Coronavirus (COVID-19): Scotland's Strategic Framework update - November 2021

Looking to the future

This update to our COVID-19: Strategic Framework has once again set out the numerous ways in which we are seeking to manage our response to COVID-19 in Scotland to alleviate the various harms of the pandemic.

Even as we now set our sights on recovery, continuing to effectively manage our response to the pandemic remains critical and will require concerted efforts by individuals and organisations across Scotland. We face a challenging winter ahead, due to existing pressures on our health and social care system and with the prospect of potential increases in COVID-19 cases alongside the return of the influenza season.

This update has set out our progress and plans across the six elements of our Strategic Framework:

• Vaccination: we have already seen remarkable progress in delivering the first two doses of the vaccine and are now pushing ahead with the vaccination of 12-17 year olds and with booster vaccines to address vaccine waning.
• Test and Protect will continue to play an important role in dampening transmission over autumn and winter. In the longer term, as we transition from an acute phase of the pandemic to managing endemic COVID, elements of testing will remain key parts of our response – notably testing for clinical care and testing for surveillance and monitoring. Ensuring capacity for genomic sequencing and surveillance (including wastewater testing) will be key to providing intelligence, and minimising risks of vaccine escape or increase in serious disease that potential variants of concern may cause.
• Protective measures: we will retain a limited set of legal baseline measures alongside guidance, for as long as they are necessary and proportionate. We will be ready to respond with targeted and proportionate interventions should epidemiological conditions require that – we have learned that responding earlier and effectively can reduce the need for tougher restrictions later – but hope to avoid the use of such measures.
• International measures: we will continue to use proportionate border measures, ideally within a four nations approach, to protect against importation, particularly of new variants of the virus.
• Adherence: continued strong adherence to the rules and guidance in place remains imperative. Our new COVID-19 communications campaign for the winter launched on 15 November. We will continue to work with our partners to promote vaccination and testing, and to support adherence to the COVID-19 rules and guidance. In doing so, we aim to avoid the need for further restrictions and to help keep ourselves and others safe.
• Care and Support: a key element within our approach to managing the pandemic is the provision of care and support to those people, organisations and businesses affected by the crisis. In particular, significant progress is being made in the treatment of COVID-19 and 'long COVID'. We continue to work closely with sectors across the economy and broader society to support the further reduction of harms from the pandemic.

In combination, we believe that these measures, supported by the continued efforts and contributions of people, businesses and organisations right across Scotland, will help us to alleviate the broader harms of the pandemic. This will provide the platform for sustainable recovery and a better and fairer future focused on:

• good, green jobs and fair work;
• financial security for low income households; and
• wellbeing of children and young people.

But we will not forget the harm and loss that we have endured during the pandemic. We must, and will, learn lessons for the future – our forthcoming public inquiry will help to explain what happened and why, and help us to manage similar challenges better in the future. We will continue to listen to those affected by COVID-19, including bereaved families, on what they wish the public inquiry to focus on. And we are committed to ensuring that the voices of people affected by the pandemic are heard through this process.

After all the suffering, resilience and sacrifice of the COVID-19 crisis, we all want a more 'normal' way of life. As we recognise the challenges the coming winter will bring it is important to acknowledge the progress that has been made in our response to COVID-19. The last two years have seen huge advances in vaccines and therapeutic developments. Based on current information and understanding, we believe that – while other scenarios are possible - there is a good likelihood that, in time, the pandemic will begin to enter a less acute phase in Scotland, when it will no longer be a public health emergency requiring bespoke legal measures. However, we do not expect the virus to disappear. Instead, we expect it to become an endemic pathogen and the additional activity associated with managing the disease to become something that the NHS has to plan for.

When the COVID-19 pandemic in Scotland moves into this endemic, less acute phase, we expect that more routine public health measures may be sufficient to keep the virus under control in Scotland, though there would continue to be the risk of occasional surges, driven – for example - by seasonality (as we see with influenza), by waning immunity or by new variants and we would need to respond appropriately.

The future management of COVID-19 may potentially include periodic booster vaccinations, ongoing testing for surveillance, monitoring and diagnostic purposes, international travel measures (including those retained by other countries), improved ventilation in buildings, the continuation of enhanced hygiene measures, voluntary wearing of face-coverings when symptomatic, and staying off work when suffering from contagious illnesses.

These measures and behaviours would have positive benefits beyond just tackling COVID-19, with the prospect of wider public health, societal and economic benefits for the long term. Most of these are already in place now, thanks to the efforts and understanding of so many. We are learning how important they are, and how to bring more normality back to our lives. We can look forward with increasing confidence to the removal of the few legal measures that currently remain necessary, while we complete and maintain the protection that good public health measures can give us.