Coronavirus (COVID-19): allocation of levels to local authorities - 15 December 2020
Outcome of the 6th review of the allocation of levels to local authorities, alongside evidence and analysis informing these decisions.
Purpose
This document sets out:
- the outcome of the 6th review of the allocation of levels to local authorities
- a summary of the reasons for changes in allocation
An evidence paper setting out the data and analysis supporting these decisions has also been published.
See: Coronavirus (COVID-19): protection level reviews and evidence to ensure you are viewing the most up-to-date review information.
Decision-making process
On 29 October 2020, as part of Scotland’s Strategic Framework, we published the initial allocation of levels to local authorities. These allocations came into effect on 2 November 2020.
The allocation document makes clear that decisions have to be based firmly on the best available evidence, assessed through a process that is open, transparent and collaborative and frequently reviewed so that restrictions are not kept in place longer than is strictly necessary to achieve the aim of suppressing the virus.
The allocations are reviewed weekly and this document sets out the outcome of the sixth review.
There will be a further review next week commencing 21 December 2020. However our general aim in setting levels this week is for these levels to remain in place until the review point in the week beginning 4 January, unless a improvement or deterioration in the position in the interim requires more immediate action.
In line with the process set out in the allocations document, the National Incident Management Team (NIMT), chaired by Public Health Scotland and including representatives from local government as observers, met to discuss the latest analysis of data, which had been agreed with local partners including Directors of Public Health. The NIMT then provided advice to a group made up of the Scottish Government’s chief advisers and lead officials representing the “four harms” and observers from local government. This group helped form recommendations for Ministers on allocation of levels, which were discussed with the relevant local authorities, and then agreed by the Scottish Cabinet today 15 December 2020.
These recommendations are informed by a broad scope of evidence, to take account of issues such as prevalence of the virus elsewhere, characteristics of the area under consideration and evidence around the efficacy of and response to measures, both in Scotland and elsewhere.
The data itself does not determine the relevant level of any local authority, and it is considered alongside local intelligence and other local, regional and national factors. As Scotland’s Strategic Framework says (p.23), “These decisions require judgement to be applied to all the facts and considerations relevant at the time they are made, and in relation to the area directly affected and for Scotland as a whole.”
Decisions about levels involve judgment, not the mechanistic application of a predetermined set of criteria. A number of broad considerations apply. These include but are not limited to:
- application of general principles of public health and effective disease control including the precautionary principle which may suggest caution in some circumstances and early intervention in others
- the prevalence of infection in neighbouring areas including relevance of travel routes in and out of an area
- trends in the data which may in some cases point to the need for a period of consolidation or stability before the allocation of a level can be reduced
- the effectiveness and sustainability of local public health measures including Test and Protect
- the relevance of “special cause” explanations such as particular outbreaks or events – such as festive relaxations - that may require more limited or specific action to suppress the virus
- hospital capacity may need to be considered regionally and even nationally
The suite of key indicators used to inform decisions around the allocation of local authorities to levels are:
a) The number of cases per 100,000 people over the past seven days
b) The percentage of tests that are positive over the past seven days
c) Forecasts of the number of cases per 100,000 consisting of the weekly number of cases in two weeks’ time
d) Current and projected future use of local hospital beds, compared with capacity
e) Current and projected future use of intensive care beds, compared with capacity
The status of these indicators, including relevant trends for each local authority, is set out in the separate evidence paper.
Summary of review
The allocation document makes clear that decisions have to be based firmly on the best available evidence, assessed through a process that is open, transparent and collaborative and frequently reviewed so that restrictions are not kept in place longer than is strictly necessary to achieve the aim of suppressing the virus.
The allocations are reviewed weekly and this document sets out the outcome of the sixth review.
There will be a further review next week commencing 21 December 2020. However our general aim in setting levels this week is for these levels to remain in place until the review point in the week beginning 4 January, unless an improvement or deterioration in the position in the interim requires more immediate action.
