Coronavirus (COVID-19): review of physical distancing in Scotland - June 2021

Background

In responding to the pandemic, we have been guided by the principles outlined in our Framework for Decision Making.^[3] In it, we set out the direct and indirect harms of the pandemic, which we consider in our "four harms" approach:

• The virus causes direct and tragic harm to people's health;
• The virus has a wider impact on our health and social care services, and our wider health and wellbeing;
• The measures necessary to protect us from the virus can in turn cause harm to our broader way of living and society; and
• Protective measures have a damaging effect on our prosperity.

Restrictions on individuals, organisations and businesses impact on the economy, society and on the exercise of fundamental rights. It is therefore necessary for decision-making and judgment on restrictions to take into account both the direct harm of the pandemic in terms of morbidity and mortality and the broader impact, or 'harm', caused by restrictions.

Scotland's Route Map^[4], published in May 2020 and Scotland's Strategic Framework published in October 2020^[5] (and subsequently updated in February 2021^[6] and June 2021^[7]) are rooted in this approach.

In order to reduce transmission of the virus, we have had to reduce opportunities for the virus to spread and protective measures, or non-pharmaceutical interventions (NPIs), are a critical tool in the management of the virus. Physical distancing has been an important component of this and throughout the pandemic, we have reinforced the importance of individuals, businesses and organisations continuing to follow the FACTS measures for a safer Scotland: face coverings; avoid crowds, clean hands, two metre physical distancing and self-isolation.

Looking forward, we expect that the role of NPIs – including physical distancing – in managing the epidemic in Scotland will be significantly reduced as the protective effect of the vaccine both reduces the direct health harms of the virus and helps to reduce transmission. As a first step, the guidance on physical distancing was changed on 17 May so that it was no longer necessary to maintain physical distancing between family and friends in a private dwelling or private garden in areas in Level 2 or lower.

General requirements to ensure that distancing is maintained between those from different households in public premises remain at all Levels as part of the Health Protection (Coronavirus) (Restrictions and Requirements) (Local Levels) (Scotland) Regulations 2020. The general requirement is to ensure that a distance of two metres is maintained, though a distance of one metre applies in places such as hospitality settings where there are particular transmission mitigations in place. In outdoor public places such as parks, individuals are advised to maintain a distance of two metres from others outwith their household.

In reviewing these remaining requirements, we have taken particular account of the fact that the vaccination rollout has been highly successful to date – and as a result, we have seen relatively fewer cases ending in hospitalisation and Intensive Care Unit (ICU) admission.

However, the virus is still out there. The spread of the Delta variant in Scotland is both a real threat and a reminder that variants of concern may continue to emerge and threaten to undo the progress we have made so far. So it remains necessary to continue to move cautiously in our approach to easing physical distancing measures.

We are still learning more about the Delta variant. It is currently thought to be much more transmissible than the Alpha variant that was the previous dominant variant in Scotland.^[8] R is now estimated to be 40–80% higher for delta than for Alpha.^[9]

There also remains a degree of uncertainty regarding the impact of the Delta variant on severity of illness, treatment or reinfections. Analysis of vaccine effectiveness against symptomatic disease with the Delta variant suggests that, while vaccine effectiveness is lower in Delta cases compared to Alpha cases after one dose, any difference in vaccine effectiveness after two doses of vaccine is likely to be small.

It is within this context that we are setting out our review of physical distancing. We understand that different sectors or settings have faced significant challenges with physical distancing measures in place and that businesses and individuals are looking for clarity on what physical distancing will look like in the period ahead.

We know that almost all sectors are economically impacted by physical distancing. We regularly engage and consult with different businesses and sectors and many have cited concerns regarding the commercial viability of operating with two metre physical distancing in place. We are grateful to them for sticking with measures to keep their staff and customers safe whilst we make further progress with the vaccination roll-out and hope that the outcome of this review will assist them in planning for resuming operations at full capacity.