Coronavirus (COVID-19): Our shared role in containing the virus: Analysis of responses submitted as part of the Scottish Government's second public engagement exercise

3) The Scottish Government Approach

There was a considerable cluster of ideas on the general approach taken by the Scottish Government to tackle the pandemic^[5]. Views on the continued use of restrictions (as well as ‘circuit-breaks’ or further ‘lockdowns’) attracted extensive engagement, appearing among a large share of the most engaged-with ideas. The engagement took place at a critical time for managing the pandemic, with infections rising and increasing restrictions following an ease in conditions over the Summer.

Views about the overall Scottish Government approach could generally be grouped into three wider “attitudes”: some were largely supportive of the the approach, though called for more stringent and enforced measures; some were opposed to the overall strategy and continued use of measures that restricted population freedoms and behaviour; and an intermediate view was that individual measures, should be eased or tweaked to better balance broader considerations around wider health and the economy. There were also general views on governance and government decision making which often informed and/or confirmed these wider attitudes.

The key themes of discussion were:

• Views on the strategy behind the Scottish Government approach
• Modifications that could be made to the Scottish Government approach
• Views on central and local government decision-making processes

Views on the strategy behind the Scottish Government approach

There was a range of views on the overall direction of the Scottish Government in tackling the virus. This included support for the approach being taken but more critical views were prominent on the platform.

Those that supported the government saw it as making good use of its powers in a difficult situation. Actions to control the spread of infection, such as “circuit breakers” were seen to be necessary, and there was confidence expressed in the scientific evidence that was taken into account.

‘Goodness, I love the amount of epidemiologists on here [the Dialogue platform] assuring me that all will be fine or that there is no need for a further lockdown. Hmm. I prefer to go with the advice from the myriad of experts (…) who come together to advise the Government. I may not 100% like the decisions which come from this advice but can accept them as being considered’

At the same time, some respondents thought that stronger action would be required in order to address rising infections, and to forestall the need for more prolonged action at a later date. The provision of a furlough scheme (at the time up to 31 October) also figured in some respondents’ concerns for improving compliance with self isolation and face-covering, combined with an effective test and trace regime (discussed in other chapters).

Those that opposed the Scottish Government approach came from a range of positions. There was opposition to the continued use of restrictions that curbed population freedoms and controlled societal behaviour - and a view that the Scottish Government should completely ‘rethink’ their strategy at the population level.

Some respondents felt that we needed to ‘learn to live with Covid’ and that further restrictions would not help in the long-term, particularly given the probable timescale associated with the development of a reliable vaccine or cure, and difficulty with compliance and enforcement over a long period of time. There was concern that with each cycle of the virus re-emerging, the efficacy of lockdown measures would begin to break down.

‘[…] we can’t keep going in and out of lockdowns. It’s clear from our last attempt that it’s only suitable as a temporary measure and that a rise in cases will be inevitable as soon as we restore some normality.’

A further group felt that the public health benefits of restrictions on virus suppression were outweighed by the negative ramifications on the wider economy and business environment, and wider population health and wellbeing.

‘I understand the public health concern but we have to learn to live with the virus. (…) We must find a way to function as a society with this virus and not be ruled by fear. We cannot do that if our economy and country fails financially, mentally, physically and emotionally.’

There was also frustration with restricted individual freedoms and calls for more personal responsibility and choice in how people can live during the pandemic.

‘People who want to shield. Let them. The people who want to live their life and make this choice. Let them. (…)’

Linked to this were concerns about the evidence underpinning restrictions (more detail below) and a desire for greater use of local-level data on transmission sites and rates. Greater evidence-based messaging was seen as being crucial in allowing individuals the freedom to make informed and empowered choices about their own behaviour and risk exposure.

‘We really should be told where the positive cases are so we can protect ourselves and our loved ones. There should be more transparency so we can make informed decisions over where we go.’

A number of respondents felt that society should be opened up to all low-risk groups, while supporting and protecting vulnerable groups. This seemed to build on the Great Barrington Declaration - a communique which began circulating among international academics shortly before the engagement opened, calling for ‘focussed protection’ for vulnerable groups while letting others decide what risks they are prepared to adopt.

