Scottish Government COVID-19 Advisory Group minutes: 6 April 2020

Attendees and apologies

Advisory group members

• Andrew Morris

• David Crossman

• Sheila Rowan

• Chris Robertson

• Mark Woolhouse

• Angela Leitch

•  Jim McMenamin

• Tom Evans

• Steven Reicher

• Aziz Sheikh

• Devi Sridhar

• Jill Pell

Invited attendees

• Mary Black

Scottish Government

• Roger Halliday
• Niamh O’Connor
• Daniel Kleinberg

Secretariat

• [Redacted]

Items and actions

• minutes
• summary note

Minutes

Welcome and apologies

Chair welcomed all including [Redacted] deputising for CMO.

Apologies – [Redacted] deputising

Minutes and action points

Chair summarised actions from last meeting.

[Redacted] reminded all that she takes part in four nations Chief Scientific Advisor calls – chair invited [Redacted] to give her priorities in a brief slot each meeting.

[Redacted] has been requested by SAGE to produce an evidence synthesis on facemask use in the general population.

[Redacted] raised a question about the note sent round on PPE, outlining that healthcare workers are reporting good coverage when dealing with confirmed patients but correct protection not always available for other patients.

[Redacted] raised that NERVTAG is looking at this, cautioned against duplication of work. HPS colleagues in infection and prevention control have also been working on this. [Redacted] also reminded the group that the guidance has been endorsed by four nations and Royal Colleges, cautioning against duplicating this.

[Redacted] noted that there is an industrial relations aspect to PPE use – e.g. police are buying but perhaps under pressure from unions and staff.

Action: [Redacted] to circulate the meta-analysis on PPE mentioned

Action: [Redacted] to check current status of PPE evidence work with NERVTAG and circulate to group

SAGE update

Chair invited the group to consider the SAGE priorities shared as in the paper. [Redacted] queried whether it would it be worth asking SAGE to publish more for public information.

[Redacted] noted that there’s some overlap in the priorities, eg evidence gathering on nosocomial infection will require a testing strategy. [Redacted] noted that there are many mentions of testing but not of tracing. The latter could be used as an exit strategy to isolate contacts of known virus carriers as overall numbers come down. [Redacted] commented that an exit strategy is a short-term concept, how will we deal with this over a longer term.

[Redacted] mentioned that the evidence base is lacking on long-term immunity. [Redacted] noted this is in her paper. [Redacted] commented that a ‘deep dive’ into longer term strategy is currently ongoing and CMO is involved in this.

The Chair summarised that the group would feed back to SAGE regarding testing and tracing. Other questions that were raised were regarding long-term thinking if this becomes a recurrent challenge, how to harness sequencing of drug-resistant mutations, and how the group can feed into government policy in Scotland.

[Redacted] noted some topics are broad and currently outside remit of group, for instance broader socio-economic considerations.

Action: Chair to feed back to SAGE that the SG CMO Advisory Group considers the following to be key issues:

• role of robust contact tracing processes at different stages of the epidemic
• overall impact beyond direct biomedical COVID-19 impact including non-COVID related health issues and wider socioeconomic dimensions
• use of sequencing to understand drug mutations transmission, particular nosocomial
• long term thinking on how we live with the virus
• understanding long term immunity

Action: [Redacted] to bring a summary to the next meeting of analytical work ongoing on broader consequences of COVID-19

Scottish modelling

[Redacted] summarised latest modelling work and areas of current development, including local area issues. He noted that data shows a not-insubstantial proportion of people working are still travelling into work

Chair noted that SAGE is now able to use Scottish data, thanks to [Redacted]. [Redacted] noted that there are large differences between the models on deaths projected.

Questions were raised by [Redacted] about what is factored into modelling. [Redacted] informed the group that length of treatment is factored into modelling. [Redacted] noted that modelling based on sub Scotland level locality is being considered but may not add significant value, based on data currently available.

