Coronavirus (COVID-19): Route Map - supporting evidence for the 10 September 2020 review

Any signs of resurgence are closely monitored as part of enhanced community surveillance

As Scotland transitions to the next phase of the COVID-19 pandemic, a responsive system of community surveillance for COVID-19 is essential. The national level measures that have become the mainstay of tracking the pandemic need to be supplemented by local active surveillance.

The Scottish COVID Data and Intelligence Network is working to provide an effective pandemic response at national, local, and sectoral levels, and to support public trust by publishing data. That includes the ability to identify potential new clusters of COVID infections at a near real time and on a small area geographical basis.

Data from Test and Protect will be critical to establish the efficacy of the system and contribute to active surveillance. This includes demonstrating that most new cases are translating into index cases and establishing that high proportions of contacts are traced within 48 hours.

Alongside this, modelling of the pandemic will also continue and will provide an ability to look at the effect of any new cases on the country as a whole and whether this may lead to additional cases that would need to be acted on e.g. around re-imposing lockdown restrictions.

We can set conditions for consideration of whether to re-impose lockdown restrictions (based on our understanding of the impact on transmission risk of the various changes we have made). Re-imposing restrictions should be considered when key measures cross certain thresholds (or meet specified criteria). This could include the estimated levels of R, infectious people, estimated new infections and observed data.

Other lead indicators are now being tracked to identify any resurgence of the virus as part of enhanced community surveillance efforts in Scotland. Maps showing areas of Scotland with higher than expected positive cases, NHS24 calls for respiratory symptoms, and trends in symptomatic patient surveillance at Community Hubs are shown in the SG Situation Report. Data, maps and insights of NHS24 calls and positive tests in local areas are now shared across Scottish public bodies.

Further development is planned for the coming weeks, in particular, we are:

• Assessing a forecast of new COVID cases that looks seven days forwards. This is based on travel patterns. We are currently assessing its predictive power for local authority areas and neighbourhoods.
• Undertaking a survey that started on 10 August that asks where people have gone and how many people they have met/spent time with. This uses a standard approach that is used across Europe that translates changes in people's contacts to likely changes in new cases. This should give good forecasts of new cases for Scotland.
• Analysing waste water for signals of COVID. This will report on 26 areas around Scotland. Early indications are that it can pick up indications when there are COVID spikes.
• discussing potential additional early warning indicators with UK Joint Biosecurity Centre.

There are well established multi-tiered, multi-agency coordinated approaches to managing any public health outbreaks in Scotland. The procedures used are set out in very well established and effective guidance: The Management of Public Health Incidents: Guidance on the Roles and Responsibilities of NHS led Incident Management Teams. This guidance is well known and well understood by local health partnerships. It was updated and published again on 14 July to reflect COVID legislation and the introduction of Public Health Scotland. To support the publication of the refreshed guidance, officials have developed a position statement that sets out six steps to surveillance and response. To support the publication of the refreshed guidance officials are developing a position statement that sets out six steps to surveillance and response.

On the basis of the evidence summarised above, the assessment is that this criterion has been met.