Coronavirus (COVID-19) update: First Minister’s speech 15 April 2020

Good afternoon everybody. Thank you yet again to all of you for joining us for this daily briefing.

I want to start as usual with an update on some of the key statistics in relation to Covid 19 in Scotland.

As was the case last Wednesday, today’s will have two parts – firstly, an update of the daily figures that you are used to hearing me present at these briefings; and secondly a summary of the key points from the latest weekly publication from National Records of Scotland.

That does mean my update today will be a little bit more complex than usual but please bear with me.

Let me turn firstly to the daily figures - that is the number of confirmed cases, the number of people in hospital and ICU and the number of deaths registered in the last 24 hours of people who had tested positive for the virus.

As at 9 o’clock this morning, I can report that there have been 6748 positive cases confirmed – that is an increase of 390 from the figures reported yesterday.

A total of 1748 patients are currently in hospital either with suspected or confirmed Covid-19 - that is a decrease of 53 from yesterday’s figures.

And a total of 195 people last night were in intensive care with confirmed or suspected cases of Covid 19. That is a decrease of one on yesterday’s figures.

As I said yesterday, these hospital and ICU figures do give us cause for some very cautious optimism at this stage – but I want to caution again that it is too early to be definitive about that. So my caution is not against cautious optimism but against reading too much into these figures at this point.

Not least because in the last 24 hours, I am afraid that 84 deaths have been registered of patients who had been confirmed as having Covid-19 – that takes the total number of deaths in Scotland as of 9am this morning, under that measurement, to 699.

I would remind you though - as I have said over the last couple of days - that death registration is likely to have been lower over the Easter weekend, which means our figures that we have reported in the last couple of days are artificially lower because of that. So today’s higher figure will in part be a reflection of that.

I spoke last week about the way in which we are recording deaths caused by Covid-19.

For our daily update figure - the one you have just heard me give - we report on deaths registered where the individual who has sadly died had been confirmed through that test as having had the virus.

Those figures are the most accurate ones that we are able to provide on a daily basis but they do not capture all deaths from or related to this virus.

So National Records of Scotland – or NRS – began last week to publish each Wednesday a new weekly report.

This weekly report captures all deaths registered within a 7 day period, ending on the preceding Sunday, and this includes – not just those people who have died with a confirmed laboratory diagnosis of Covid-19 - but also deaths which are presumed to be linked to the virus.

So it includes cases where Covid-19 is entered on the death certificate as a suspected cause of death, or as a contributory factor in someone’s death, but where no formal test was carried out.

The number of deaths covered under this reporting system is therefore larger than under the daily system, when you compare the two figures according to the same date. But it is a comprehensive figure and therefore obviously a more accurate one.

NRS published the second of those weekly reports today. It covers the period up to Sunday 12th April – just three days ago. Let me remind you that at that point, we reported a total of 566 registered deaths of people who had tested positive.

However, today’s report shows that by Sunday, the total number of registered deaths linked to the virus - confirmed and presumed - was 962.

608 of those were registered in the 7 days up to the 12th of April.

Now I am acutely aware that this information is hard to hear. It is also very hard to report on. These numbers are higher than anyone could ever want to think about. But we do need this fuller information to understand the toll the virus is having, how and where the virus is progressing, and to inform what we need to do next.

There are three other points that I want to highlight about these figures.

The first is that they provide breakdowns of the deaths according to health board area, sex and age.

And, for the first time, this week’s report provides information about the setting in which people died. They show that 596 of these deaths as of Sunday were in hospitals; 237 took place in care homes; and 129 were at home or in some other setting.

I want to say more about the 237 deaths – that is almost 25% of the total - that had occurred in care homes up until Sunday.

We know that older people are more at risk of becoming seriously unwell or dying from this virus – although I should stress, people of all ages are at risk - and we also know that care homes can be places that are more susceptible to infection outbreaks.

Care Inspectorate figures, to be published daily by the Scottish Government from now on, show 433 care homes have so far recorded incidents of Coronavirus since the epidemic began.

So I want to stress again how hard we are working and will continue to work with care home providers, local health protection teams and the Care Inspectorate to ensure that care home staff and residents have the support and equipment they need.

I also want to make very clear, and this should not need said but I want to say it, that the residents of care homes matter every bit as much to us as people in the community or in hospital.

It is just as important in care homes as it is anywhere else – in fact, I would say it is more important given their vulnerability and susceptibility to infections spreading - that we do all we can to prevent infection and control it when there is an infection in a care home.

The role of testing in this has also been questioned.

We already test the first residents in any care home who become symptomatic of Coronavirus in order to establish the presence of the virus in that home and ensure that all appropriate measures are then taken to protect all residents.

