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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