‘Instead of lockdown and quarantining the healthy - I propose we protect the vulnerable and allow all others to return to normal life. Open all businesses and social/civic activities. The young and healthy are at minimal risk from harm caused by Covid and the more exposed to it the quicker we can achieve herd immunity - thus protecting those with compromising health conditions and the elderly. Those who are fearful can choose to continue isolating. Treat us like adults who can make informed decisions.’

However, there was opposition to this idea because of the difficulty in defining who fits under ‘vulnerable’ categories and the ethical considerations associated with limiting the freedoms of those considered most ‘at risk’ in society. There were also counter-suggestions about how, in the case of a mass re-opening of society, high-risk groups could be further protected by increased testing (see chapter on Testing and Use of Information ).

‘[The] words “protect the vulnerable” concern me. Who will be the judge of who is vulnerable? There is a real danger that people considered vulnerable will be isolated. Unacceptable.’

Views on modifying the Scottish Government approach

There were differing views on the best balance that could be achieved between restrictions for public health and and support for the economy and broader health and wellbeing, while protecting the most at risk in society.

There were many pleas to ease restrictions on social contact, particularly because of the mental health benefits and need to counter isolation and loneliness (see section on mental health, loneliness and isolation).

‘Many like myself live alone and their partners or those closest to them do not live with them, due to work or distance etc. Please continue to allow us these bubbles and to stay within our new extended households. And allow us to travel between them. (…) Mental health needs to be brought to the front.’

There was much discussion on the extent to which social restrictions could be eased, what constituted a bubble, how many people should be able to meet at any one time, and how many households per day. Seasonal changes were emphasised - with respondents worried that it would be harder to meet people outdoors as winter approached.

‘It is essential that we be allowed to have small gatherings in private homes - the mental health impact of banning these is already severe, and will become catastrophic as we get further into autumn and winter.’

A number of comments with some of the highest engagement on the Scottish Government social media posts announcing the enagement exercise, were about care/nursing homes and the isolation and loneliness faced by their residents due to lack of contact with families.

There were also comments which advocated lifting guest limits on weddings and funerals and on associated receptions and wakes. With regard to weddings, there was concern that uncertainty was making it difficult for people to plan and putting increased stress on couples. There was also a perceived contradiction associated with restrictions on weddings compared with other areas of mixed socialising (such as restaurants or religious services). It was suggested that businesses overseeing wedding venues should have more jurisdiction over guest limits - and that perhaps this could be linked to the size and capacity of the venue itself.

There were calls for an easing on some restrictions on certain economic sectors and calls to reopen some businesses. Proponents voiced concern about the impact of continued and/or increased restrictions on the broader economy and the associated welfare of business owners and employees. Sectors highlighted were the beauty industry, arts and entertainment industry, tourism industry and night-time economy (such as night-clubs).

Some contributors expressed safety concerns about hospitality venues and customers’ abilities to maintain physical distancing, and proposed a variety of solutions designed to better ensure safety, ranging from booking systems and temperature checks to entire closure of premises or the wider sector.

However, there was particular evidence of support for hospitality (and tourism), especially following the restrictions on licensed premises announced mid-way through the Dialogue project. There was a view that licensed premises were being scapegoated and the restrictions would only negatively affect business owners and the economy more generally. Additionally, there was debate about the efficacy of curfews, with some voicing concerns that curfews would result in increased numbers congregating in the street, on public transport and inside private homes.

‘We run an extremely Covid secure restaurant, we have distance, one way systems, ventilation, track and trace system, traffic light system, temperature checking and many other procedures in place (…), [Why] is a small day run tearoom put under the same umbrella as a late night pub/music venue with everything that falls in between. We are a massive contribution to the national and local economy but are painted as the villains of corona virus. Activate your EHO's to do unannounced spot checks on all their local venues to make sure of compliance and therefore preventing the "bad apples" of hospitality destroying the whole barrel.’

There was an argument for extending travel restrictions, both nationally, and locally. Ideas included testing at airports, better checks on quarantining on arrival from abroad, and restricted travel between Scotland and other parts of the UK.

Some argued that greater use of targeted restrictions would represent a more balanced and proportionate approach to generic national ones. Localised geographical restrictions were favoured because of the perceived fairness in keeping communities without high infection rates unaffected by further individual restrictions; the advantage of being able to keep the economy and community support open in areas without high infection rates; and lack of trust in the public complying with a full national lockdown. There were also arguments that local data could enable highly targetted action by local authorities to meet issues specific to the area.