However, we are moving to test all symptomatic patients in care homes.

The CMO can say more about this if there are questions later. But his advice to me is that while this is not strictly necessary for - nor will it change - the clinical management of cases in care homes, it is nevertheless important for the confidence of relatives, staff and the wider public, given the vulnerability of care homes.

But let me also stress, the guidance to care homes is already very clear about isolation and social distancing and that remains the most important factor in making sure we are managing and preventing infections in care homes.

The second point I want to make about these weekly figures is that the overall number of deaths registered last week is again much higher than the average for the same week in previous years. And while this week most of that can be attributed directly to Covid-19, not all of it can.

That issue, as we talked about last week, is one which has been observed in other countries – it is a very serious issue for us to look into and explore further. As our understanding of this develops, we intend to publish more information about it in future reports that we will talk about at these briefings.

And the third point is that these figures record deaths according to the date on which a death is registered. While registration normally happens reasonably quickly – within three days - there can be a gap of up to eight days between somebody dying, and the death being registered.

Because of this, we cannot publish information by the date of someone’s death – as we would like to do - right up until 12th April.

NRS has however published this information - which is the number of deaths by date of people dying rather than date of death registration - for the period up to 5th April. While this is not quite as up-to-date as the other figures we are talking about today, it still gives us a more accurate picture of the spread of the virus to this point.

Now, I focus on the statistics in these updates because they are important. They give some overall sense of how the virus is spreading. And at a briefing like today’s, the statistics do need some explanation.

But I am always very acutely aware that standing here, each death is not just a statistic. Every single one represents a unique, irreplaceable individual, and we should always keep that in mind. I want once again to express my condolences to everybody who has lost friends, a family member or a loved one to this virus.

I also want to acknowledge that listening to these figures and statistics is hard and it is horrible. It is hard and horrible to stand here talking about them. And it can also make you feel powerless – that something we cannot see is claiming so many lives amongst us.

But the point I want to stress as I always do is - none of us are powerless and all of us have some control here. By following the rules, by staying home and by self-isolating when we have symptoms, all of us can help to reduce the number of deaths.

I have one other issue I want to briefly update on today before I hand over to others and to questions and that relates to our support for businesses. We have reflected often that what is a health crisis has become an economic crisis and that we must also do everything we can to support businesses and the economy because jobs and living standards, prosperity and ultimately our health all depends on that.

The Finance Secretary has announced measures worth a further £220 million to help companies which have been affected by this pandemic.

£120 million will allow us to widen eligibility for the Small Business Grant, in order to help businesses with more than one rateable property. In addition to being able to claim a grant of up to £10,000 or - for some businesses - £25,000 for one property, these businesses will now be able to apply for grants up to 75% for each subsequent property that they own. That is a measure that directly addresses a concern that businesses had expressed to us.

In addition, a further £100m fund will target people who might not currently be eligible for other forms of support either from the Scottish Government or the UK Government.

It will be open to self-employed people, particularly newly self-employed people, who are suffering hardship and are ineligible for the UK scheme - and also to smaller companies who simply cannot wait for other sources of support to take effect, or who again may be ineligible for other schemes.

This funding will be open for applications no later than the end of this month. We will publish details on eligibility in the coming days and as soon as possible.

These measures, if they are taken up in full, as I would expect them to be, mean that the overall support for business offered by the Scottish Government will actually exceed the £2.2 billion of budget consequentials we received and which were so welcome from the UK Government’s package of support.

They are a direct response to feedback from businesses. And they, I hope demonstrate our determination to support to the maximum we possibly can, businesses across the country which are suffering through no fault of their own. I hope it demonstrates as well, our willingness to listen and to always seek to respond to concerns that are expressed.

Before I hand over to the Interim Chief Medical Officer, I’d like to end by repeating the key public health rules.

Other than for a few very specific reasons, such as exercise or buying essential goods, you should stay at home – you should not be going out.

You should stay 2 metres apart from other people when you do go out for essential purposes.

You should not meet up with people from other households. And, if you or other people in your household have symptoms of Covid 19, you should be isolating completely – you should not be going out at all, even for essential purposes.

I know how difficult these rules are, but the figures I have read out – some of them show signs for cautious optimism, but others - still deeply distressing. These figures demonstrate just how important it is that we all continue to follow these rules. They are making a difference and they will continue to make a difference. They will hopefully bring much closer - the time when we can start to get our lives and the country back to normal.

So thank you, once again, to each and every one of you for doing the right thing and sticking to these rules. By doing this, we are all helping to slow the virus, save lives and to protect the National Health Service from being overwhelmed. Thank you sincerely to all of you.