Scottish Government COVID-19 Advisory Group minutes: 23 April 2020

Attendees and apologies

Advisory group members

• Andrew Morris
• Angela Leitch
• Aziz Sheikh
• Chris Robertson
• David Crossman
• Jill Pell
• Mark Woolhouse
• Stephen Reicher
• Sheila Rowan
• Tom Evans
• Jim McMenamin
• Jacqui Smith.

Invited attendees

• Mary Black

Scottish Government

• Roger Halliday
• Nicola Steedman
• Niamh O’Connor
• Richard Foggo
• Daniel Kleinberg
• Donna Bell

Secretariat 

• [Redacted]

Items and actions

• minutes

• summary notes

Minutes

Welcome and apologies

Chair welcomed all group members, especially [Redacted] and [Redacted] joining the group today.

Apologies – [Redacted].

Minutes, action points, Chair update

Chair confirmed he is in discussion with the Secretariat regarding the implications of the group being in the public eye and reminded the group of the need to be cautious when dealing with the media as their comments can be taken as an indication of upcoming government policy.

Chair and [Redacted] thanked the group for their input in response to policy requests, noting that the First Minister values the work of the group and has asked to receive the minutes.

Terms of reference, [Redacted] requested that it should be set up as more of a two-way relationship with SAGE. Chair will include a standing item on the agenda to ask the group for key messages to convey to SAGE.

The group discussed priorities for deep-dive topics, Chair summarised:

• schools / education
• Test-trace-isolate (TTI)
• care homes
• Non-COVID health impacts
• public order from a behavioural science perspective
• considering health requirements of people who have survived COVID-19, particularly rehabilitation after ICU

Important to engage across Scottish Government and link into SAGE on all of these key items.

Group noted that the Department for Education has set up a new group to consider schools and education and that there is a Scottish Government representative on the group. Scottish Government officials who sit on the advisory group can ensure information is passed both ways.

Update on modelling

[Redacted] gave a brief update on the current modelling process and ongoing work. A Scottish version of the Imperial model has been developed. Also work is ongoing on options such as school return and outdoor work.

[Redacted] has spoken to [Redacted] about the hospital modelling work. His group is also doing some work on this and he noted that it is healthy to have advice from more than one modelling group and that it would be good for this capacity to be developed further in Scotland. [Redacted] noted that it is key for policy and programme managers to understand R.

[Redacted] – this is a key function for this group to take ownership of. There is a need to ensure that different aspects of modelling are joined up, e.g. of health surveillance, clinical planning, and the science behind the models. Some groups are applying for money to look at the science behind the models – maybe Scottish groups should also apply. Can we pull Scottish modellers together under [Redacted]’s leadership?

[Redacted] – it would be good to understand how / if this work joins up with Board modelling of capacity.

[Redacted] – is there a need to consider different ways of working if there is likely to be significant pressure on hospital beds? [Redacted] also noted that medicines capacity in ICU is a current challenge.

[Redacted] – gathering different approaches to work towards broad consensus would certainly be valuable and they are working with different modellers across the NHS.

Action: [Redacted] will share work on modelling hospital capacity in relation to different rates of infection and will speak to [Redacted] and [Redacted] directly on hospital pathways.

Action: [Redacted] to put together a one-pager on how the group can support him on modelling, including how the group can coordinate Scotland’s modelling expertise in a coherent way.

CSA update

Edinburgh Centre for Robotics has produced information on how robotics could help in the current outbreak. [Redacted] has put this on Slack. Together with [Redacted] and CSA network from England, [Redacted];s team has produced a review of virus survival on surfaces. ScienceWise – run by BEIS, UKRI, and a charity called Involve – has offered to engage with public on science issues relating to COVID-19, [Redacted] will put the information on Slack.

Action: [Redacted] will ensure Scotland is represented on SAGE group about environmental spread.

SAGE update

Chair spoke to the SAGE note shared with the group.

Face coverings – defining ‘situations in which social distancing is difficult’ would be useful.

[Redacted] noted the importance of having information on date of death and not date of death reporting. This is being worked on. [Redacted] noted this is done for flu and [Redacted] agreed this could be shared after NRS data has been published each week.

[Redacted] – if all patients were to be tested upon admission to hospital as in England, what would that mean for PPE and testing capacity in Scotland? As a study to show the current rate it could be very useful though. Noted need to consider asymptomatic infection in TTI. [Redacted] agreed important and noted importance of test return time.

[Redacted] – anonymous testing in emergency departments could be very useful, also what to do with cohorting where cases are not yet confirmed is an important consideration. Care homes – there is a taskforce working on this and looking at international evidence.

[Redacted] – it has taken a number of weeks of negotiation to get testing at the front door in hospitals in England. Anonymous testing of hospital workers is still not happening. England is doing a 3-week programme to test care home residents in different settings. [Redacted] noted that a range of data on care homes is being gathered in Scotland.

SPI-M not currently modelling crowd behaviour, [Redacted] noted that this would be useful.

[Redacted] – the total number of tests required is going to be enormous if all different avenues are pursued and beyond what had been originally planned for in the UK. Contact tracing and diagnosing a case in hospital is very different and this should be made clear.

[Redacted] – if approved by Ministers, essential workers will soon be able to book tests online, so the question of who to test may move out of direct policy control to some extent.

[Redacted] – has already communicated England’s plans within Scottish Government, Ministers will have a view on this.

Action: [Redacted]i to consider the key issues around care home and hospital spread and how TTI would work in different scenarios – to speak to [Redacted] about this.

Action: Chair and Secretariat to put stratification of social distancing on Monday’s agenda.

Behavioural science considerations

[Redacted] noted that public compliance has been high and leadership is a factor in this, leading to a sense of legitimacy in the community. Practical and financial support has also been provided. If legitimacy and trust is lost then non-adherence could become a problem. For example, doing different things in different parts of the country. Listening could help to maintain legitimacy and identify ground-level issues – the paper provided to the group outlines some key considerations.

Resource would be required, although social scientists may be willing to work on it in the same way that the Royal Society’s RAMP initiative coordinated modellers.

[Redacted] – is any segmentation likely to cause unrest, eg. segmenting different school years? [Redacted] – this is dependent on the perceived equity of the process and the outcome, if the process by which decisions are seen to be made is seen to be fair that will help. Equality is key here – for example, the poor are disadvantaged if financial support isn’t given to stay at home.

Action: [Redacted] will put his paper into the format of draft advice to Ministers and [Redacted] will assist in framing and formatting it.

Action: [Redacted]to discuss ScienceWise, which could provide an avenue for public engagement.

Action: Secretariat and Chair to put this first on Monday’s agenda.

AOB

Data sharing – concern that this isn’t progressing, e.g. GP data

Summary notes

The Advisory Group discussed modelling work specific to Scotland which is being carried out both within Scottish Government and by other groups. The Advisory Group agreed that it is desirable to have a number of different groups working on this in order to be able to consider the results of different approaches. The group discussed how this capacity can be developed further in Scotland, in partnership with SPI-M wherever appropriate 

The group noted the publication of the Framework for Decision Making by the Scottish Government and reiterated the importance of ongoing public engagement work. Sciencewise was cited as a potential partner in this. 

An update on the most recent SAGE meeting was given and the group discussed the implications of current SAGE work in the Scottish context.

The Advisory Group held a short discussion on how behavioural science could inform communication with the public, including options for enabling the public to share their experiences with the Scottish Government and other external organisations.