Coronavirus (COVID-19): Strategic Framework update - February 2021

Summary

Our strategic intent remains to suppress the virus to the lowest possible level and keep it there, while we strive to return to a more normal life for as many people as possible.

We have six main tools for achieving this:

• the quickest practical roll-out of our vaccination programme
• the most effective use of Test and Protect
• applying proportionate protective measures (rules and guidance) to suppress transmission of the virus
• effective measures to manage the risk of importation of the virus
• supporting individuals, businesses and organisations to adhere to protective measures
• providing care and support to mitigate the harms of the crisis

All six of these need to be used together and it will take commitment from all of us to make them work effectively.

Due to the concerted efforts of people across Scotland, under the current restrictions case numbers are falling and the current published R number is between 0.7 – 0.9. In time, we hope that vaccination will also have a significant impact in reducing transmission and allow us to live much more normally. However, despite remarkable progress, it is still early days for our vaccination programme and the challenge in the weeks and months ahead is to be able to ease restrictions safely before the vaccination programme has reached its full extent. That is why we are continually striving to maximise the effectiveness of all the tools available to us to both suppress the virus and alleviate its broader harms.

We have strengthened restrictions on international travel and quarantine for people arriving in Scotland from outside the Common Travel Area. We will continue to liaise with the UK Government and the other Devolved Administrations in the hope of being able to adopt a common Four Nations approach to this issue.

We are also continuing to expand our testing capacity. Between them, NHS Scotland and the UK Government laboratories now have the capacity to process 80,000 tests a day for Scotland. We are using this capacity to provide additional testing for people in key public services and critical infrastructure.

We are also expanding the use of targeted community testing – where we make COVID tests available to people who do not have symptoms of the virus. This is especially useful in areas of high or stubborn prevalence.

The new variants of coronavirus that we are dealing with pose a significant challenge. In particular, the increased transmissibility of the now dominant B.1.1.7 variant makes it far harder to open up activities and settings while keeping the R number below one and the virus suppressed. Consequently, we expect that opening up after this current lockdown will be more gradual and more cautious than was the case last summer: this reflects the reality that we are no longer dealing with exactly the same virus.

This update to our Strategic Framework highlights our early priorities for gradually easing measures, when the epidemiological conditions allow us to do so safely. We are deliberately setting conditions for easing, rather than fixed dates, to reflect the ongoing uncertainties with the epidemic. However by outlining our early priorities and a suggested sequencing of easing, initially on a national basis and in due course with a return to geographically varied levels, we hope that people, businesses and other organisations can better understand the likely path back to something much closer to normality. The diagram below sets out how we intend to proceed illustrated through a series of stages.

The Scottish Government has always made it clear that we will prioritise education and a phased return for ELC and schools. That has already started and we hope that more young people will be able to return to school later in March.

However, achieving that, together with the opening up of care home visiting, means that any further easing of restrictions before mid-March is highly unlikely. Indeed, we envisage that the current requirement to stay at home, unless you have a reasonable excuse for leaving, will be in place until at least early April so that we can create sufficient headroom to get more young people back to school.

The timing of any changes will be driven by evidence and data, not predetermined dates. It is also important that we leave enough time between reviews to see the impact of changes.

However, if we manage to keep R below 1 as schools return and have room to ease further, we will start with a gradual easing of the current Level 4 lockdown restrictions where they apply. To ensure that we undertake this easing process safely, we will make use of the six conditions set out by the World Health Organisation.

In due course, we then expect to move back to a geographically differentiated levels approach until the virus is no longer a significant threat to public health in Scotland. Because vaccination roll-out will be important for reducing transmission as well as protecting health, our current plan is that we must have offered the vaccine to at least all of the JCVI 1-9 priority groups before it will be safe to return to fully variable levels across Scotland.

As we take these steps, continued testing, roll-out of the vaccine, border measures and support to people and businesses to help them adhere to protective measures will be key. We will strive to ensure these tools are as effective as they can be to suppress this deadly virus. This will work best if we all play our part.

