any decision to ease restrictions is based on the best scientific advice possible – but we are in uncharted territory and we must be prepared to adapt. That might mean having to reapply restrictions after they are lifted.
“Only when we are sure the virus is under control, can we even start to ease any of the restrictions because the virus will not have gone away.
“There are no easy answers – but it is right for the Scottish Government to be clear about the factors that will inform decision making.
“In the coming days and weeks members of the public will be invited to contribute their thoughts and views on the next steps we must make together.
“Unfortunately, returning to what we regard as a normal life will not be possible in the near future so we need to prepare for a new normal until treatments and a vaccine offer different solutions.
“While these measures are difficult for all of us, they are saving lives and protecting our NHS.”
The discussion document:
A message from Cat Harvey
I’m Cat Harvey and I wanted to write and let you know that from Monday 27th April, I am hosting a brand new show in association with the Scottish Government all about YOU!
Join me three times a day, morning afternoon and evening, where we will look at different ways of taking care of ourselves and our loved ones as we continue to spend more time at home.
So what would you like to hear about? Would you like some top tips on setting a routine, clearing your head, moving more or learning how to properly switch off? What about home schooling, cooking, gardening or how to get Granny on Houseparty? Let me know what YOU want to know… and I’ll do my best to find some answers.
I would also love to hear and share your uplifting stories through these tricky times: it could be a neighbour who has been an absolute star, a community pulling together, family fun, businesses going above and beyond or essential workers making you proud from your posties to care workers and teachers and all those in the food supply chain.
Get in touch and share your story with me and I’ll share as many as I can across the nation.
Catch-up with Cat, on-air from Monday in association with the Scottish Government – be part of it on the Forth 1 website.
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Coronavirus could see Scotland’s economy shrink by a third
The economic impact of the efforts to tackle the coronavirus (COVID-19) pandemic could see Gross Domestic Product (GDP) fall by around a third, according to a report by the Chief Economist.
The latest State of the Economy report, published by the Scottish Government’s Chief Economist Gary Gillespie, presents analysis showing that GDP in Scotland could fall by around 33% during the current period of social distancing, similar to estimates from UK and international bodies such as the Office for Budget Responsibility (OBR) and the Organisation for Economic Co-operation and Development (OECD).
Alongside a summary of latest economic developments, the report includes Scottish Government analysis of:
• channels through which COVID-19 is impacting Scotland’s economy;
• short term impact of social distancing on GDP and the labour market;
• exposure of different sectors to COVID-19 risks;
• medium term path of the economic recovery.
Economy Secretary Fiona Hyslop said: “Our response to COVID-19 is saving lives, but I am deeply aware that the pandemic is having an economic effect that is already being felt across Scotland.
“The Scottish Government is doing everything we can to support businesses at this very difficult time.
“We want Scotland to recover as quickly as possible from this outbreak, and that includes rebuilding our economy as quickly as is safely possible.
“None of us should be under any illusions about the scale of economic recovery and, as we have said before, no government will have all of those answers.
“That is why we have set up an independent advisory group to provide expert economic advice and this will be crucial to help us deal with the challenge of rebuilding our economy.”
Lifeline support for business confirmed
Economy Secretary Fiona Hyslop has confirmed that grant funding for the newly self-employed suffering hardship and SMEs in distress will be available ‘in the coming days’.
The £100 million fund to support the self-employed and SMEs announced last week will be broken into three separate funds as follows:
• £34 million Newly Self-Employed Hardship Fund, managed by Local Authorities, will be allocated to the newly self-employed facing hardship through £2,000 grants
• £20 million Creative, Tourism & Hospitality Enterprises Hardship Fund, managed by the Enterprise Agencies in partnership with Creative Scotland and VisitScotland for creative, tourism and hospitality companies not in receipt of business rates relief
• £45 million Pivotal Enterprise Resilience Fund, managed by the Enterprise Agencies for vulnerable SME firms who are vital to the local or national economic foundations of Scotland
The Scottish Government is also providing £1 million to top up Creative Scotland’s Bridging Bursaries in the not-for-profit sector.
Speaking in parliament, Ms Hyslop also confirmed that the grant funding will be open for applications by the end of April, and that recipients will receive funds in early May. She said: “This funding is intended to relieve the hardship of individuals and smaller firms that are ineligible for support from the UK Government or are not in receipt yet of the funds they need to survive.