There have been significant volunteers for a Scottish-specific modelling base. [Redacted] expressed that we will want to draw on these volunteers. [Redacted] noted that the need to carefully manage these given the remit of the SG COVID-19 Advisory Group to build on scientific and modelling evidence produced by SAGE. All agreed value in strengthening existing Scottish modelling work as observed data increases as pandemic progresses. 

[Redacted] asked whether Boards can obtain modelling data for planning. [Redacted] confirmed that this is the case and that the Scottish Government would arrange a briefing with key local partners to help them to understand the model.

The Chair summed up that the group supports sharing data with local areas, in a user-focussed way. To enable this, it is important to understand what they need. 

Actions:

• ensuring data flow to SPI-M is essential
• explore relationship with RAMP (Royal Society) as a co-ordinated forum to enable modellers to engage

Testing

[Redacted] had to leave, before this he noted the Scottish Government would soon appoint a lead Director for Testing.

[Redacted] discussed the testing paper she shared with the group and noted that the paper focussed on PCR testing which tells whether the virus is currently present. [Redacted] priority was to fill in missing information needed from the Scottish Government. Mary invited questions on the paper and said timescale will determine how quickly she will take it forwards.

Enhanced community surveillance will start this week and sentinel samples for particular age groups will be submitted. This will cover both individuals who are unwell enough to be seen at assessment centres, and also individuals who have contacted phone triage and can self-sample at home.

[Redacted] asked whether we wanted to go further than surveillance and do case finding.

The Chair asked whether Thursday would be morning be possible to get another draft of the paper. [Redacted] invited comments by the end of the day on Tuesday so the team can work on another draft on Wednesday.

Action: group to get any comments or questions to [Redacted] by end of Tuesday 7 April, [Redacted] to revise paper by Thursday morning.

Data taskforce

[Redacted]are working on a statement from the Scottish Government to ask data owners to share data urgently. Both emphasised that speed is important though we must act legally.

[Redacted] asked who within the Scottish Government will make a statement on blocks to data release. [Redacted] noted that the government is working on this, there being a need to balance seniority and speed.

The Chair noted the need for work on data to be joined up in order to be useful. The group strongly recommends a strategic approach to Scotland’s data infrastructure.

[Redacted] agreed with this, noting this is the idea underpinning the data taskforce.

Action: [Redacted] to progress advice on senior communication to data owners from SG recommending a joined up approach to data and the importance of “data as infrastructure” in Scotland and encouraging prompt data sharing to support pandemic response.

Exit strategy – enhanced shielding and decentralised policy

The group noted this point and confirmed it will be discussed in full on Thursday.

[Redacted] circulated a short paper on the exit strategy in advance of the meeting, this has been seen by senior officials in the U.K government. Enhanced shielding is under active consideration as an element of exit from current restrictions. [Redacted] will go into more detail on Thursday. [Redacted] noted that fully developing options around an exit strategy from current restrictions is key, as waiting for a vaccine is not a viable option.

Next meeting

16:00 – 17:30 on Thursday 9th April.

Summary note

The Chair welcomed input from members on their ongoing research. Members Topics discussed included testing and ongoing development of pandemic modelling at the Scotland level, based on modelling from SAGE and increasingly including observed data as the pandemic progresses in Scotland. 

The Advisory Group reiterated the importance of ensuring the smooth flow of data between Scotland and the UK. Group members were able to question modellers on the inputs that feed into their models. The group welcomed the expressions of interest from modellers in Scotland and discussed how these could best be leveraged. 

The group discussed current UK advisory group priorities including testing strategies and how they relate to overall pandemic response; options for exit from current restrictions; and managing nosocomioal infection.  The group added that consideration of the potential role of contact tracing and case isolation at an appropriate stage of the pandemic is also important.  

The group discussed the data taskforce and the manner in which it can be supported to be ensure it can provide the government with the most accurate information to feed into its policy development. The group agreed on the importance of taking a strategic approach to Scotland’s data infrastructure in the short, medium, and long term.