Scottish Government Covid 19 Advisory Group minutes: 30 July 2020

Attendees and apologies

Advisory Group Members

• Andrew Morris

• Harry Burns

• Tom Evans

• Angela Leitch

• Devi Sridhar

• Mark Woolhouse

• Steve Reicher

•  Carol Tannahill

• Aziz Sheikh

• Roger Halliday

• Jacqui Reilly

Invited attendees

• Mary Black

• Cat Carver

• David Goldberg

Scottish Government 

• Daniel Kleinberg
• [Redacted]
• Ian Turner

Secretariat

• [Redacted]

Items and actions

• minutes
• summary notes

Minutes

Welcome and apologies

The Chair welcomed group members and the observers attending today: Vittal Katikireddi, Ima Jackson and co-chairs for the Expert Reference Group on COVID-19 and Ethnicity, and [Redacted] and Ian Turner from Scottish Government.

David Goldberg is deputising for Jim McMenamin.

Apologies – [Redacted]

Minutes and actions

All group members were content with the minutes from the previous week.

The chair noted the request for a point person to link with an informal group led by Sir John Bell, to ensure the flow of information to the C-19 Advisory Group.

A candidate has been suggested from the University of Glasgow, group members were content with this, with Tom Evans noting his availability to support if necessary.

Action: Secretariat to upload HE/FE advice onto SLACK with aim to submit to Ministers mid-afternoon tomorrow.

Action: The Chair to reach out to Sir John Bell’s group to indicate potential candidates.

Expert Reference Group on COVID-19 and Ethnicity

Co-chairs noted their support for the letter to the CMO from this group. They outlined the main focus of their group and subgroups, which is to provide input on COVID-19 response in relation to ethnicity, particularly for data, risk and public health messaging. The group includes a subgroup on systemic issues and a subgroup on data. The group reports to the Minister for Older People and Equalities.

The systemic issues part of expert group is there to guide communities and offer guidance to other stakeholders and expert groups. It is important that lessons that arise from the pandemic are built into response to wider systemic issues.

Data subgroup – within Scotland there is scope to improve the way data on ethnicity is recorded. The group discussed data linkage and potentially for data infrastructure improvements. A possibility of integrating this into the community health index was raised. Group members noted that work in underway to link ethnicity, religion and other data from the 2021 census, allowing for more detailed analysis.

Terminology and classification issues and added value of looking at religion and migration as well as ethnicity.

Important to ensure connection between work of groups. There has been a UK-wide call to improve data though group members noted the outcome of this has primarily been changes to England data. It is crucial that devolved assemblies should be represented on UK groups looking into these issues.

Communications – data has shown there is currently a greater proportion of cases in ethnic minority groups. It is important that messaging targeting these groups is adapted and translated as appropriate. The use of translated leaflets by healthcare practitioner was noted as being effective, particularly for groups which may not have high digital literacy. Group members noted a paper from SPI-B about communication with ethnic minorities (endorsed by SAGE) and the move to form a UK Government cross-departmental group around terminology used (e.g. BAME). There are also reports in research of lower trust in government from groups, leading to lower compliance with measures such as mask wearing.

There are concerns about the public discourse around the higher proportion of cases with ethnic minority groups. The risk of a blame-game and negative repercussions on minorities is a concern. Wider issues of racism, marginalisation and health inequalities also at play.

Risk stratification tools – Public Health Scotland (PHS) currently developing a tool similar to the one used in Wales.

There is an opportunity and need to ensure we are on front foot in relation to schools reopening to ensure staff and pupils from BAME backgrounds are supported as schools reopen. Work is underway with PHS for enhanced surveillance of schools. The Scottish Government’s elimination objective will benefit all groups.

Action: The Chair to raise points from this discussion in his meeting with the CMO and report back to group.

Action: Carol Tannahill to follow up with Vittal Katikireddi regarding a linkage between groups .