“Our hospitality, tourism and creative sectors have been decimated by this crisis and previously profitable businesses have seen demand dry up overnight.
“However, because of the decisions the Scottish Government has taken, thousands more self-employed people and small businesses will be able to benefit from support compared with elsewhere, and we have been able to help sectors of the economy that are not being supported in other parts of the UK.
“As well as dealing with this immediate crisis, we must look to the future. We must ensure that those businesses with a part to play in strengthening resilience in Scotland’s economy survive this crisis and thrive in future, which is why £45 million is being allocated to those firms.
“We continue to engage with businesses on a regular basis to understand their needs and press the UK Government to deliver for them.”
Following this afternoon’s announcement, Creative Scotland’s Chief Executive Iain Munro commented: “We welcome today’s Scottish Government announcement of £100 million funds to support the self-employed and SMEs.
“Creative Scotland will work hard with partners to ensure that those who are eligible in the creative sector can access the new funding as far as possible.
“Today’s announcement also includes the extra £1m from the Scottish Government which we announced yesterday to supplement the Creative Scotland Bridging Bursary Fund and has enabled us to double the budget, providing much needed financial support for freelance creative professionals most deeply impacted and disadvantaged by the cancellation of work due to the COVID-19 emergency.”
Over 110,000 Universal Credit claims since coronavirus outbreak
Claims for Universal Credit in Scotland have increased from an average of 20,000 per month in 2019 to over 110,000 between 1 March and 7 April, highlighting the impact the pandemic is having on people’s finances.
That’s why the Scottish Government, in partnership with the Citizens Advice network, is launching a new campaign to raise awareness of the financial support available to people.
The campaign will provide information and advice on issues including rent and mortgage payments, energy bills, council tax, and benefits people may be entitled to.
People will be able to access this advice online, by phone or by contacting their local Citizens Advice Bureau.
Cabinet Secretary for Social Security and Older People Shirley-Anne Somerville said: “This huge increase in claims for Universal Credit demonstrates just how many people across the country are struggling financially due to the coronavirus pandemic.
“These are difficult and worrying times for everyone, with many people requiring financial support for the first time and even more pressure on those who were already struggling to make ends meet.
“It is welcome that people are claiming the support that they are entitled to from the DWP, and I would encourage people to look into what additional help is available. Even if you are not entitled to Universal Credit, there could be other assistance that you can access so it is worth checking.
“That’s why we’ve been working with the Citizens Advice network in Scotland to create this central source of information – with everything from guidance on benefits, right through to what you can do if you are worried about paying your mortgage or rent.”
DWP entered into a new partnership with Citizens Advice in March last year, providing £39 million of funding to Citizens Advice and Citizens Advice Scotland to provide this service. DWP also funded Citizens Advice and Citizens Advice Scotland a further £12 million to set up delivery to ensure a smooth transition to the new delivery model.
Citizens Advice Scotland Chief Executive Derek Mitchell said: “The Citizens Advice network in Scotland is known for always being there to help and the support we give will be more important than ever to help people avoid getting into crisis.
There may also be lots of people who have never used our services before and it’s crucial that they know our information and advice is there for them too.
“Our national network of Citizens Advice Bureaux is still operating for those who need it – if you have been financially impacted by the coronavirus outbreak your local Citizens Advice Bureau can help make sure you have access to all the income you are entitled to, as well as giving tailored advice about what’s on offer within local communities across Scotland.
“There’s increased demand for our advice on financial services, that’s why we’ve created dedicated COVID-19 content online so people get the information they need 24/7 and from the comfort of their own homes.
“We’ve also got a dedicated helpline for people who might not be able to access our services online. If you have been financially impacted by the coronavirus outbreak and require free, confidential, financial support, please visit cas.org.uk or call 0800 028 1456.
“Local Citizens Advice Bureaux are situated around the country. To find your local service, simply enter your postcode at cas.org.uk/bureaux”
Scottish government issues new guidance to support home learning
New guidance to support the home learning of children and young people during the new term has been issued by the Scottish government.
It aims to build on the significant amount of positive work that has already been undertaken by teachers and education professionals across Scotland to support learning at home, as well as the advice and resources that are already available.