In line with the process set out in the allocations document, the National Incident Management Team (NIMT), chaired by Public Health Scotland and including representatives from local government as observers, met to discuss the latest analysis of data, which had been agreed with local partners including Directors of Public Health. The NIMT then provided advice to a group made up of the Scottish Government’s chief advisers and lead officials representing the 'four harms' and observers from local government. This group helped form recommendations for Ministers on allocation of levels, which were discussed with the relevant local authorities, and then agreed by the Scottish Cabinet today 15 December 2020.
These recommendations are informed by a broad scope of evidence, to take account of issues such as prevalence of the virus elsewhere, characteristics of the area under consideration and evidence around the efficacy of and response to measures, both in Scotland and elsewhere.
The data itself does not determine the relevant level of any local authority, and it is considered alongside local intelligence and other local, regional and national factors. As Scotland’s Strategic Framework says (p.23), “These decisions require judgement to be applied to all the facts and considerations relevant at the time they are made, and in relation to the area directly affected and for Scotland as a whole.”
Decisions about levels involve judgment, not the mechanistic application of a predetermined set of criteria. A number of broad considerations apply. These include but are not limited to:
- application of general principles of public health and effective disease control including the precautionary principle which may suggest caution in some circumstances and early intervention in others
- the prevalence of infection in neighbouring areas including relevance of travel routes in and out of an area
- trends in the data which may in some cases point to the need for a period of consolidation or stability before the allocation of a level can be reduced
- the effectiveness and sustainability of local public health measures including Test and Protect
- the relevance of “special cause” explanations such as particular outbreaks or events – such as festive relaxations - that may require more limited or specific action to suppress the virus
- hospital capacity may need to be considered regionally and even nationally
The suite of key indicators used to inform decisions around the allocation of local authorities to levels are:
- The number of cases per 100,000 people over the past seven days
- The percentage of tests that are positive over the past seven days
- Forecasts of the number of cases per 100,000 consisting of the weekly number of cases in two weeks’ time
- Current and projected future use of local hospital beds, compared with capacity
- Current and projected future use of intensive care beds, compared with capacity
The status of these indicators, including relevant trends for each local authority, is set out in the separate evidence paper.
In announcing the initial allocation of levels to local authorities to Parliament on 29 October, the First Minister made it clear that the Scottish Government was taking a deliberately cautious approach. This was not only to reflect the fact that we were introducing a new framework for the first time, but also the fragility of the situation we were facing.
Compared to late October, when the levels approach was introduced, the daily number of positive cases being reported is generally lower. This suggests that the protective measures that have been in place are having a positive effect. The number of confirmed cases Scotland-wide continues to fall but at a slower rate than in previous weeks.
Cases in Scotland over the past week have remained similar to last week, West Central Scotland is the area of highest concern.
A cautious and limited relaxation of rules over the festive period was announced on 24 November 2020. Over the period 23-27 December, up to 8 people from a maximum of 3 households can form a “bubble”. This measure is being introduced to address issues of loneliness and isolation over the festive period.
There is a significant risk that if family and friends gather for the festive period this could lead to a rise in the R number and increased cases of COVID-19 as a result. It is therefore important to manage this risk carefully to ensure that the hard work and sacrifices of people and businesses across Scotland are not undermined.
In order to safely allow limited gathering over Christmas a deliberately cautious approach has been taken to this review. Lowering prevalence of the virus prior to the festive period is key to avoiding the need for more restrictive protective measures in the new year and ensuing that the NHS does not become overwhelmed by a COVID-19 in January, which is traditionally the most challenging time for it.
The risks around increased social activity over the festive period are particularly acute in large urban areas. The frequent transport links and high concentrations of hospitality and retail venues mean that these areas can attract large numbers of people over the festive period creating increased opportunities for transmission. This additional risk remains a factor for consideration in this week’s review.
