As you may have seen, the Scottish Government have today published a document setting out the principles that will guide the eventual and phased easing of the lockdown. It ticks pretty much all the boxes that most of us were hoping for. Here are the key lines –
“Our objective is to contain and suppress the virus in order to minimise the harm it can do.”
“As and when we lift restrictions, we will need to put in place public health measures to stop cases becoming clusters, clusters becoming outbreaks, and outbreaks becoming an uncontrolled peak…”
The use of the word ‘suppress’ is significant, because a suppression strategy is the opposite of the previous ‘herd immunity’ strategy that applied UK-wide until March, and that the Scottish Government’s own Jason Leitch evangelised for during his infamous tour of the TV studios, and that would have deliberately allowed 60%+ of the population to be infected. But the use of the word ‘contain’ is arguably even more significant, because the UK explicitly abandoned containment efforts in mid-March on the grounds that containment of the virus was literally impossible, in spite of experience in China and South Korea suggesting that was not true. At least as far as Scotland is concerned, that stance has now been fully reversed and containment is regarded as both achievable and desirable.
“We are clear that an assumption that there is a proportion or section of the population that it is safe or acceptable to allow to be infected forms no part of the Scottish Government’s policy or approach.”
Again, those words are an unmistakeable repudiation of the discarded ‘herd immunity’ approach, which only sought to shield a relatively small percentage of the population from the virus. The vast majority of people under the age of 70 and without known underlying health issues would have been allowed to be infected, precisely because of an outrageous assumption that it was “safe and acceptable” for that to happen.
“To contain the virus we must keep the R number below 1, and this means minimising the risk of spreading the virus at every turn.”
“Suppress the virus through compliance with physical distancing and hygiene measures, ensuring that the reproduction number remains below 1…”
“The World Health Organisation has stated that before any decision is made to lift restrictions, transmission of COVID-19 must be controlled. That means that we must see R stabilise below 1.0 and ensure that the impact of any decision to ease restrictions must maintain R below 1.0.”
This is absolutely vital, because keeping the reproduction rate below 1 ensures that the epidemic is always in retreat. That effectively ‘locks in’ the suppression strategy and makes the pursuit of herd immunity through mass infection impossible.
“If we see evidence of outbreaks of the disease we will need to be ready to act decisively to suppress them and so prevent wider transmission. This will require both a very high degree of virus-aware public behaviour along with enhanced public health services. These services would come in five stages.”
Those five stages are the ‘test, trace, isolate’ approach that the World Health Organization have been urging all along, but that the UK has been so resistant to. The Scottish Government have now – albeit belatedly – accepted the need for it completely.
The only caveat that has to be placed on this good news story is that the document reiterates that Scotland is committed to the ‘4 Nations’ collective decision-making process, and suggests there will only be a departure from this at the margins, for example on “optimal timings”. Given that it appears the UK government advisers are still split on whether or not to attempt the type of full-on suppression strategy that the Scottish Government are now committed to, what happens if Westminster shoots off in completely the wrong direction and lifts the lockdown without ‘test, trace, isolate’ in place? How can Scotland follow a completely different strategy with only small discretionary differences in the measures that are enforced?
That would be a difficult circle to square. But the hope must be that the Scottish Government have laid down a strong marker today that will ensure any collective UK approach that sidelines contact tracing and that doesn’t attempt to fully suppress the virus is a non-starter.
