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Scotland could eliminate the coronavirus – if it weren’t for England

Scotland may be only weeks away from no new daily cases of coronavirus. As the nation gets close, cases from over the border will become a big problem.



Health


| Analysis

30 June 2020

A handmade sign outside Ballachulish in Scotland’s Highlands

A handmade sign outside Ballachulish in Scotland’s Highlands

Jane Barlow/PA Wire/PA Images

SCOTLAND is only weeks away from suppressing the coronavirus altogether, a situation that highlights the different approaches taken by the nation and England in recent months. While Scotland initially made many of the same mistakes as England, since late March, its government has acted on its own scientific advice.

The two nations responded to the coronavirus similarly from January and up until March, says Devi Sridhar at the University of Edinburgh. “There are a couple of things where Scotland’s gone slightly earlier, but not radically.”

One early Scottish success came in community testing for the disease. When Kate Mark at the National Health Service Lothian in Edinburgh realised that suspected cases were increasing, her team began testing people in their homes and set up one of the world’s first drive-through testing centres. But on 12 March, the UK government abandoned all community testing efforts to focus on testing in hospitals and other healthcare settings, due to a lack of resources. From then on, the disease spread fast until, on 23 March, prime minister Boris Johnson announced a lockdown across the UK.

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This wasn’t soon enough to prevent waves of deaths in care homes in Scotland and England. In both nations, protecting social care had been deprioritised in favour of healthcare. When Scotland began collecting data on covid-19 in care homes on 11 April, 37 per cent of homes were already infected, according to a report co-authored by David Henderson at Edinburgh Napier University. “In certain weeks, there was a 300 per cent increase in care home deaths in England, and 200 per cent in Scotland,” he says. “We could say we were slightly better, but I wouldn’t say a 200 per cent increase in deaths is something to shout about.”

Then the paths taken by Scotland and England began to diverge. Two days after the national lockdown began, Scotland’s first minister Nicola Sturgeon created a scientific advisory group for Scotland to supplement the advice from the UK-wide Scientific Advisory Group for Emergencies. “That’s probably when you started seeing more divergence,” says Sridhar.

“We’ve stuck to our principles of old-fashioned, traditional, evidence-based contact tracing”

Scotland has been slower to relax lockdown than England and has done so in a step-by-step way, so that each change’s effects can be measured. This differs from England’s rapid relaxation, says Sridhar.

Scotland has also been more successful at building up testing and contact tracing, without banking on the UK government’s much-delayed app. “We’ve stuck to our principles of old-fashioned, traditional, evidence-based contact tracing,” says Mark.

Two other factors have contributed to Scotland’s relative success, says Sridhar. The first is clear messaging. On 10 May, the UK government changed its “stay at home” slogan to “stay alert”, but Scotland stuck to the original line. It has since switched to “stay safe”.

What’s more, “there is a very high level of trust in the Scottish government and in Nicola Sturgeon’s leadership”, says Sridhar. According to YouGov, as of 1 May, 74 per cent of Scottish people approved of their government’s handling of the pandemic and 71 per cent were confident in Nicola Sturgeon’s decisions. In contrast, a June poll found that 50 per cent of British people disapproved of Johnson and only 43 per cent approved of him.

On 29 June, Scotland reported just 5 new cases, out of 815 for the UK as a whole, and announced no new covid-19-related deaths for the fourth day in a row. The nation could soon have days with no new confirmed cases. “Scotland’s weeks away from that,” says Sridhar. “England’s months away.”

Yet in practice, Scotland is unlikely to achieve full elimination in the near future, because it has a 154-kilometre border with England. “Many people cross that border every day,” says Sridhar. “I think we will probably never get, without England’s cooperation, to full elimination.”

On 29 June, Sturgeon said that there are “no plans” to quarantine people who enter Scotland from other parts of the UK, but that the nation would need to “be able to consider all options” to stop the virus bouncing back if infection rates are different elsewhere in the country.

However, it should be possible for Scotland to keep the number of new cases very low – and perhaps encourage England to follow suit.

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