So, it’s the start of Autumn 2023 and we were all hoping COVID-19 was well behind us. COVID-19 restrictions have been removed but COVID-19 infections persist. This blog provides an update on the COVID-19 situation in Scotland, the monitoring is still taking place and relevant policy developments.
On 5 March 2023 the World Health Organisation (WHO) declared that COVID-19 was no longer a public health emergency of international concern.
Testing and monitoring
There is much less monitoring of COVID-19 in Scotland than during the height of the pandemic. Since 30 August 2023, the Scottish Government has paused all routine testing in health, social care and prison settings. An exception exists for people in hospital who are being discharged to a care home or a hospice, who will still be tested. The Office for National Statistics had also stopped its COVID-19 Infection Survey.
The WHO has urged Member States to maintain, not dismantle, their established COVID-19 infrastructure as:
“it is crucial to sustain early warning, surveillance and reporting, variant tracking, early clinical care provision, administration of vaccine boosters to high-risk groups, improvements in ventilation, and regular communication”.
WHO
Public Health Scotland now publishes COVID-19 statistics alongside information on seasonal respiratory infection. The interactive dashboard includes information on the results from COVID-19 surveillance from wastewater alongside the number of acute COVID-19 admissions, ICU admissions and hospital inpatients with COVID-19. The most recent publication covering the period 14 August to 27 August reported:
- There were on average 328 patients in hospital with COVID-19.
- COVID-19 levels in wastewater have increased sharply in recent weeks.
- All-cause excess mortality remained within seasonal expectations.
The charts below show the recent increase in hospital admissions since the start of July. However, the numbers are still small compared with the height of the pandemic.
The level of COVID-19 detected in wastewater has also been increasing in recent weeks, as shown in the chart below.
The number of COVID-19 deaths is reported by the National Records of Scotland in its weekly deaths report. In the week beginning 21 August 2023, 24 deaths mentioned COVID-19.
SARS-CoV-2 variants
The WHO reports on SARS-CoV-2 (the virus which causes COVID-19) variants. There are currently three variants of interest and seven variants under monitoring. There is an increasing trend seen in the variant EG.5 (also called Eris) and the WHO has conducted an initial risk evaluation of this variant. It has also been attributed to increases in hospital admissions.
Another variant, BA.2.86, is on the WHO’s variants under monitoring (VUMs) list. This is due to the large numbers of mutations in this variant. The WHO says that the impact of the BA.2.86 mutations are presently unknown and is under assessment. This variant has been detected in two samples in Scotland through PCR testing and in another Health Board area through wastewater sampling (as at 4 September). The UK Health Security Agency and representatives from the four nations have published a risk assessment of this new variant.
The WHO continues to call for enhanced surveillance, sequencing, and reporting of SARS-CoV-2 variants as the virus continues to circulate and evolve.
Vaccination
The Joint Committee on Vaccination and Immunisation (JCVI) has advised that for the autumn booster programme the following groups should be offered a COVID-19 vaccine:
- residents in a care home for older adults
- people aged 65 years and over
- people aged 6 months to 64 years in a clinical risk group
- frontline health and social care worker
- people aged 12 to 64 years who are household contacts of people with immunosuppression
- people aged 16 to 64 years who are carers and staff working in care homes for older adults.
Public Health Scotland and the Scottish Government published further information on the winter vaccination programme. The programme in Scotland began on Monday 4 September. Following the identification of the newly identified COVID-19 variant of interest, BA.2.86, PHS and the Scottish Government are working with Health Boards on how to bring winter vaccinations forward for those at highest risk of becoming seriously ill from flu and COVID-19. Further information is published in a letter from the Chief Medical Officer for Scotland Winter Programme 2023 – Seasonal Flu and COVID-29 Vaccination.
Scottish Parliament’s COVID-19 Recovery Committee
The COVID-19 Recovery Committee was established on 15 June 2021. Its remit was to consider and report on matters relating to COVID-19 falling within the responsibility of the then Cabinet Secretary for COVID Recovery and other Scottish Ministers where relevant.
On 28 March 2023, Humza Yousaf MSP was appointed as First Minister and formed a new government. The COVID Recovery portfolio was not included in the First Minister’s appointments to the cabinet.
Following consideration by the Parliamentary Bureau and a motion to wind-up the Committee, the Committee’s final meeting was held on 29 June 2023. The Committee published a legacy report which included a list of remaining priority issues for COVID recovery, specifically:
- long COVID
- NHS dental services
- NHS cancer services
- public transport.
Scottish Government guidance and policy
Current guidance on COVID-19 is available on the Scottish Government’s website and NHS inform publishes information on symptoms and treatments for COVID-19 as well as on long COVID and vaccination.
The Scottish Government has established a Coronavirus (COVID-19): Learning and Evaluation Oversight Group. The work of the Covid Recovery Strategy Programme Board which was set up to oversee the delivery of the Covid Recovery Strategy – for a fairer future is coming to an end.
Future developments
The Scottish Government has established a Standing Committee on Pandemic Preparedness. This is intended to be a permanent advisory group of scientists and technical experts to advise the Scottish Government on the future risks from pandemics. The COVID-19 Recovery Committee took evidence on the work of the Standing Committee on Pandemic Preparedness in May 2023. At this meeting the Chair said:
“The request was that the final report be published within 18 months of the interim report, which would be February 2024, but we actually hope to publish the report in the fourth quarter”.
Professor Andrew Morris
The work of the UK Covid-19 Inquiry is ongoing and the Scottish Covid-19 Inquiry held its first preliminary hearing on 28 August 2023.
Lizzy Burgess (Senior Researcher Health and Social Care, SPICe)