For this week’s review almost all of the Local Authorities will remain in their current level, with the following exceptions:
- Aberdeen City, Aberdeenshire and East Lothian will all move from Level 2 to Level 3
These changes will take effect from this Friday 18 December
Increasing trends in case numbers and test positivity in Aberdeen City and Aberdeenshire continue to be a source of concern. Details around the cause and progression of recent infections were examined closely by the National IMT in the week of 7th December. Since then both test positivity and case rates have been rising in Aberdeen City and there are clear signs of continuing high levels of community transmission in Aberdeenshire that are not being addressed by the existing Level 2 restrictions in place across the area. For this reason, both areas will move to Level 3 protections from this Friday.
We have been concerned by an increase in case numbers in Falkirk. However its test positivity rate remains low – at 4.2% - and there are some signs in recent days that the rise in case numbers may have stabilized. For that reason, we are keeping Falkirk in level 2 this week– but we will continue to keep the situation there under close review.
East Lothian has seen a consistent and rapid increase in cases since the end of November (+287% between 30 Nov and 11 Dec. Test positivity has also increased consistently over the same period from 3.3% to 6.0%. Case numbers have increased by more than 50% in the last week - from 69 per hundred thousand people, to 116. That is part of a sustained increase over the last few weeks, and it may also be part of a wider regional trend. For that reason, we have decided that East Lothian should move from level 2 to level 3 from this Friday.
Case numbers in Edinburgh have increased by more than 40% - from 70 per hundred thousand, to 100 cases per hundred thousand. Numbers in Midlothian have risen even more sharply - from 88 to 147. Test positivity in both areas has also increased. These rises are indicative of community transmission, rather than the result of one-off factors, such as specific outbreaks or testing of the student population. As things stand, we cannot responsibly lower restrictions in Midlothian or Edinburgh – at a time when cases are rising, and when we are about to enter the Christmas period.
Argyll and Bute saw a very significant and sharp increase in case numbers in recent weeks, which has been identified as resulting from a single outbreak within a workplace. This resulted in an increase in cases from 66 to 155 cases per hundred thousand as of last week’s review. As a result of the rapid measures and local actions to contain the outbreak and successfully isolate affected staff, this figure has dropped back to 39 cases per hundred thousand. This is in line with what was expected given the previous low Covid rates in the area. However, we will keep Argyll and Bute at Level 2 this week and monitor progress over another transmission cycle to ensure that the outbreak has definitely not seeded the virus in the wider community.
In view of the specific circumstances of island communities with very low incidence of the virus and limited connections with the mainland, we have decided to relax the restrictions on in-home socialising for a number of inhabited islands in the local authority area of Argyll and Bute.
These are Islay, Jura, Colonsay, Oronsay, Coll, Tiree, Mull, Iona, Ulva, Erraid and Gometra. These islands must follow the 6/2 rules for in-home socialising that apply to islands in Level 1 areas.
While these remain the only changes to levels from last week, it is notable that several of the indicators across a number of local authority areas have seen rises in the last week, indicating a lack of sustained progress. In that context, we will continue to scrutinise the evolving situation across all areas, and will hold a further review on 22 December.
We remain confident that with local authorities allocated to the appropriate level, the measures in place within the levels will impact positively on the course of the pandemic. That, however may take some time. So while the decisions summarised in this document are justified, necessary and proportionate for each local authority, the overall national impact of the measures has also to be considered as part of that assessment. That means that local authorities will not move down levels until there is sustained evidence of improvement, but may require to move up levels quickly in the event of a worsening position to mitigate the risk of deterioration and associated harms.