Horizon scanning

In August the group will meet fortnightly. This will be on Monday 10 and 24 August from 16:00 to 18:00.

The Chair opened discussion to the future of the group. It was noted that the First Minister and Chief Medical Officer remain very appreciative for the engagement and outputs from the group.

The majority of group members expressed their satisfaction for the way the group is engaged with by the Scottish Government. Group members feels their advice is having impact and being used by policymakers and leaders.

Areas that can be improved going forward are greater communication of final Scottish Government policy by the Secretariat, additional clarity around subgroups. It was noted that the group’s remit is to provide science advice, though discussions may occasionally touch on policy points.

Group members expressed their desire for the group to move from being reactive to being more proactive in determining what advice may be necessary and what issues need to be considered, acknowledging that this must remain scientific advice and not policy design.

Ideas of future topics: vaccination and immunization, planning beyond winter, budgeting/feasibility of future interventions and likelihood of funding, rising prominence of social issues, politics of blame, community cohesion, reluctance towards vaccination/uptake of vaccination, upper respiratory tract infections as kids go back to schools. Future discussions may also need input from additional data scientists where deep-dives into behavioural issues are scheduled. There may be a need for greater monitoring progress as we move into next stages of pandemic.

The Chair recognised the huge contribution of group members since the beginning of group meetings, noting that there will be increasing demands on many group members’ time with the start of the university term.

Summary:

• group being heard and understood
• need to be more proactive going forward – with forward planning session
• improve communications (two ways) with government. Suggestion the Chief Medical Officer attends once a month
• need to be candid, complex challenges ahead and big issues in science and social issues (blame, adherence to NPI)
• need for activity in group to be built in to realistic job profile with full-time load – fatigue
• articulate benefits from CMO AG
• line of site to key decision makers shorter with CMO AG than SAGE

Action: Secretariat to ensure group members are kept aware of final policy decisions that have drawn on advice.

Subgroup updates

Education and Children’s Issues subgroup: The education group agreed their advice on early learning and childcare. They also confirmed their position on face coverings: that these are not required to be worn in schools. There are concerns about the risk from students moving between schools and colleges,, which may require further advice from the group. The risk of superspreading events within schools was also raised. There is a need for clear information about the steps taken when outbreaks occur.

Public Health Threat Assessment subgroup: – the group is preparing a paper for the Cabinet Secretary on flu vaccination programme. This will ask for vaccination to be extended to those aged 50+ with additional groups of children receiving the vaccine. Healthcare workers – not suggesting mandatory vaccination. The British Medical Association will advise all healthcare staff to get vaccinated, this would also engage the Royal College of Nursing. Potential to use similar routes as for healthcare worker. The group noted the concern of refusal of vaccination by healthcare workers which would undermine public confidence in vaccines.

Testing subgroup - Recommendations around testing and unused capacity. Testing numbers have gone up, though data on these is not very granular. Anecdotal evidence shows that uptake of healthcare testing is low. Suggestions were noted on this and included in paper shared with the main group. There is a need to have different factions in testing working more closely together. Where weak positive tests occur in Lighthouse Labs, these may need to be retested by NHS laboratories

Summary notes

• the group welcomed the co-chairs of the Expert Reference Group on COVID-19 and Ethnicity
• the group discussed available data on the health impact of COVID-19 on minority ethnic groups, and the work underway to improve this. This will allow for more detailed analysis. The co-chair also outlined the systemic issues that face minority ethnic communities and noted the importance of integrating lessons learnt from the pandemic into a response to wider systemic issues
• group members recognised the importance of translating messaging to these communities, including by adapting materials where necessary. Alongside this, the group also discussed concerns around communications and rhetoric around the increased proportion of new cases affecting minority ethnic groups at UK level
• the group discussed the operational aspects of the group, agreeing to meet on a fortnightly basis in August to enable group members to take annual leave. The chair recognised the invaluable contribution of group members since the start of the pandemic