The guidance covers three main areas:
- learning and teaching at home: this includes support for digital learning; children who are likely to be disproportionately impacted; and learners with additional support needs
- parental involvement and engagement: this includes details of local and national support and how local authorities/schools will require a different approach to being updated on a child’s development
- support for teachers and school leaders: including advice on learning resources; supporting pupils’ and staff health and wellbeing; and on leading colleagues and teams during this period
Deputy First Minister John Swinney said: “Given the unprecedented circumstances, we cannot predict when schools in Scotland will reopen. However, our focus is that while schools are closed, learning continues, and we all have a role to play.
“Local authorities, schools, teachers and practitioners know their learners really well and have shown extraordinary dedication and professionalism in adapting and making decisions in the best interests of the children and young people.
“While we do not expect teachers, parents and families to replicate schools or classrooms, we are committed to working with all partners in Scotland’s education system to protect pupils’ wellbeing, and ensure learning can continue in an appropriate way, wherever possible.
“The guidance is aimed at those working in our education system. We are working closely with the National Parent Forum of Scotland (NPFS) on further advice, aimed specifically at parents and carers, which will be published in the coming days.”
Education Scotland Chief Executive Gayle Gorman said: “Moving into the summer term, practitioners, learners and their families will be preparing for more learning at home. Education Scotland is working with partners, prepared and ready to support all who are working with our learners across Scotland.”
Educational Institute of Scotland (EIS) General Secretary Larry Flanagan, said: “This acknowledgement of the work being undertaken by teachers and schools is welcome as is the commitment to provide further support to parents, pupils and teachers across an unprecedented period of extended closure.
“The EIS also welcomes the recognition that supporting the health and well-being of pupils and staff is a critical aim, as without that, maintaining engagement with education at any level becomes even more difficult.”
The guidance is aimed at those working in our education system. We are working closely with the National Parent Forum Scotland (NPFS) on further advice, aimed specifically at parents and carers, which will be published in the coming days.
Guidance: Supporting Pupils, Parents and Teachers – Learning During Term 4 is aimed at those working in Scotland’s education system.
The guidance has been developed by the Scottish Government and Education Scotland, with advice and input from COSLA, Solace, The Association of Directors of Education in Scotland (ADES) and professional associations.
Find Practitioner support for Online Remote Learning.
The Parentzone Scotland website continues to be updated with relevant information on home learning for parents.
NHS Louisa Jordan facility stands ready
Construction work has been completed at the NHS Louisa Jordan hospital at the Scottish Events Campus (SEC) in Glasgow. From today (Monday 20 April), the hospital will be equipped and clinically ready to treat patients during the coronavirus (COVID-19) outbreak, if required.
It is hoped the hospital will not be needed thanks to the public’s continued efforts to stay at home and the other measures that are being taken to increase the number of NHS Scotland beds.
Health Secretary Jeane Freeman said: “I want to offer my sincere gratitude and thanks to the contractors and NHS Scotland staff who have come from across Scotland to work tirelessly to transform the SEC into the NHS Louisa Jordan. You are an inspiration to us all.
“The decision on patients being accepted at the NHS Louisa Jordan will be reviewed on a regular basis. I hope this facility will not be needed as, alongside the public’s continued efforts to stay at home, NHS Scotland has already taken steps to increase the number of NHS beds.
“The exceptional efforts of everyone involved in creating NHS Louisa Jordan during this unprecedented public health emergency will ensure this national facility will be able to treat patients from across Scotland, helping to save lives and protect our NHS.”
Chief Executive of NHS Louisa Jordan Jill Young said: “Building the NHS Louisa Jordan has been an incredible effort. It has been a privilege to lead the project and I want to thank all those who have come from across the country to help us establish this national facility.
“The hospital stands ready to treat patients from across Scotland in a safe, effective and compassionate way, if required.”
The First Minister announced on 30 March that the NHS Louisa Jordan would be established to help ensure NHS Scotland has extra capacity to treat patients during the coronavirus (COVID-1) pandemic.
The hospital was named after Glasgow born First World War nurse Sister Louisa Jordan who died on active service in Serbia in 1915 as part of the Scottish Women’s Hospitals for Foreign Services.
The hospital has a capacity for an initial 300 patients and this can be expanded to more than 1,000 beds. 1036 bed bays have been built at the hospital.



