Local authority: allocation of level to each area and summary of indicators
| Local authority* |
Cases / 100k |
Test Positivity |
Cases / 100k forecast |
Hospital forecast |
ICU forecast |
Present level |
New Level |
| East Ayrshire |
H |
M |
L |
L |
L |
3 |
3 |
| North Ayrshire |
H |
H |
L |
L |
L |
3 |
3 |
| South Ayrshire |
M |
M |
VL |
L |
L |
3 |
3 |
| Scottish Borders |
M |
M |
VL |
L |
L |
1 |
1 |
| Dumfries and Galloway |
L |
L |
VL |
L |
L |
1 |
1 |
| Fife |
M |
H |
L |
L |
L |
3 |
3 |
| Clackmannanshire |
H |
H |
M |
L |
L |
3 |
3 |
| Falkirk |
M |
M |
VL |
L |
L |
2 |
2 |
| Stirling |
M |
M |
VL |
L |
L |
3 |
3 |
| Moray |
L |
VL |
VL |
L |
L |
1 |
1 |
| Aberdeen City |
M |
H |
VL |
L |
L |
2 |
3 |
| Aberdeenshire |
M |
M |
L |
L |
L |
2 |
3 |
| East Renfrewshire |
M |
H |
L |
L |
L |
3 |
3 |
| Inverclyde |
L |
L |
VL |
L |
L |
2 |
2 |
| Renfrewshire |
M |
H |
L |
L |
L |
3 |
3 |
| West Dunbartonshire |
M |
M |
VL |
L |
L |
3 |
3 |
| East Dunbartonshire |
M |
M |
VL |
L |
L |
3 |
3 |
| Glasgow City |
M |
H |
L |
L |
L |
3 |
3 |
| Highland |
VL |
VL |
VL |
L |
L |
1 |
1 |
| Argyll and Bute |
L |
L |
H |
L |
L |
2 |
2 |
| South Lanarkshire |
M |
H |
VL |
L |
L |
3 |
3 |
| North Lanarkshire |
M |
H |
L |
L |
L |
3 |
3 |
| East Lothian |
M |
H |
VL |
L |
L |
2 |
3 |
| Midlothian |
M |
H |
VL |
L |
L |
3 |
3 |
| City of Edinburgh |
M |
H |
VL |
L |
L |
3 |
3 |
| West Lothian |
M |
H |
L |
L |
L |
3 |
3 |
| Orkney Islands |
VL |
VL |
VL |
L |
L |
1 |
1 |
| Shetland Islands |
VL |
VL |
VL |
L |
L |
1 |
1 |
| Angus |
L |
M |
VL |
L |
L |
2 |
2 |
| Dundee City |
M |
H |
L |
L |
L |
3 |
3 |
| Perth and Kinross |
M |
H |
VL |
L |
L |
3 |
3 |
| Na h-Eileanan Siar |
VL |
VL |
VL |
L |
L |
1 |
1 |
*Ordered by health board
VL = very low, L = low, OC = of concern M = moderate, H = high, VH = very high
Summary of reasons for change in allocation of level
The following table sets out summary information only. Further data is contained in the supporting evidence paper. Broader information, including at the local level by the National Incident Management Team, has also been considered in reaching these allocation decisions.
| Local authority |
level |
Summary of reasons for decision |
| Aberdeen City |
3 |
|
| Aberdeenshire |
3 |
|
| Angus |
2 |
|
| Argyll and Bute |
2 |
|
| City of Edinburgh |
3 |
|
| Clackmannanshire |
3 |
|
| Dumfries and Galloway |
1 |
|
| Dundee City |
3 |
|
| East Ayrshire |
3 |
|
| East Dunbartonshire |
3 |
|
| East Lothian |
3 |
|
| East Renfrewshire |
3 |
|
| Falkirk |
2 |
|
| Fife |
3 |
|
| Glasgow City |
3 |
|
| Highland |
1 |
|
| Inverclyde |
2 |
|
| Midlothian |
3 |
|
| Moray |
1 |
|
| Na h-Eilean Siar |
1 |
|
| North Ayrshire |
3 |
|
| North Lanarkshire |
3 |
|
| Orkney Islands |
1 |
|
| Perth and Kinross |
3 |
|
| Renfrewshire |
3 |
|
| Scottish Borders |
1 |
|
| Shetland Islands |
1 |
|
| South Ayrshire |
3 |
|
| South Lanarkshire |
3 |
|
| Stirling |
3 |
|
| West Dunbartonshire |
3 |
|
| West Lothian |
3 |
|
Evidence paper
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