Figure 1: Phasing of the Strategic Framework

The process of gradual easing of protective measures has begun with the return of early learning and childcare, children in Primary 1, 2 and 3, and secondary school pupils in the senior phase who have to be in school for essential practical work. We are also enabling a small increase in the provision available for vulnerable children – specifically those with the most significant additional support needs – where schools believe that this is essential. We will be monitoring the impact of these changes very carefully as any change could push the R number back above 1, in which case we would have to respond with appropriate measures. We have also announced some opening up of care homes from early March to facilitate meaningful contact between relatives/friends and residents.

Following this initial easing, when we are confident that it is safe to do so, we are planning for the ongoing reopening of schools to all children and young people, as well as a cautious, progressive lifting of some of the additional restrictions beyond education in Level 4 (for those in Level 3 areas, see the section: protective measures and levels system on what Level 3 looks like). These include: reopening places of worship with restricted numbers; allowing 12-17 year olds to take part in outdoor group non-contact sport; easing socialising rules to allow meetings between more than two people from two households outside the home; and opening of child contact centres. Before each new set of easings, we will check that it is safe to proceed further. In particular, we will use the six conditions for safe easing set out by the World Health Organisation. There is likely to be a gap of at least three weeks between sets of easings while we assess the impacts of earlier changes.

As we continue to roll out the vaccination to priority groups and enhance testing, we will maintain protective measures and   border controls will remain in place to limit the spread of the virus and particularly to prevent new variants entering the country. This includes the need for arrivals from overseas to quarantine in specific locations.

Following the re-opening of schools and the other limited easings within Level 4, as the state of the epidemic permits, we expect to return to a situation where the level of restrictions is variable across different parts of the country, depending on the levels of the virus, and consistent with our aim to suppress the virus while returning to greater normality for as many people as possible. Before returning to variable Levels across Scotland, we will make sure that it is safe to do so. In particular, we intend that at least the first 9 JCVI priority groups should have been offered the vaccine. That will be important not only for their protection, but because we expect this vaccination roll-out to help reduce transmission, giving us the headroom to ease restrictions safely. The effects of vaccination on transmission remain uncertain, so we will continue to keep the required vaccine coverage under review.

More generally, this process of easing restrictions and allocating areas to levels will be informed by data to give us confidence that it is safe to make changes. For example, we want to be confident that there will be no resurgence of the epidemic or overwhelming of the NHS. This conditionality is key, given ongoing uncertainties both about the status of the epidemic and the impacts of making any changes to restrictions. As a result of this data-driven approach, we will generally seek to avoid announcing forward schedules of dates beyond those required for short-term planning purposes. We intend to re-align some of the indicators that inform judgements about allocating areas to levels in light of current World Health Organisation (WHO) guidance, to ensure that we can safely open up while continuing to suppress the virus, including the new variants.

Ultimately we want to progress to the stage where, although COVID-19 is unlikely to have disappeared entirely, it stops having such a disruptive impact on our daily lives and is no longer considered a serious threat to public health. This stage is Phase 4 from our original Route Map and remains our goal. However, to get to this stage, a strategy of maximum suppression is essential.

As a society, we are likely to have to live with COVID as a permanent feature. It will not have been eradicated, and we will always have to be vigilant because of the risk of new variants, or further outbreaks.

But if we suppress it as far as we can - as close to elimination as possible - we will get life back to something much closer to normality.

At every stage in our management of the epidemic, we will recognise the wider harms that the virus brings, to people, their communities and to businesses. We will continue to support people and businesses by providing clear guidance, access to information and advice and financial assistance where required and we will redouble our efforts in working with employers, trade unions, Local Authorities, the third sector and others to make workplaces and public spaces safe. The UK Government also needs to play its part, with continued support through the furlough scheme, which this strategy assumes will continue beyond 1 April. Without adequate support for businesses and workers, we cannot mitigate the worst economic harms.

This updated Strategic Framework has been informed through engagement with Parliament and also by the views of business organisations, trade unions, third sector bodies and others. It sets out a targeted and coordinated approach which brings together the many measures required for us to take our next steps forward. The following pages set out our phased approach to easing restrictions and the key actions within each element of this Strategic Framework.

Figure 2: planned easing of restrictions