Scottish Government COVID-19 Advisory Group minutes: 4 May 2020

Advisory Group Members

• Andrew Morris
• Aziz Sheikh
• Chris Robertson
• David Crossman
• Jill Pell
• Mark Woolhouse
• Stephen Reicher
• Sheila Rowan
• Tom Evans
• Jim McMenamin
• Jacqui Reilly
• Devi Sridhar

Scottish Government

• Roger Halliday
• Niamh O’Connor
• Richard Foggo
• Donna Bell

Secretariat

• [Redacted]

Attendees and apologies

 

 

Items and actions

• minutes
• summary notes

Minutes

Welcome and apologies

Chair welcomed all attendees. Apologies – [Redacted].

Minutes, action points, Chair update

Chair thanked the group for the deep dive on the reproduction number held for the First Minister, and for their work over the weekend. Thanks to secretariat for security advice.

Discussion of paper shared with the group on nosocomial transmission in Lothian. CoCIN data update, this will be shared on a hospital-by-hospital basis. Large variability in hospital transmission and IPCC practices, this should be highlighted for learning and not judgement.

Work is ongoing on open data sharing, group agreed this is a priority.

CSA update

Update on additional SAGE meetings last week, including working group on opening schools. Still a lack of clarity from data about infection rates in children and how infective children are.

Outdoor transmission

New guidance is likely to relax all outdoor activity, not just exercise – SPI-B were more content with this guidance. Discussion of paper shared with the group on implications for transmission and behavioural science, including the health benefits of time spent outside. Should children’s playgrounds be included, or do slides etc pose an infection risk?

Clear messaging is very important to avoid confusion and associated problems. ‘Go out, stay apart’. Need to reinforce messaging on hand hygiene and cough / sneeze etiquette to remind people of this, if this goes ahead. Could hand gel be made available in public spaces such as playgrounds? Caution required about gloves.

Outdoor sports – probably shouldn’t be allowed for now, but for consideration. Issue of driving for exercise, guidance needs to be clear and make sense. Consistency of logic vs equity – e.g. tennis and golf are more elite sports but could comply with distance requirements. Time / distance interaction, what happened to the 15 mins rule?

Action: [Redacted] to reflect discussion points in final draft of paper. Paper to be submitted to CMO and Ministers

Testing

PHS is working on contact tracing and welcomes input from the group. Testing results and isolation of contacts of positive cases needs to happen within 48 hours. Denmark, with similar population size to Scotland, is doing 6,000 tests per day including some asymptomatic contacts in some environments. Capacity building towards ability to test asymptomatic contacts after a number of days. Ireland, with a slightly smaller population is aiming for just over 14,000 tests per day.

Contacts of positive cases will be isolated, but should they be tested too? For example, to get people out of isolation before 14 days.

Important for decision makers to understand that testing to suppress transmission could be in competition with other testing goals, e.g. testing to allow key workers back to work. Purpose of TTIS must be clear.

Assumption that people will isolate could be problematic – will people really isolate if they are a contact, will this be left to them, or will this be enforced?

Test turnaround time is going to be very important. Systems engineering is key here – it is not just a case of the assay time, but of how this is processed and communicated. Logistics is key.

Will household members be offered a place to stay away from vulnerable household members? Spare hotel capacity could be used.

Definition of contacts must be completely clear – is this still two metres for 15 mins?

Action: Group to consider how advice on TTI can feed into policy and decision makin

Summary notes

1. The Advisory Group discussed the evidence from SAGE regarding outdoor transmission and agreed that, as the risk seems to be significantly lower than indoors, and the evidence is clear for the benefits of spending time outside, considering existing guidance on exercising outdoors as part of the overall consideration of any change to existing restrictions is advisable.

2. The group agreed that clear messaging would be very important to avoid confusion in the case of any change. In particular, the message must be clear that people must still maintain distance and that hand hygiene and cough / sneeze etiquette would be more important than ever.

3. Public Health Scotland is working on contact tracing and testing, and requested input from the group on these topics. The group considered the plans of other nations with a similar population size to Scotland and noted the importance of a few key issues in the development of a strategy for Scotland:

• Clear definition of a contact
• Test turnaround time, which was noted to be a largely logistical issue
• If and at what point testing will be offered to contacts of positive cases
• Ability for positive cases to self-isolate away from vulnerable household members