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

Protective measures

Scotland, like many other countries, retains a number of legal requirements ('baseline measures') and a range of good practice guidance to reduce transmission of the virus and to alleviate current and future pressure on the health and social care system. These protective measures are considered both necessary and proportionate to achieve our strategic intent of suppressing the virus to a level consistent with alleviating the broader harms of the virus. Continued strong adherence with these measures will be essential to their effectiveness. The current baseline measures required by legislation are set out in Box A.

Box A: Scottish Government legislative baseline measures

• face coverings continue to be required in most indoor public settings and on public transport (unless exempt);
• hospitality and entertainment venues are required to collect the contact details of customers so that Test and Protect can continue to contact-trace positive cases;
• businesses, services providers and places of worship continue to be required to have regard to Scottish Government guidance about measures to minimise risk of exposure to COVID-19 relating to their business, service or premises; and
• the Vaccine Certification scheme (see Box B for detail).

Other measures are covered by guidance rather than regulation and include:

• good hand hygiene and surface cleaning;
• continued promotion of good ventilation; and
• continued compliance with Test and Protect, including self-isolation when necessary.

While some employers are already working with employees on a phased return to office working, in line with what is appropriate for their business, customers and staff, we continue to encourage a greater degree of working from home than pre-COVID-19, where this is possible and appropriate, particularly over these coming winter months to help reduce transmission.

There is clear evidence on the effectiveness of good ventilation in reducing transmission of COVID-19 in enclosed spaces. You cannot see infectious particles but they can hang around in the air in enclosed spaces unless fresh air is introduced to disperse them. That is why we established an expert short-life working group to consider how we enhance our approach to ventilation. In response to their recommendations, we have established a £25 million business support fund to support small and medium enterprises to enhance ventilation. We provided additional funding of £10 million to enable local authorities to undertake CO₂ monitoring to assess the ventilation levels in all learning, teaching and play spaces and we continue to consider how this approach could be of benefit in other settings. In parallel we continue to encourage businesses and individuals to improve ventilation by ensuring they are using properly maintained mechanical systems, or opening windows, doors or vents a small amount regularly to improve the flow of fresh air in indoor settings.

As noted earlier in this Update, it has been very encouraging to see COVID-19 case numbers in Scotland twice fall significantly without the need for increasing restrictions. This indicates that at those times, and with the prevailing epidemiological conditions, the combination of fairly high levels of immunity with other factors – including behaviours shaped by the protective measures and seasonal factors – was sufficient to put the reproduction (R) number below one and the virus on a downward trajectory. However, recent increases in cases from a high 'plateau' points to the need for both continued caution and continued adherence to the rules and guidance in place, as weakening adherence may push cases up further. The current resurgence of COVID-19 across much of Europe underlines the risk that the virus continues to pose.

Of course, epidemiological conditions can and do change over time – positively and negatively – and so the measures required to be in place to keep the virus under control at any given moment will change over time too. This is why we keep our baseline measures under ongoing review to ensure their continued necessity and proportionality. Factors that may shift epidemiological conditions include:

• new variants – particularly those that better evade immunity and those that are more transmissible;^[11]
• waning immunity over time – particularly vaccine waning; and
• changing behaviours – particularly those that make transmission of the virus more or less likely (which could be due to seasonal factors, for example).

For this coming winter, given what we know and expect about current and future pressures and the risk of potential increases in case numbers, we currently judge that we need to retain baseline measures alongside the other factors that are helping to keep the virus under control that are set out in this document including:

• high levels of immunity (driven primarily by increasing vaccination coverage and booster vaccinations);
• effective and proportionate testing, contact tracing and self-isolation where appropriate; and
• clear communications and support to help people, businesses and other organisations adhere to the rules and guidance that are in place.

This multi-faceted approach has sometimes been described as a 'vaccine plus' approach. Alongside many other countries, we judge that we cannot yet rely on the effectiveness of vaccination alone to achieve our aim of alleviating the broader harms of the virus.

These baseline measures now include a vaccine certification scheme (see Box B) which was introduced on 1 October 2021 and is required for entry to some specific settings. The aims of the scheme are to:

• reduce the risk of transmission of coronavirus;
• reduce the risk of serious illness and death thereby alleviating current and future pressure on the National Health Service;
• allow higher risk settings to continue to operate as an alternative to closure or more restrictive measures; and
• increase vaccine uptake.

As with the other baseline measures, we recognise that measures such as certification sometimes impinge on personal freedoms and fundamental rights, but we judge that this is both necessary and proportionate for managing this stage of the epidemic. These legal measures are not interventions that we would wish to make in normal times. They reflect the ongoing public health emergency caused by the virus and we will continue to keep them under review to ensure their ongoing necessity and proportionality. We will remove them when they are no longer necessary, but equally we may have to extend them should the state of the epidemic require further action to control infections.

Box B: COVID-19 vaccine certification scheme summary

From 1 October 2021, COVID-19 vaccine certificates are needed to access the following higher risk settings in Scotland:

• late night premises with music, which serve alcohol at any time between midnight and 5am and have a designated place for dancing for customers;
• indoor events (unseated) with 500 or more people;
• outdoor events (unseated) with 4,000 or more people; and
• any event with more than 10,000 people.

To gain entry, everyone attending these settings and events must be able to show they have been fully vaccinated with an approved vaccine as set out in the guidance (unless exempt) and two weeks have passed for the vaccine to take effect.

In settings where vaccine certification is required, venues and event organisers will need to ensure there is a reasonable and proportionate system for checking and restricting entry to only those who are permitted to be on the premises.

From consideration of potential scenarios about how epidemiological conditions might change, particularly over the coming winter, there are some scenarios in which further targeted and proportionate interventions would again be required, on a temporary basis, to control the virus. We hope that these scenarios – such as a new variant of concern that is worse than, and replaces, the now dominant Delta variant – do not become the reality, but we need to be ready in case they do. And past experience from this pandemic has taught us that early, effective intervention can reduce both future harm and the need for tougher restrictions later.

We already have our system of protective levels of gradated restrictions, which would enable us to respond in a targeted and proportionate way, potentially tailored by geography, in response to epidemiological conditions. But we hope not to have to deploy the levels again, even on a temporary basis, and were we to reach the point where further restrictions were deemed necessary, we might well adjust the previous levels to reflect the epidemiological conditions at the time. Alternatively, we might pursue specific restrictions on certain high-transmission risk settings that would avoid the need for a more general levels approach and thereby alleviate broader harms.

We want people and organisations to be assured that we will be ready to respond effectively should the epidemiological conditions require that. However, the re-imposition of restrictions remains very much a contingency that we hope not to have to deploy: the current baseline measures, as part of the broader strategic approach set out in this Update – including our plans for maintaining high levels of protection through vaccination – are how we intend to keep the virus sufficiently under control in Scotland, particularly during this coming winter, thereby avoiding the need to deploy such contingency measures. For this approach to work we need to sustain our nationwide, collective effort to adhere to the rules and guidance in place.