COVID 19: First Minister’s symptom-led approach to testing is not enough to control the virus

Ms Baillie said that since the beginning of the pandemic last year, the World Health Organization has told countries to “test, test, test”, but she claimed the Scottish Government was falling down on the job in this regard.

Professor Devi Sridhar, the First Minister’s adviser.

She told MSPs: “Yesterday, once again, Professor Devi Sridhar, the First Minister’s adviser, could not have been clearer that the best way to stop the spread of the virus and to avoid rolling lockdowns is by testing, finding contacts and isolating them.

“Scotland has a daily testing capacity of 65,000 tests. We could have done 2 million in the past month alone, but we have used only 32 per cent of that capacity. We have known for some time that the First Minister’s symptom-led approach to testing is not enough to control the virus.

“South Korea, Germany and other countries have been using polymerase chain reaction tests for months to find asymptomatic carriers. Even in England now, nearly one in every 100 people is tested daily for Covid-19. What is the equivalent figure for Scotland?”

Ms Sturgeon was obviously pout out by the question. She replied: “I say to Jackie Baillie that, if her central proposition is that England has done so much better than Scotland, why are Scotland’s virus rates so much lower than England’s right now?

“I do not think that this should be some kind of competition. We are all working really hard to control the virus and get rates as low as possible. Throughout the pandemic, Scotland has consistently had rates that are too high in my opinion, but that are lower than other nations in the UK, certainly those of England and, more recently, those of Wales.

“The numbers of people dying are far too high and none of us should be comfortable with that. However, we are working hard to suppress the virus and we are using testing appropriately in order to do that, expanding that as we go.

“The numbers that are quoted are for people with symptoms. The reason why that quantity of tests is not used every day is that the levels of the virus are, thankfully, lower than they would be if that volume was being used up to capacity.

Three leaders – Willie Rennie, Jackie Baillie and Nicola Strugeon – clashed over Covid 19.

“We are using asymptomatic testing much more widely now, through care homes and of national health service staff, and we are using community asymptomatic testing, all of which is helping us to decrease the rates of the virus, which is so crucial.

“I will never stand here and say that there is not more that we can do, more things that we should learn or other advice that we should take.

“I do not stand here and speak for Professor Sridhar, but I speak to her often. It is true that she advises a range of things—she has been a voice of wisdom throughout the pandemic.

“Without wishing to speak for her, I think that she considers that many of the things that we are currently doing in Scotland are the right ones. We need to keep at them and improve as we go, which is exactly what we will do.”

However, that answer did not satisfy Jackie Baillie, who is currently interim leader of the Scottish Labour Party.

She persisted: “Let me help the First Minister out with a figure, which is that, each day in England, one person in every 100 is tested. Other countries in Europe and the rest of the world have mass testing programmes in which many more people are tested daily.

“In Scotland, that figure is one in every 250 people. Even in the past week, our test and protect system averaged only 20,622 tests per day out of a capacity of 65,000 per day. Nearly three-quarters of those were actually repeat tests of people who had already been seen.

“Let us look at another crucial part of our current system, which is contact tracing and self-isolation. In the week ending 17 January, the test and protect system failed to reach, within 72 hours of their tests, more than 850 people who had tested positive.

“At the start of the month, that figure was as many as 1,625 people. When people are asked to self-isolate, there is no follow-up and little support. They get a text—that is it. In some parts of the world in which proper support is on offer, as many as 95 per cent of people are managing to follow self-isolation rules.”

The testing lab team for West Dunbartonshire’s local health board.

The First Minister, asked for the equivalent figures in Scotland, said she would give them “later on” and added: “I think it is really important that we engage with the issues here, of which there are two.

“Jackie Baillie said that it is terrible that only 20,000 people were tested, as opposed to 50,000. The figure is for symptomatic testing. If that figure of 20,000 had been 50,000 or 60,000, it would have meant that our rates for the virus were three times what they actually are. It is a good thing that there are fewer people with symptoms and that means that fewer people are coming forward for testing.

“That means that we are succeeding in starting to suppress the virus, which is the really fundamental point that has to be understood.

“If England’s number of tests carried out per 100 people in the population being greater than Scotland’s was the be-all and end-all, we would expect England’s virus rates to be lower than Scotland’s. However, they are not—they are significantly higher.

“I will never stop trying to listen and learn about how we can do those things better, but the idea that we are somehow just getting them all wrong is not actually borne out when we look at our relative position compared to those of other countries.

“Jackie Baillie is just downright wrong on the question of self-isolation. When someone is contacted and told to self-isolate, if they agree to having their details passed on to the local council they will get a follow-up call to triage their situation and find out whether they have particular needs.

“We have given councils [such as West Dunbartonshire] additional resources so that if someone needs practical help in addition to the financial help that is offered through the self-isolation support grant, up to and including accommodation, that is available. We will shortly set out further plans to extend the support that is available to people who are self-isolating, but it is simply not true to say that no support is available to them. Those are the facts of the situation. We will continue to work hard to improve as we go.”

