Coronavirus (COVID-19): Route Map - supporting evidence for the October 2020 review
Supporting evidence to inform decisions about timings of changes within Phase 3 as set out at the review point on 15 October 2020.
WHO criterion 1: Evidence shows that COVID-19 transmission is controlled
- R is consistently low
- Number of infectious cases is showing a sustained decline
These criteria are not met. SAGE's consensus view, as of 8 October, was that the value of R in Scotland was between 1.3 and 1.6. The various groups which report to SPI-M use different sources of data in their models (i.e. deaths, hospital admissions, cases) so their success at capturing recent changes varies from group to group, leading to increased levels of uncertainty at this point in the epidemic. However R in Scotland is now above 1. The SAGE consensus is updated weekly on a Thursday.
Supplementary measures
The number of new confirmed COVID-19 cases by specimen date showed a sustained decline since peaking in late April 2020, based on the 7 day moving average, up until 9 July, even in the context of increased testing and expanded eligibility. In early July there were fewer than 10 new cases a week and at the last review we reported 232 per day in the week to 19 September. Since then the weekly average number of new cases per day has increased to its highest ever level of 988 on 10 October.
Source: Public Health Scotland daily dashboard, 12 October 2020
The number of hospital admissions per day for those with a positive COVID-19 result showed a sustained decline from 7 April 2020, based on the 7 day moving average, but has recently started to increase. In the week ending 8 October there were 46 admissions per day, compared with under 5 per day in early September and fewer than 1 per day in mid-July.
Source: Public Health Scotland daily dashboard, 12 October 2020
The number of new daily ICU admissions showed a sustained decline from 4 April based on the 7 day moving average, and while still low has shown signs of increasing again recently. In the week ending 11 October, there were 21 confirmed COVID-19 patients admitted to ICU compared with 8 in the week ending 21 September.
Source: Public Health Scotland daily dashboard, 12 October 2020
After peaking at 661 in the week ending 26 April (week 17), the number of deaths involving COVID-19 reduced to less than 1% of the peak level but has started to increase slightly again.
As of 4 October, there have been a total of 4,276 deaths registered where COVID-19 was mentioned on the death certificate. In the latest week (to 4 October) there were 20 deaths, which was double the previous week's number and 3% of the peak level. The previous review reported 5 deaths in week ending 13 Sept.
Source: https://data.gov.scot/coronavirus-covid-19/detail.html#1_direct_health_harms
The proportion of those who have a positive test for COVID-19 out of those who are symptomatic of COVID-19 in community healthcare has increased in recent weeks. There were no swab positives for three weeks, week 27 (29 June to 5 July) to week 29 (13 to 19 July) but 36 positive swabs in the most recent week (28 September to 4 October) which represents 7.6% of swabs.
In conclusion:
A significant increase in case numbers has been observed over recent weeks and the weekly average number of new cases per day has now increased to its highest ever level. Hospital and ICU admissions and deaths have increased over recent weeks and continue to rise.
The estimated range on R has been above 1 in Scotland for the last three weeks.
On the basis of the evidence summarised above the assessment is that these criteria have not been met at this review point
Contact
Email: craig.gibson@gov.scot
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