Scottish Government COVID-19 Advisory Group minutes: 7 May 2020

Attendees and apologies

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

• Angela Leitch

Invited attendees

• Mary Black

Scottish Government

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

Secretariat

• [Redacted]

Items and actions

• minutes
• summary notes

Minutes

Welcome and apologies

Chair welcomed all attendees. Apologies were [Redacted].

Minutes, action points, Chair update

Chair confirmed all actions from last meeting were complete.

CSA Update

There has been lots of interest into evidence associated with schools. This will be discussed later today.

Discussion of latest figures

All indicators are coming down, agreement that deaths will come down last and are the most conservative indicator.

SAGE Update

Topics discussed:

• nosocomial transmission – spread may be being driven by healthcare workers
• modelling phased changes to restrictions
• demands on scientific advice from policy commissions – SAGE is receiving a significant volume of requests. It is important that questions are well formed and appropriate time is given
• track and trace app – further development may take place to address privacy concerns
• 99% have a serological immune response following infection
• social bubble idea still needs more work. SPI-M suggests this is not likely to work well. Note New Zealand using a social-responsibility based bubble. [Redacted] will report back to the group with data on how this has worked next week

Agreed that the group should be able to generate ideas as appropriate rather than just respond to requests.

Noted ongoing significant media interest and high likelihood of future public enquiry.

Action: Chair to speak to secretariat about making sure group’s formal advice is made clear in the record, clearly differentiated from discussion on Slack etc.

Review of restrictions

Thanks to group from Scottish Government on their input to recently published documents.

Hospital and care home transmission

Update on first Nosocomial Review Group which took place today. Priority for further scientific work: impact of asymptomatic cases on transmission. Some testing of asymptomatic HCWs will take place. Work done by PHE in England may be worth carrying out in Scotland too.

Discussion: could an app identify symptoms in HCWs and potential spread back to the community? The DHI app does code for occupation.

Testing for HCWs or anyone who believes they are positive and are already self isolating should have no impact on R. Testing asymptomatic workers may.

Note that people being cared for at home and their carers are not always being considered in this group.

Action: [Redacted] to share Nosocomial Group papers with group.

Education

Noted some questions on Slack about physical distancing requirements.

• there have now been case reports of transmission between children at school in France and other places
• there is likely to be a non-trivial impact on R, SPI-M may have underestimated effect
• noted that models cannot answer detailed questions intended to fine tune policy
• evidence still suggests children play a minimal role in transmission and are at low risk
• potentially COVID19-related syndrome in children, this is still being looked into
• is there a potential for outdoor teaching?
• potential for children to positively influence behaviour if appropriate teaching on hygiene and social distancing is given

Action: [Redacted] to supply bullet points to [Redacted] on this, [Redacted] will pull together a response.

Test Trace Isolate Support (TTIS)

Views sought on key assumptions in HPS proposal, which were shared with the group. Raised in discussion:

• asymptomatic carriage, antibody testing, and use of sequencing was raised
• how best to present to FM tomorrow – clear justification of scientific rationale for key decisions in TTIS development

Action: group to contribute to slide deck on Slack tonight, ready for tomorrow’s meeting with FM. 

Summary notes

The Advisory Group was updated on the first Nosocomial Review Group meeting that took place earlier in the day. Advisory Group members discussed asymptomatic healthcare workers and the risk of transmission to the wider community. 

The group discussed data on the impact of children returning to schools and drew on existing evidence from other European countries where schools have reopened. The discussion included modelling work being undertaken to identify the impact of reopening schools on R, acknowledging that models may include other factors such as parents returning to work.

The Scottish Government’s Test, Trace, Isolate, Support plan was discussed, with group members noting areas likely to impact on this are asymptomatic carriage, viral sequencing and antibody testing.