“In raising such matters I am bringing into the chamber the real experience of people who are self-isolating. They tell me that they are getting little support. She herself will know that a third of those who applied for the self-isolation grant did not get it.

“I did not hear an answer to my question, so I am happy to help the First Minister out again. Only 18 per cent of people in Scotland are able to follow self-isolation rules, which is fewer than one in five. It is a pity that the Scottish Government’s performance cannot be matched by the First Minister’s spin.

“Eleven months into the pandemic, it has been slow to test, slow to trace and slow to support people who are self-isolating.

Although the vaccine gives us hope, experts tell us that Covid will be here for some time to come. In order to lift current restrictions and not end up in a third wave and another lockdown, we need a functioning test, trace and isolate system. That is not what we have in Scotland today.

“Last year, community testing pilots uncovered hundreds of asymptomatic cases in just a fortnight, but instead of the promised wide-scale roll-out, the Government is still only in the planning phase.

“If we are going to get the virus under control, we need mass testing in all our communities. Can the First Minister tell me when that is going to happen, or will we be back here in a few weeks, quoting the same expert advice, asking the same questions, and with more lives lost?”

Nicola Sturgeon said: “Listening to Jackie Baillie, people would not think that in Scotland we actually have the lowest levels of Covid in the whole of the UK—but they are too high, so we will continue to do more. We did pilots of asymptomatic testing before Christmas and we are about to roll out a number of community asymptomatic initiatives.

“We are about to do asymptomatic testing in more industrial settings—I am checking with the health secretary; I am not sure, but there may be one in Jackie Baillie’s constituency. There is a testing centre in Jackie Baillie’s constituency, or maybe a mobile testing unit.

“We use testing appropriately; we will continue to do that and we will continue to extend that. Frankly, it does a real disservice to the people who are working so hard on test and protect to say that is not functional. It is functional—it is functioning well—and those people have my gratitude for that.”

LibDem leader Willie Rennie is not content with the Government’s performance. She said: “The First Minister claimed that we were slower than England at first, because we did the hard-to-do care homes first. That argument does not wash.

“According to a new survey, England and Scotland are now in the same place on care home vaccination but the gap is still around 140,000 for everyone else. That is the number of people who would have had the vaccine by now if Scotland had kept pace with England.

“Every day that a vaccine is left in a vial is another day that a person is left exposed to the threat of this deadly virus. With 100,000 lives lost, we cannot afford such slippages any more. It is not to do with care homes and the First Minister says that it is not to do with the ordering system, so why are we so far behind England?”

Crosslet House Care Home in Dumbarton – First Minister says “we were ahead in terms of care homes and now we are getting through the other groups”.

“I am sorry that people do not agree that we should have prioritised care homes early; I think that we were right to do that. I do not know what survey Willie Rennie is quoting—if England has now caught up with us in relation to care home vaccinations, that is good news. However, the fact is that we were ahead in terms of care homes and now we are getting through the other groups.

“If we were missing the targets, I could understand the criticisms that are being made. We are putting in place a programme that involves working through the cohorts as clinically recommended, in an appropriate and sustainable way, and we will continue to do that.”

Willie Rennie objected: “At no stage did I say that we should not prioritise care homes first; let us get that straight. What we are saying is that the First Minister should not use the care homes argument to hide the fact that the Scottish Government has not kept pace with the rest of the United Kingdom.

Professor Linda Bauld criticised the lack of preparation for the second wave.

“Yesterday, Professor Linda Bauld criticised the lack of preparation for the second wave. She went on to urge the Government to get ready now to increase polymerase chain reaction testing to catch more people with the virus.

“Last week, I reported that the Government had failed to use one million gold standard PCR tests since Christmas. This week, it is even worse. The number is now 1.2 million tests that have not been used. The Government is sometimes only using a quarter of the capacity. Is it not time to turn that around?

“I know that the First Minister does not want to listen to me, but will she at least listen to Professor Bauld and use those tests? Why is the First Minister ignoring the advice of such a professor?”

“I do not believe that Willie Rennie really misunderstands the approach to testing, but I think that he continues to pretend that he misunderstands it in order to bandy about figures such as one million unused tests. We use the PCR testing capacity principally for symptomatic cases, so that people can be caught and diagnosed and then put into self-isolation, and so that their contacts can be contacted and told to isolate.

“The reason why the symptomatic cases are not meeting the capacity that we have is that the levels of virus are, thankfully, lower than that.

“However, we are extending the use of PCR testing for asymptomatic use, just as we are using lateral flow devices, community projects, industrial projects and asymptomatic testing among care home staff, visitors to care homes and national health service staff.

“We are piloting approaches for asymptomatic testing using PCR testing and lateral flow devices in schools to help us as we transition to having children back in school, which I hope will be soon.

“We are doing all those things, and doing so in a way that makes sense and that takes account of the very good advice that we get from people such as Professor Bauld and Professor Sridhar.”