Coronavirus (COVID-19) protective measures: indicators and data

Overview

The Levels system within our Strategic Framework has been designed to be applied either nationally or at a lower level of geography should the need for local protective measures arise.  To inform decision making around the appropriate degree of restriction to apply, a set of indicators based on local data has been developed and is set out in this paper.

We describe how we plan to use routinely collected COVID-19 data on epidemiological conditions and health system capacity to inform when and how we change protective measures, in accordance with the Strategic Framework and the Levels Approach.  This document outlines a set of core and secondary local indicators that have been selected for their relevance to the Scottish epidemiological context.

These local indicators will be used alongside wider data and intelligence.  Local intelligence on the source and nature of outbreaks will form a core input to the decisions.  Other factors, such as geography, population density and the level of public adherence will also be considered.  Tighter restrictions may need to be quickly applied in areas where there is a resurgence of the virus.  This may apply if new variants of concern arise that result in breakthrough cases among those who are vaccinated, or where other factors necessitate changing non-pharmaceutical interventions. Applying higher levels of restrictions is just one of the tools we can deploy to suppress the virus and may not always be the most appropriate response; other public health interventions, particularly at the local level, have a key role to play.

Decisions on whether and when to apply geographical variations in restrictions involve numerous evolving and sometimes competing factors.  There is no textbook solution for these complex problems and the decisions will need to take account of data, trends, as well as careful consideration of Four Harms impacts, local population and geographical characteristics and experience gained from managing previous outbreaks.  Judgement will be key to this decision making.

During the process of easing restrictions as Scotland moved out of the early 2021 lockdown, a national ‘lockstep’ move on 26 April to Level 3 was considered as most appropriate and proportionate, particularly taking account of domestic travel considerations.  Up to that date, as set out in our updated Strategic Framework in February 2021, decisions on whether to proceed with nationwide easings[1] were informed by six conditions set out by the World Health Organisation (WHO).

Following this phase, while it is intended that a ‘national’ level of restrictions will still be set (with reference to the six WHO conditions), there will also be scope to vary the level of restrictions on a local basis, where that is considered necessary or appropriate.  For example, this might be done to cater for areas which have experienced significant outbreaks, or (where appropriate) to support earlier moves to lower levels where local conditions support that, for example as announced for certain islands on 11 May 2021.

Aim

The aim of this document is to set out the indicators that will be used to inform – but not determine – the geographical application of Levels of restrictions.  It is designed to contribute to a consistent, transparent and proportionate decision-making approach to managing the pandemic in Scotland.