‘I believe the Scottish Government was correct in taking a comparatively more cautious approach to leaving lockdown. A long and painful necessity. However now we know more. We know who the virus affects, how it spreads, where there are likely to be / are particular issues. A more targeted approach allows for swift action but for areas of the economy and community unaffected to continue. I also worry how (…) tolerant and ultimately compliant people will be with a full lockdown.’

An alternative idea was that a targeted approach take account of demography in terms of high-risk categories (as discussed above) and/or groups who were deemed more likely to to be transmitting the virus based on recent data.

‘It can be shown that infection is not being spread by retired people to any great extent but rather in settings attended by younger people such as colleges, universities, schools, nurseries, house parties, etc., then further restrictions should be targeted on those groups by making restrictions age specific. In this example, those aged 60 and over (not in mixed age households) could be made exempt from further restrictions.’

However, there was also counter-arguments to localised restrictions because of a perceived lack of evidence of the positive impact where they had been imposed (e.g. North of England and Glasgow area) and a perceived inconsistency with where administrative ‘borders’ lay and other local conditions which would determine how practical it would be to comply.

Views on the Scottish Government decision-making processes

A number of contributions were submitted on how decisions were made. Some ideas explored these processes in principle. However general views on governance and government decision making were also evident in discussion on the wider attitudes outlined above, and sentiment about decision making could be similar to the attitudes on the decision itself.

There was discussion around the science, data and evidence informing decision making, and calls for a wider evidence base to be sought and utilised, particularly on the range of impacts associated with introducing restrictions, and utilising testing data to a greater degree There was a range of views on where scientific opinion lay, with respondents citing it both in opposition to the lockdowns, and in calling for stronger restrictions.

Contributions were also received on how decisions were being communicated to the wider public with some respondents wanting to see greater transparency about the evidence informing decision making. There was a suggestion that public support and compliance, though initially at higher levels, was decreasing because some believed the risk of the virus to many in the population is relatively low.

‘Although the initial unprecedented public health response to this crisis had been generally understood and supported, the subsequent measures lacked coherence and scientific justification. There is a clear decreasing support for continued restrictive measures when for vast majority of the public the risk of serious illness or death of this virus is low.’

There was positive commentary on the First Minister’s daily briefings – seeing it as a key source of information which was well communicated .However views included wanting the briefing to be at another time outside the working day to allow for greater convenience for the television audience, but also that the briefings should be scaled back due to percieved repetition.

There were concerns about how potential future measures were discussed. ‘Threats’ of further restrictions in the media and in government briefings, without full details and/or rationale behind them were said to cause anxiety, frustration and confusion and contributors suggested that this had the potential to erode trust in government and individual compliance.

‘Waking up to see articles that seem to know everything [on] 'circuit breaker introduced from 7pm Friday' is not only confusing but causing people extreme anxiety. I don't think anything above will be taken into consideration[;] the decisions have clearly already been made.’

Others found the government messaging confusing, with a perception of uncertainty about what the ‘end goal’ is (‘flattening the curve’ or ‘eradicating the virus’) and the principles underpinning them. They wanted to see clearer explanation in order for the public to better evaluate measures taken and whether they are justifiable.

Some contributions suggested that there was a need for greater parliamentary debate, scrutiny and approval of further measures, and greater citizen participation^[6].

‘The government is making a decision that preventing deaths from Covid is the most important thing for the population and dominates every other disease and quality of life issue. This assumption needs to be tested with the population and deserves rigorous debate in the Scottish Parliament.’

Views on the Dialogue platform itself were relevant here. Some contributors deemed it ‘tokenistic’ and/or were sceptical that it would be useful or used to influence government policy. However, the Scottish Government promotion of the platform was retweeted by many users who stated the importance of participating, and there were requests that the site remain open longer for more contributions. There was also a call for a wider variety of feedback routes to be available for citizens to voice their opinions on the Scottish Government response.

In terms of comparison with the approach of other countries, there was limited discussion, with contrasts being made with other governments often associated with the respondent’s preference (for example, Sweden or New Zealand as exemplars of different approaches). Commentary pointed out that lessons should be learned from outside the UK as well as through comparison within the UK.